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SSN ID Replacement Project Q&A for Providers

September 01, 2004

Identity theft using Social Security numbers is a growing problem. Blue Cross and Blue Shield of North Carolina (BCBSNC) considers the privacy of members’ information to be of the highest importance, and that’s why we are taking steps to give all members new identification numbers that will not contain their Social Security number (SSN).

Q: When will we see patients with the new ID number? Top of Page

A: BCBSNC will begin to replace all SSN-based ID numbers on member ID cards and correspondence in 2005. Beginning in April 2005, we will start issuing new ID numbers and cards for groups that renew in February, March or April of that year, and will continue issuing new ID numbers upon group renewal dates through January 2006.

This schedule means that all BCBSNC members will have new identifiers by the end of January 2006. All member ID cards – as well as correspondence with members and providers – will contain the new identifiers.

The following schedule outlines the planned conversion to the new numbers. This plan may change as the project progresses:

  • Commercial Group Business – Starting 4/01/05 and completing 1/01/06
  • Medicare Supplement – 4/01/05
  • State Health Plan – 7/01/05
  • Individual Products (Blue Advantage®, etc.) – 1/01/06

Based on this schedule, the earliest you might see an ID card with the new non–SSN ID number would be the end of March 2005.

Q: How will you notify providers of this change? Top of Page

A: BCBSNC started communicating with providers in the spring of 2004 via the Blue Link newsletter and the Blue Book provider manual updates. BCBSNC will continue to communicate project updates with providers via Blue Link.

Upon renewal, BCBSNC will send each member a new ID card with a notice highlighting the new non–SSN identifier. The notice will instruct members to destroy their old ID card and present their new ID card to their provider when receiving medical services.

Q: What will the new ID number look like? Top of Page

A: The current 9–digit SSN of the ID number will be replaced with a lead alpha character “W,” followed by eight numeric digits. The prefixes and suffixes used today will remain unchanged. For example, if a three–digit prefix and two–digit suffix is part of the current subscriber ID (YPP – 059485274 – 01), the same prefixes and suffixes will be used with the new ID number (YPP – W12345678 – 01).

For State Health Plan members, the ID number will include the lead alpha character “W” followed by eight numeric digits followed by a one–digit suffix and one–digit modifier (ex. W12345678–0–1).

Q: What happens if a member or a provider sends in a claim with their old SSN - based ID instead of the new identifier? Will it be returned? Top of Page

A: We plan to make a gradual transition to the new identifiers, which means that for a while, our systems will continue to accept the SSN–based ID number as well as the new subscriber IDs on incoming claims. However, our goal is to encourage all providers to use the member’s ID number that is in effect for the date of service.

Providers should ask their patients for their most current BCBSNC ID card when obtaining health care services. The information on the ID card will enable the provider to file the claim accurately.

Note: The Notice of Payment will display the ID number that was in effect for the date of service

Q: Why are we changing ID numbers to these new identifiers? Top of Page

A: Identity theft is becoming an increasing concern in the United States. Several states have already passed legislation prohibiting the display of an individual’s Social Security number (SSN) on member ID cards and/or member correspondence, and other states are following suit.

While North Carolina does not yet have legislation to this effect, Blue Cross and Blue Shield of North Carolina considers the security of members’ information to be of the highest importance. That’s why we are taking steps to eliminate the use of SSNs as identifiers for people enrolled in our health plans. Transitioning away from the use of SSN-based ID numbers will reduce the threat of identity theft and other potential security problems.

Q: Will BCBSNC provide us with a list of the new identifiers for our patients? Top of Page

A: No, BCBSNC does not have record of the provider’s patient base with BCBSNC coverage. The best way to ensure that you have the most recent member ID number is to request that your patient present their ID card at each visit.

Q: What happens if the provider calls in to BCBSNC Customer Service with a SSN but not the new identifier? Will you take the call? How will the HIPAA privacy protocols change with the new identifier? Top of Page

A: Yes, BCBSNC will take the call if the caller does not have access to the new ID number. BCBSNC currently has a procedure in place to verify the identity of callers requesting information. Today the HIPAA Privacy protocol is to ask the caller to provide the following information for verification:

  • BCBSNC provider number
  • Caller name
  • Provider name
  • Member ID or member name + date of birth
  • Subscriber’s address

If the caller does not have access to the new ID number, the subscriber’s SSN can be given in lieu of the member ID number. The caller should take this opportunity to obtain the member’s new ID number.

Q: If you’re still collecting the SSN, how does the new identifier prevent identity theft? Top of Page

A: We will collect the SSN and use it for internal processing and limited reporting. However, the SSN will not be displayed on the ID card or on member and provider correspondence. This will greatly reduce the risk of identity theft via mail theft or the visual display of the member’s SSN.

Q: Does this new identifier system comply with HIPAA? Top of Page

A: There are no HIPAA regulations that are impacted by this change.

Q: Will every BCBSNC member have a new identifier by January 1, 2006? Top of Page

A: Yes.

Q: Will there be any delay in processing claims and payment during the transition period? Top of Page

A: BCBSNC anticipates no problems in the timely payment of claims due to the SSN ID replacement project. BCBSNC is currently testing systems to ensure that claims will continue to be processed accurately and timely.

Q: How will the new identifiers affect BlueCard®? If a member receives care in another state, will the claim be routed correctly? Top of Page

A: All Blue Cross and Blue Shield Plans across the country will be replacing their Social Security number identifiers by January 2006. You will see subscriber ID numbers from other Blue Plans in various formats; however, all ID numbers will maintain the 3–digit alpha prefix that identifies the member’s home Plan. BlueCard systems (Blue Exchange, Blue eSM1, etc.) will be able to accept any possible ID formats that other Blue Plans may use.

Q: Will your vendors (Medco for Rx, Magellan for mental health, ACS for dental, etc.) update their systems with the new identifiers? Top of Page

A: Our vendors plan to revise their business processes and systems to handle the new alphanumeric identifiers.

Q: Will we still be able to use Blue e for eligibility and claims inquiry? Top of Page

A: All BCBSNC systems that you currently use today will accept the new member ID numbers. If you use a vendor for claims submission, you should verify that your vendor can accept the new ID number format.