Medicare Advantage
Outreach and Education Bulletin
Empire BlueCross
Medicare Advantage Member Identification Prefixes
Updated for 2015
Empire BlueCross moved Individual (non-group) Medicare Advantage members to a single claims
processing system Jan. 1, 2015. Member identification prefixes were updated as part of that transition. The
2015 member identification prefixes for individual Medicare Advantage plans are listed below.
Please file 2014 charges with the 2014 prefix and 2015 charges with the 2015 prefix to ensure claims are
delivered to the appropriate claims system for processing.
2015 Individual Medicare Advantage plans
Prefix
State/Area
Plan Type
Plan Name
VOF
VOG
NY
NY
MA HMO
MA PPO
MediBlue HMO
MediBlue PPO Plus
Provider and
member service
1-800-499-9554
1-866-395-5175
CMS
contract
H3370
H3342
Sample ID cards for 2015 are available at the Medicare Advantage public provider portal:
www.empireblue.com/medicareprovider
Group-sponsored Medicare Advantage plan members are not affected by these changes. Members
with the following member identification prefixes on their member card will represent group sponsored
business only and will remain on the current claims processing platform:
JQF JWM VZM VZP WGK WSP
XDK XDT XGH XGK XKJ XVJ XVL YCG
YGJ YGS YLR YLV YRA YRE YRU
Y0071_15_23389_I_01/29/2015
Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield
Association, an association of independent Blue Cross and Blue Shield plans. The Blue Cross and Blue Shield names and symbols are registered
marks of the Blue Cross and Blue Shield Association.
Medicare Advantage
Outreach and Education Bulletin
Empire BlueCross BlueShield
Medicare Advantage Member Identification Prefixes
Updated for 2015
Empire BlueCross moved Individual (non-group) Medicare Advantage members to a single claims
processing system Jan. 1, 2015. Member identification prefixes were updated as part of that transition. The
2015 member identification prefixes for individual Medicare Advantage plans are listed below.
Please file 2014 charges with the 2014 prefix and 2015 charges with the 2015 prefix to ensure claims are
delivered to the appropriate claims system for processing.
2015 Individual Medicare Advantage plans
Prefix
State/Area
Plan Type
Plan Name
VOF
VOG
NY
NY
MA HMO
MA PPO
MediBlue HMO
MediBlue PPO Plus
Provider and
member service
1-800-499-9554
1-866-395-5175
CMS
contract
H3370
H3342
Sample ID cards for 2015 are available at the Medicare Advantage public provider portal:
www.empireblue.com/medicareprovider
Group-sponsored Medicare Advantage plan members are not affected by these changes. Members
with the following member identification prefixes on their member card will represent group sponsored
business only and will remain on the current claims processing platform:
JQF JWM VZM VZP WGK WSP
XDK XDT XGH XGK XKJ XVJ XVL YCG
YGJ YGS YLR YLV YRA YRE YRU
Y0071_15_23389_I_01/29/2015
Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the
Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The Blue
Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.