Insurance Committee Report

Highlights from the State Meeting Presentation – October 2019

Highlights from the State Meeting Presentation – October 2019

Always have an updated fee schedule for all of your private insurance carriers.

Blue Cross/Blue Shield releases a fee schedule three times a year
– January 1st
– June 1st
– October 1st

Blue Review Newsletter (from BC/BS) is an excellent source for news releases and on-going information. Access it off the Blue Cross website under Providers. They have monthly issues.
– Blue Cross Blue Shield – publishes Comprehensive User guides for GOV, PPO, and HMO plans – Please make sure you have these guides.
– Blue Card – Through BC/BS can be used in any state

• Used by Military
• Submit bill to BCBS Illinois
• Has its own benefit profile

Federal Employees FEP (BC/BS):

– Usually will not cover wound grafts.
– Usually will not cover regenerative products

Prior authorization for:

– MRI’s
– CT’s

• Know your Acronyms
• XOG – Government and MMAI
• XOH – HMO
• XOF – High Level
• XOX – Tiered product
  (Know your tier – If you have not received a letter – Call Provider).

Relations

Make sure you take advantage of all the educational training available for your employees.
– Webinars on Availity
– New Provider Training
– Hot Topic Training
– Workshops

All available registration on their Website BCBS.il gov

Jondelle B. Jenkins, DPM