Reminder: Medicare Plus Blue migrated individual, some group membership from ikaSystems to NASCO

On Jan. 1, 2025, Blue Cross Blue Shield of Michigan will complete the transition of its billing and claims processing for Medicare Plus Blue℠ individual plans and 165 national Michigan group plans from ikaSystems to the NASCO platform.

Affected members have received new member ID cards that must be used in claims submission as part of this process. Please scan their new member ID cards to be sure claims will be routed correctly.

Timeline and implementation

We started processing groups new to Medicare Plus Blue in 2024 on the NASCO platform. Beginning Jan. 1, 2025, we are moving our Medicare Plus Blue individual plans and some national Michigan group plans from ikaSystems to the NASCO platform. In 2026, we plan to transition the remaining national Michigan groups and our key accounts to the NASCO platform to ensure continuity and efficiency.

Changes to provider vouchers

Refer to the article in the October 2024 issue of The Record, which details the changes and provides a sample of the Medicare Plus Blue voucher. Here’s a summary of the changes:  

• A new field indicates the provider network.
• Additional columns identify the tax ID and electronic funds transfer dates.
• Adjustments such as sequestration and withhold amounts appear in the remittance advice section.
• Diagnosis-related group claims for acute inpatient or rehabilitation services are listed on a single line in the remittance.

Outpatient claims will continue to be listed on the claim line level.

Important member ID cards update

The October 2024 article in The Record also provides a sample of the new individual and group member ID cards. Changes include:

• An alphanumeric prefix
• A deidentified ID number
• A nine-digit group number for easier identification and processing

Eligibility

Prior to Jan. 1, 2025, if providers can’t find a member’s eligibility for 2025, they should be able to find the member in the system by searching the member’s name and date of birth.

Beginning Jan. 1, 2025:

• If a migrated member doesn’t share the new member ID card with the provider, the membership system at Blue Cross will cross-reference the old member ID number to the new information.
• If the provider enters the old member ID number in the membership system, the new member ID number will replace the old number in the system response.

Claims

If a provider submits a claim for services on or after Jan. 1, 2025, using the member’s old member ID, it will deny with the message “Contract not found.” The provider needs to resubmit the claim with the new member ID number.

Further reminders

The voucher for payments received from the NASCO platform will show the check or EFT number series below:

• Paper checks — Check numbers will begin with “4;” currently they begin with “1.”
• EFT payments — Numbers will begin with “7;” currently they begin with “6.”

All Medicare Advantage claims will be finalized on a Tuesday and either a check or EFT will be issued at that time. EFT funds will be received on Friday of the same week unless that day is a federal holiday.