Author: Marc Abla, CAE

Rethinking Your Office Habits

When is the last time you took a very close look at your practice… including the areas that haven’t changed in years, or maybe even decades? When you came out of chiropractic college and started your practice, you wanted to make sure that everything in your office was operating in a certain way, with a certain look, and for a specific purpose. However, now it has been months, years or even decades since that time, and although health care continues to change, many things in the office have not.

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BCBSIL Delays September 1 Implementation Date

The ICS has previously relayed information published in the May 2014 and June 2014 editions of the Blue Review regarding billing for services rendered by licensed massage therapists in the physician office. Blue Cross and Blue Shield of Illinois (BCBSIL) announced upcoming policy changes that would: 1) require licensed massage therapists to obtain an NPI and bill all services to BCBSIL under the massage therapist’s NPI, rather than under the supervising provider’s NPI; and 2) that a “reimbursement differential” would apply to services rendered by a licensed massage therapist.

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BCBSIL Billing for Medically Unnecessary and/or Medically Unproven Services

“Effective for dates of service on or after July 14, 2014,* claims submitted to BCBSIL for services that are deemed to be medically unnecessary and/or medically unproven (experimental and investigational) will be denied with a message specifying that the member will not be financially responsible for charges associated with…any outpatient procedure or other services that are determined by utilization management to be medically unnecessary and/or medically unproven.

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