Members

Which website is listed on the back of your ID card?

Employers

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Providers

How Are We Creating the Future of Health Care? Together.

The future of health care is extremely complex and constantly changing. This resource is designed to give health care providers easy access to timely, accurate information, allowing you to focus on what’s most important — your patients’ health.

Have you registered for the PEAR portal?

Our transition to the Provider Engagement, Analytics & Reporting (PEAR) portal is complete! The PEAR portal offers participating providers a single point of entry to multiple digital tools, including PEAR Practice Management, PEAR Comprehensive Visit, and PEAR Analytics & Reporting.

Learn more

Visit the Provider News Center

Faster Reimbursement

Providers and facilities can use InstaMed to receive fully reconciled remittance advice and claims settlement payments electronically for services provided to Independence Administrators plan members.

Visit InstaMed

Streamline Requests with iEXCHANGE®

Providers can streamline inpatient and outpatient precertification requests and treatment updates using iEXCHANGE, a convenient, HIPAA-compliant online service offered through MEDecision, Inc. Precertification can also be requested by calling the phone number on the plan member’s ID card.

Call 1-888-444-4617 to contact the iEXCHANGE Help Desk or Request a Free Webinar.

AmeriHealth Administrators, a leading independent national third party administrator, provides medical management services for Independence Administrators.

Provider Access

Resources

Claim Appeals and Reimbursements

To appeal a claim, download the Provider Claim Appeals Form.

Download

To request a reimbursement for an implant, download the Implant Reimbursement Request Form.

Download

Electronic Data Interchange (EDI)

Submit claims and obtain important documents online through our Electronic Data Interchange (EDI) services. Submission by EDI can increase accuracy of claims processing and the speed of claim payments. Trading partners can access the EDI Trading Partner Business Center and register to submit and receive transactions. You can also access additional information about submitting transactions through Highmark Gateway, maintained and managed by Highmark, Inc.

EDI Trading Partner Business Center

Provide the following information at the EDI Trading Partner Business Center:

Payer ID:

  • ISA08 = 54704
  • GS03 = TA720 or 54763

Download the HIPAA Companion Guide.

Provider Claim Appeals

To appeal a claim, download the Provider Claim Appeals Form.

Prescription Drug Information

Independence Administrators’ preferred pharmacy benefits manager is FutureScripts®. Before prescribing a medication, you should work with the plan member to determine if the drug is included on the formulary.

Many FutureScripts plans require prior authorization for certain medications.* Send authorization requests directly to FutureScripts. Visit FutureScripts to download a request form, or call FutureScripts at 1-888-678-7013.

Visit FutureScripts

*Some specialty medications, such as infusion drugs or drugs administered by the physician in the office, may be covered by the plan member’s medical benefits plan and may require precertification.

Direct Ship Drug Program

Independence Administrators offers a Direct Ship Drug Program to our in-network physicians. Under this program, physicians can order certain specialty drugs that are given in the office and are eligible for coverage under the plan member’s medical benefit when medical necessity criteria are met.

Direct Ship Program

Most Cost-Effective Setting Program

Find out how Independence Administrators reviews the requested treatment settings for certain specialty drugs that are eligible for coverage under the medical benefit.

Learn more

Dosage and Frequency Program

Learn how Independence Administrators reviews treatment regimens for certain specialty drugs to ensure they adhere to safe prescribing limits.

Learn more

Medical Management Services

Independence Administrators uses various policies including Independence Blue Cross medical policy and InterQual® criteria. Visit the Independence Blue Cross medical policy page for more information.

AmeriHealth Administrators, an independent company, performs medical management services on behalf of Independence Administrators. You can obtain a copy of a specific policy by calling the clinical services department at 1-888-234-2393.

Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.

Precertification

Certain procedures and prescription drugs require precertification before they are performed or administered. You can request precertification online using iEXCHANGE or call the phone number on the plan member’s ID card. Required precertification must be obtained to avoid reduced payment or non-payment for the service or medication.

Provider Contact Information

Provider finder

Find an Independence Administrator Network Provider.
1-888-356-7899
Find Providers

Precertification

Call the number on your patient’s ID card or log into iEXCHANGE®
Log In

Media

Information for and interview requests from members of the media.
Submit an Inquiry

Provider services

Reach provider services, care management, and clinical pharmacy services.
1-888-356-7899
Submit an Inquiry

Claims, benefits, & eligibility

Call the toll-free service phone number on your patient’s ID card.
Submit an Inquiry

FutureScripts®

1-888-678-7013 (phone)
1-888-671-5285 (fax)
Visit

iEXCHANGE®

1-888-444-4617
Visit

Behavioral health services

Please call the phone number listed on the patient’s Independence Administrators ID card.

FutureScripts, an independent company, provides pharmacy benefit management services for Independence Administrators.

Flexible, Scalable Technology

We’ve adopted more nimble, advanced technologies so we can offer more comprehensive services, greater flexibility, enhanced interoperability, and improved health data management. What does that mean to you? More options.

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Help When People Need it Most

If patients are facing a serious illness or medical condition, Independence Administrators’ case management program might be right for them. This free, confidential program provides support, guidance, and coordinated care for complex health concerns.

Learn More