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Member ID Prefix to Include Numbers

As announced recently on the Provider Resource Center (PRC), the Blue Cross and Blue Shield Association (BCBSA) was to begin issuing prefixes containing alpha-numeric characters as early as April 2018 and moving forward.

This change is a result of diminishing options for solely alphabetical character combinations. The alpha prefixes, now called “Prefixes” due to inclusion of numeric characters, are used to appropriately route claims across the BlueCard® network to the correct home plan and are primarily visible on member ID cards.

Although April 2018 was the effective timeframe for new BCBSA prefixes, you may not begin seeing the alpha-numeric prefixes until later in 2018 or even 2019.

Transition Details:

  • No existing member prefixes will change.
  • The change will occur only when health plans, like Highmark, request new prefixes. These prefixes will then be assigned to new client accounts throughout the year or during open enrollment.

As noted in the PRC announcement, Highmark wants to ensure you and your trading partners are prepared to submit and accept this new prefix on electronic transactions and that documentation and communications reflect “Prefix” instead of “Alpha-Prefix.” (Note: This includes the 837I and 837P Health Care Claim and the 835 Electronic Remittance Advice transactions.)

Please talk to your clearinghouse, vendor, or billing service immediately so that you don’t experience electronic payment or transaction delays.

It’s important to note:

  • “0” and “1” will not be used in the prefixes
  • “2” through “9” will be used in the prefixes
  • A prefix will never include all numeric values (For example, “111”).
  • R22 – R99 will not be used, as that number sequence overlaps with the Federal Employee Program

 

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