Here are some upcoming changes to 2020 ConnectiCare plans and operations that will affect you and your patients:
- It will be important for your office to check member ID cards for patients with employer-sponsored plans. ConnectiCare members with employer-sponsored plans will get new member ID cards with new ID numbers, starting with group plans that enroll or renew on Aug. 1, 2020.
- We are continuing to make changes to how we pay claims to our providers as we align our processes with our parent company, EmblemHealth. We started in January with our Medicare Advantage claims for 2020 dates of service. We are continuing with our commercial claims, starting with new and renewing employer-sponsored plans on Aug. 1, 2020.
New member ID numbers and ID cards for employer-sponsored plans
Starting Aug. 1, 2020 through 2021, ConnectiCare commercial members with employer-sponsored plans will get new member ID numbers that begin with the letter “K.” These members will get new ID cards that will also include new group ID numbers.
Make sure to check ID cards for ID numbers for all your commercial patients and only use the new ID numbers for dates of services on and after Aug. 1, 2020.
There are no changes to the claims submission process. But to avoid delays in claims payments, please make sure to use the right member ID number for your claim submissions.
Updates to 2020 provider payments
We will continue to make changes to how we pay providers as follows:
- Frequency of provider payments to increase: We will move from once-a-week check runs to a daily schedule for our commercial members with new “K” ID numbers starting Aug. 1, 2020. We have been paying claims daily for our Medicare Advantage members since Jan. 1, 2020.
- Changes to EFT registration and access to ERAs: We will use PNC Bank and the ECHO Health payment platform to pay Medicare Advantage claims starting July 15, 2020 and commercial claims2 starting Aug. 1, 2020. This means providers will need to go to the ECHO website:
- https://view.echohealthinc.com/EFTERADirect/EmblemHealth/ — to sign up for electronic funds transfer (EFT) for EmblemHealth and ConnectiCare payments, or
- providerpayments.com — to view electronic remittance advice (ERA) statements
Please note, if you have already enrolled for EFT/ERA through PNC Bank’s Remittance Advantage (PNC-RA) you don’t have to do anything to continue receiving EFT/ERA after July 15. PNC Bank will move your bank account information and EFT payment preferences into the ECHO website, providerpayments.com.
If you don’t currently have log-in credentials for the ECHO website, you will be able to sign up for access through that website after July 15 for Medicare Advantage claims and Aug. 1 for commercial claims.
- Virtual card payments after July 15 for Medicare claims, Aug. 1, 2020 for commercial claims:2 If you are not enrolled for EFT through the PNC-RA website or the ECHO website, your office will receive virtual credit card payments for your claims. You will get payment notifications via fax or mail, each containing your explanation of payment (EOP) along with a virtual credit card number unique to that ConnectiCare claims payment. Normal transaction fees apply, based on your merchant acquirer relationship.
If you want to continue receiving virtual card payments, you don’t have to do anything. If you want to get EFT payments instead, go to the ECHO website after receiving a virtual card payment and enroll for EFT.
You can avoid possible transaction fees by contacting ECHO to decline the initial virtual card payment, ask for a paper check for the full amount of the claims payment, and, if you like, opt into EFT through ECHO.
We will keep our providers updated throughout the year regarding these changes and other important information you need to know.
2This only applies to commercial claims submitted after Aug. 1, 2020 for commercial members with the new ID numbers that start with the letter “K.” You will still get EFT payments through Bank of America for claims submitted for commercial members with the old ID numbers.