Self-Funded Billing

Self-Funded Billing

Self-Funded Billing

New features and enhancements will be available after migration.

Reduction in amount of funds

required to have on deposit with IBC

Access to invoices and notification

system via e-Bill

Easy access to reports on claims

payments, deposits, and expenses

Stop loss credits available directly

on invoices

Self-Funded Billing

Payment with e-BillSimpler and more convenient

Pay bills online (one-time,automatic,recurring)

View invoice summaries

online

Enhanced notification

system

Summary and detail-level

reports

Payment with e-Bill

Simple, customizable,

and easy payment process

After migration, customers can choose to pay by e-Bill, a secure online system that offers enhanced notification features.

Customers receive email notification when:•The invoice is available.•The amount due changes.•A payment is returned.

Information on InvoicesChanges to Fee Presentation

• IBC is adopting a new standard for how fees appear on customer invoices. – Not because of new charges – but due to changes

to how some fees are calculated.• Administrative expenses:

– Most admin fees will be billed on a PCPM basis• Claims Related Administrative Expenses:

– A new field type labeled “other medical expense fee” will be created

Reporting Hyperlink reports available

• Customers will have an opportunity to determine role-based reporting access.

• Customers are able to access summary and detail level reports on claims payments, deposits and expenses on the same day as invoice is received.

Changes to Billing Cycle and Format

• An email with a link to e-Bill will be sent out every Wednesday.

• All self-funded customers must move to a weekly billing cycle.

• All self-funded customers must pay their invoice within 24 hours of receipt.

Stop Loss Coverage

• Following platform transformation, claims will be fed directly to Highmark Insurance Group (HMIG) systems and stop loss credits can be advanced to customers who meet certain criteria.

• Customers with stop loss coverage from HMIG may receive stop loss credits directly on their invoices, eliminating the current need to file claims for reimbursement.– HMIG requires a run-in period for claims and the period varies

based on the stop loss policy. Consistently timely payment (i.e. pays weekly amount due, within 24 hours) required for credits.

Claims Run Out• Currently, self-funded customers receive information

on claims run-out activity on their IBC invoice.

• Following migration:– Information on claims run out activity related to

dates prior to migration will appear on the “additional item” line of the new invoice.

– IBC will continue to send the reconciliation file to the customer until run out is complete.

Self-Billing of Administrative Fees

• Currently, customers that self-bill administrative fees are unable to view an administrative fee-only invoice.

• Following migration, self-billed admin fees will be filed on a separate admin fee invoice.

• Allows customers to pay the medical invoice as billed via e-Bill.

Support from IBC

• The following information is available: – Claims billing guide for information on accessing invoices

through the e-Bill portal, fee types and reporting– Annual calendar of billing cycles (including weekly claims and

monthly admin cycles)– Dedicated billing analyst to walk through the first invoice and to

directly answer questions regarding portal access, invoices and reporting

IBC offers support and education about new e-Bill features