Medicare Supplement:

Q. Why can't I reach a customer service representative?
We now provide all necessary information concerning benefits, eligibility verification, and claims status via our Self-Service IVR (800-800-2254) or via the Online Provider Portals. Q. I can't find a policy?
There are multiple provider portals based on a policy's underwriting company found at https://www.bankerslife.com/providers/. Please note that the portals are not linked together. Individual registration is required and separate for each portal. You may need to check another portal to find the policy you are looking for. Please check all portals before reporting a policy not found to our service desk. Q: Are Electronic Payments offered for Medicare Supplement Products?
Yes. We offer Electronic Payment (EFT) and Electronic Remittance & Advice (ERA) for Medicare Supplement Products. Enroll here.

 

Medicare Supplement (Med Supp) claim payments are sent to providers by CNO and Zelis (provider.zelispayments.com). Zelis handles questions specific to the Zelis Network, payment look-up and provider escalations. A basic or essential funds transfer and remittance advice option is offered free of charge. If you would like additional services, Zelis provides additional value-added payment services, for a cost, through their Zelis Payments Network for EFT.

Zelis is a web-based program available for health care providers to access payment and claim information. Zelis provides the following advantages:

• Allows authorized users immediate access to information about:
  • Claim status
  • Remittance details
    • Claim payment details
    • Claim rejection details
  • Payments
• Provides delivery of claim payments in the following ways:
  • Claim Payment Cards
  • Electronic Funds Transfer (EFT)
• Provides electronic delivery of Explanation of Payments

Zelis Customer Service: (877) 828-8770.

Zelis Hours: Monday-Friday 8 AM-7PM EST.

Q: What types of deductibles are available under Bankers Life and Casualty Company Medicare Supplement plans?
We offer the following deductible options based on the insured's Medicare Supplement plan as specified on their ID card:

• Part A deductible

• Part B deductible

• Plan F high deductible

• Plan G high deductible

• Plan K Out of Pocket Limit

• Plan L Out of Pocket Limit

Q. How do I enroll in the required or basic or essential claim payment and remittance at no cost?
Please contact our ePayment Center at 855-774-4392. Q. How do I enroll in Zelis Payments?
Please contact Zelis at 855-496-1571. With this option, Zelis provides additional value-added payment services, for a cost, beyond basic or essential funds transfer and remittance advice.

Q: How do I submit a claim?
Please submit a copy of the Medicare Summary Notice (MSN) also known as the Explanation of Medicare Benefits (EOMB). Each document must include the control number on the document. This will be noted as the ICN number.

Q: What are the benefits on the Medicare Supplement policy?
BASIC BENEFITS Included in all plans:

• Hospitalization: Part A co-insurance after the 60th day of hospitalization.

After the 90th day of hospitalization, the current lifetime reserve co-payment amount will be paid until the insured uses up all of his or her 60 Lifetime Reserve Credit Days. 
Once 60 Lifetime Reserve Days are used up and Medicare Benefits end, the policy will pay Medicare Part A eligible expenses for up to an additional 365 days of hospitalization.

• Medical Expenses: Part B co-insurance (20% of Medicare eligible expenses)
• Blood: First 3 pints of blood each year
• Hospice: New benefit as of 2010, by MIPPA, includes cost-sharing for all Part A Medicare eligible hospice case and respite care expenses. 

These are the basic benefits and each plan may cover more expenses.  Please check your individual plan for full list of policy benefits. Q. How do I submit an Electronic Medigap Claim?
1. If you want claims to be submitted directly to Bankers after Medicare has paid, the following needs to be completed on your electronic submission to Medicare. 2330B loop (Other Payer Information) needs to be completed.
2. Enter on NM101: PR (payer)
3. Enter on NM102: 2 (non Person entity)
4. Enter on NM103: Bankers Life & Casualty or Bankers Life NY
5. Enter on NM108: PI (payer identification code)
6. Enter on NM109: 55000 Q. How do I submit an Electronic Crossover Claim?
1. If you want claims to be submitted directly to Bankers after Medicare has paid, the following needs to be completed on your electronic submission to Medicare. 2330B loop (Other Payer Information) needs to be completed.
2. Enter on NM101: PR (payer)
3. Enter on NM102: 2 (non Person entity)
4. Enter on NM103: Bankers Life & Casualty or Bankers Life NY
5. Enter on NM108: PI (payer identification code)
6. Enter on NM109: 30065 Q. How do I submit a Paper Medigap (electronic) Claim?
1. In Box 9 enter the last name, first name and middle initial of the insured if it is different from that shown in block 2.
2. 9A Enter the policy number of the insured proceeded by Medigap, MG or MGAP.
3. 9C Enter the Bankers administrative mailing address. (PO Box 1935, Carmel, IN 46082-1935) 9D Enter the 5-digit Medicare ID code 55000 Q. How do I submit an electronic claim directly to Bankers Life and Casualty Insurance?
To submit either of the below electronic claim transaction types to Bankers Life and Casualty Insurance, please submit these transactions through the clearinghouse - The SSI Group. The Payer ID that should be used is 99999-0178 for both claim transaction types. If you do not use the clearinghouse - The SSI Group, and your clearinghouse of choice does not have Bankers Life and Casualty Insurance setup as an available Payer; please submit a request to your clearinghouse stating you would like both or either of the below transaction setup with the Payer ID 99999-0178 through the clearinghouse - The SSI Group.

Health Care Claim - Professional (837P)
Health Care Claim - Institutional (837I)

https://cws.ssigroup.com/payerlist/
Q. How do I request re-processing of a claim or re-issue of a payment dated prior to May 22, 2023?
To request the reprocessing of any claim or re-issue of a payment dated before May 22, 2023, please fax your inquiry to 312-396-5951. Q: What is our procedure/policy for paying?
Our general policy for paying Medicare Claims is based on Medicare's approval of the claim. If Medicare approves the claim for payment we will consider the coinsurance due and or deductible amounts based on Medicare's approved amounts. (Percentages may vary based on the plan.) If you are seeking pre-approval on a medical visit or procedure, please contact Medicare. Q: Must hospitalization be pre-certified for a person that has a Medicare Supplement Policy?
No. For a policyholder to enter the hospital, they do not need to contact Bankers for pre-certification. However to guarantee the visit or procedure will be approved by Medicare, please contact Medicare.

 

Q: What address should be used when mailing a claim?
For Medicare Supplement: Send a copy of Medicare's Explanation of Benefits to:
Policy Benefits Dept.
PO Box 1935
Carmel, IN 46082-1935 Q: How do I delete my online account?
If you no longer wish to have access to policy and claim information through the Healthcare Provider Services site, please contact the Service Desk by calling 877-817-3400 to delete your online account.

Long Term Care:

Q: Are Electronic Payments offered for Long Term Care Products?
At this time, Electronic Payment and Electronic Explanation of Benefits are not offered on Long Term Care Products. Q: How do I file a Claim?
Please include:
 

•  Claim form completed in full
•  Itemized Bill (UB-04, UB-92, HCFA-1500). This form should include:
  •         Date(s) of service(s)
  •         Cost(s) of service(s)
  •         Amount of units per service 
  •         Diagnosis(Dx) Codes (Ex. 123.45)- What's wrong with the policyholder
  •         CPT Codes (Ex. 12345)- What services were received
• Copy of your license 
• Copy of your plan of treatment

You may be contacted by Bankers for further details regarding the policyholder's claim. Q: What address should be used when mailing a claim?
For Long Term Care and Home Health Care, send all requested documents to:
Bankers Life and Casualty Co.
Policy Benefits
PO Box 1902
Carmel, IN 46082-1902