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Blue Plus PMAP Payer ID Change on 1.1.2019

Overview  

As of January 1, 2019, Blue Plus PMAP will change their payment processor to Amerigroup and will have a new Payer ID (00562) . You will need to submit all claims for dates of service (DOS) on or after 1/1/2019 to this new Payer ID. Complete the steps outlined in this article before January 1, 2019 to ensure that you do not experience interruptions in billing claims for clients who are currently on Blue Plus PMAP.

 

Add Blue Plus PMAP 01/01/2019 to the Payers Module

If you have clients that are on Blue Plus PMAP, you'll want to add the new payer Blue Plus PMAP 01/01/2019 to your Payers Module, so you can be prepared for the switchover. You'll want to complete the steps outlined below before January 1, 2019.

Step 1: Add the new payer Blue Plus PMAP 01/01/2019 (ID: SB720) to the Payers Module.  

  • The payer ID will be the same as the existing Blue Plus PMAP payer ID.  
  • We will automatically update the payer ID for Blue Plus PMAP 01/01/2019 to (ID: 00562) on 1/1/2019.

Step 2: Copy over current codes and rates and other pertinent settings (eg. Payer Rules tab) to Blue Plus PMAP 01/01/2019.

Step 3: Rename existing Blue Plus PMAP payer to Blue Plus PMAP 12/31/2018 and before.

Add Blue Plus PMAP 01/01/2019 to the Necessary Clients

Blue Plus PMAP will issue new ID cards to all their clients. This will be an easy way for you to update your client’s payers. When your client presents their ID card after 1/1/2019, update their Clients Module > Payers tab accordingly:

  • Keep the existing Blue Plus PMAP payer.
  • Add the new payer Blue Plus PMAP 01/01/2019.

Your clients will need both of these payers in their record during the transition as you will submit claims to one or the other based on Date of Service.

Step 1: Go to the Client Profile > Payers tab.

Step 2: Locate the existing Blue Plus PMAP payer > Eligibility Dates tab.

Step 3: Enter a To Date of 12/31/2018.

Step 4: Add the new Blue Plus PMAP 01/01/2019 payer to the client.

Step 5: Go to Eligibility Dates tab in the new payer and enter a From Date of 1/1/2019.

Step 6: Click Save.

According to these eligibility rules that you set up, any claim on or before 12/31/2018 will use the older Blue Plus PMAP payer ID.  Any claim on or after 1/1/2019 will use the new Blue Plus PMAP payer ID.

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