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Payer UpdatesFebruary 1-11, 2015, Experian’s Payer Team has added the following new payers and made improvements to existing payers. New Eligibility PayersAetna Better Health (NJ)Care Improvement PlusCenpatico (IL)Culinary Health Fund UNITE HERE HealthHealth Partners of PhiladelphiaHealthSmart Benefit Solutions-West VirginiaMagnaCareOklahoma Employees Group Insurance DivisionAmeriHealth District of Columbia*Employment Benefit Plan Administrators (EBPA)*New Claims Status PayersAetna Better Health (NJ)C and O Employees’ Hospital AssociationCare Improvement PlusMagnaCareOklahoma Employees Group Insurance DivisionSelect Administrative ServicesTRICARE for LifeTRICARE OverseasPayer ImprovementsNone*Web capture – special enrollment requiredIf your clients would like to access any of the available payers, please have them contact their Client Administrators who can configure the payer access, Provider ID, and NPI information. If you have any questions about the payer list, please contact Customer Support at customer.support@.Payers Health Exchange Identification and Information For the 2015 benefits year , the below payers are reporting generic Health Insurance Exchange (HIX) information indicating that a member is enrolled through the exchange in their 271 eligibility response. The message and type of information may vary by payer; however we will always flag these payers as “This is a Health Insurance Exchange Member”. AetnaAmbetter of ArkansasAmeriHealthAnthem Midwest (IN, KY, OH)Anthem Northeast (CT, ME, NH)Anthem Southeast (VA)Anthem West (CO, NV)Avera Health PlansBlue Cross Blue Shield of AlabamaBlue Cross Blue Shield of ArizonaBlue Cross Blue Shield of ArkansasBlue Cross Blue Shield of FloridaBlue Cross Blue Shield of GeorgiaBlue Cross Blue Shield of IllinoisBlue Cross Blue Shield of KansasBlue Cross Blue Shield of LouisianaBlue Cross Blue Shield of MichiganBlue Cross Blue Shield of MissouriBlue Cross Blue Shield of MontanaBlue Cross Blue Shield of North CarolinaBlue Cross Blue Shield of OklahomaBlue Cross Blue Shield of Tennessee BlueCareBlue Cross Blue Shield of Tennessee CommercialBlue Cross Blue Shield of Tennessee TennCare SelectBlue Cross Blue Shield of TexasBlue Cross Blue Shield of WisconsinBlue Cross of CaliforniaBlue Cross of Northeast PennsylvaniaBlue Shield of CaliforniaCapital BlueCrossCareSource HealthCHC of Kansas CityCHC Southern Health ServicesCIGNAConnectiCareCoventry Advantra SavingsCoventry Health and Life-TNCoventry Health Care FederalCoventryCares of KentuckyEmblem HealthEmpire Blue Cross Blue ShieldExcellus BCBSHealth Net NationalHighmark BCBSHorizon Blue Cross Blue Shield of New JerseyIndependence Blue Cross FOCKeystone FirstKeystone Health Plan EastMagellanMDWise St. CatherineMolinaMolina (CA)Molina (FL)Molina (MI)Molina (OH)Molina (TX)Molina (UT)Molina (WA)Molina (WI)Molina Healthcare of New MexicoMountain State Blue Cross Blue ShieldMVP Health CarePacific Source Health PlanPersonalCare/Coventry Health of IllinoisPreferredOnePremera Blue CrossQualCareQualChoice ArkansasScott and White Health PlanSummaCare Health PlanSummaCare Health Plan MedicareUniveraUPMC Health PlanWestern Health AdvantageWINhealth PartnersFor the 2015 benefit year, the below payers, in addition to generic indication of enrollment through the exchange, are also reporting grace period begin/end date and/or premium end date information in their 271 eligibility response. We will add this functionality to additional responses as more payers make this information available. Because all payers do not provide the same level of data in their responses, the data provided will vary.Payers That Report Grace BeginPayers That Report Grace EndPayers That Report Premium EndAmeriHealthAmeriHealthAmeriHealthAnthem Midwest (IN, KY, OH)Anthem Midwest (IN, KY, OH)Anthem Midwest (IN, KY, OH)Anthem Northeast (CT, ME, NH)Anthem Northeast (CT, ME, NH)Anthem Northeast (CT, ME, NH)Anthem Southeast (VA)Anthem Southeast (VA)Anthem Southeast (VA)Anthem West (CO, NV)Anthem West (CO, NV)Anthem West (CO, NV)Avera Health PlansBlue Cross Blue Shield of AlabamaBlue Cross Blue Shield of AlabamaBlue Cross Blue Shield of AlabamaBlue Cross Blue Shield of ArizonaBlue Cross Blue Shield of ArizonaBlue Cross Blue Shield of ArizonaBlue Cross Blue Shield of GeorgiaBlue Cross Blue Shield of FloridaBlue Cross Blue Shield of GeorgiaBlue Cross Blue Shield of IllinoisBlue Cross Blue Shield of GeorgiaBlue Cross Blue Shield of IllinoisBlue Cross Blue Shield of LouisianaBlue Cross Blue Shield of IllinoisBlue Cross Blue Shield of LouisianaBlue Cross Blue Shield of MissouriBlue Cross Blue Shield of KansasBlue Cross Blue Shield of MissouriBlue Cross Blue Shield of MontanaBlue Cross Blue Shield of LouisianaBlue Cross Blue Shield of MontanaBlue Cross Blue Shield of North CarolinaBlue Cross Blue Shield of MichiganBlue Cross Blue Shield of North CarolinaBlue Cross Blue Shield of OklahomaBlue Cross Blue Shield of MissouriBlue Cross Blue Shield of OklahomaBlue Cross Blue Shield of TexasBlue Cross Blue Shield of MontanaBlue Cross Blue Shield of TexasBlue Cross of CaliforniaBlue Cross Blue Shield of North CarolinaBlue Cross Blue Shield of WisconsinBlue Cross of Northeast PennsylvaniaBlue Cross Blue Shield of OklahomaBlue Cross of CaliforniaBlue Shield of CaliforniaBlue Cross Blue Shield of TexasBlue Cross of Northeast PennsylvaniaCapital BlueCrossBlue Cross of CaliforniaBlue Shield of CaliforniaEmpire Blue Cross Blue ShieldBlue Cross of Northeast PennsylvaniaCapital BlueCrossExcellus BCBSBlue Shield of CaliforniaCareSource HealthHighmark BCBSCapital BlueCrossEmpire Blue Cross Blue ShieldHorizon Blue Cross Blue Shield of New JerseyEmpire Blue Cross Blue ShieldExcellus BCBSIndependence Blue Cross FOCExcellus BCBSHighmark BCBSKeystone FirstHighmark BCBSHorizon Blue Cross Blue Shield of New JerseyKeystone Health Plan EastHorizon Blue Cross Blue Shield of New JerseyIndependence Blue Cross FOCMountain State Blue Cross Blue ShieldIndependence Blue Cross FOCKeystone FirstSummaCare Health PlanKeystone FirstKeystone Health Plan EastSummaCare Health Plan MedicareKeystone Health Plan EastMountain State Blue Cross Blue ShieldSummaCare Health PlanSummaCare Health PlanSummaCare Health Plan MedicareSummaCare Health Plan MedicareUniveraHIX information can be found in three locations within Experian Health/Passport eligibility:eCare NEXT and OneSource clients:MyResponse:This information will be displayed in the widget labeled “Health Insurance Exchange.”This widget will combine an indicator “This is a Health Insurance Exchange Member,” any grace period and/or premium paid to dates that were provided, along with any free-form text message segments received from the payer response pertaining to the member’s HIX information.Full response:This information will be displayed in a “Benefit Description” section of the response and the description label will be HIX/ACA.The “Benefit Description” section will combine an indicator “This is a Health Insurance Exchange Member,” any grace period and/or premium paid to dates that were provided, along with any free-form text message segments received from the payer response pertaining to the member’s HIX information.EDI clients:EDI:This information will be displayed in the 271 returned to the client as an EB*D****HIX/ACA~ segment.Any segments following the EB*D in the related loop(s) will pertain to the member’s HIX data.? This will always include a message segment MSG*This is a Health Insurance Exchange Member.~ and can also include DTP and additional MSG segments if the payer returned that information in the eligibility response.Please note that your responses must be configured to see this information on MyResponse. Contact your facility administrator or customer support to have this added. ................
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