Author: Marc Abla, CAE

BCBSIL Orthonet Alert

The most effective method of effecting change is through the purchaser. As we have asked throughout 2013, the ICS is asking doctors around Illinois to inform their patients covered by BCBSIL health plans of the looming changes concerning physical medicine under their BCBSIL policies.

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Increasing Value

The Illinois Chiropractic Society understands the current challenges for our doctors and their practices. The number of changes that have happened and are coming in the next year are simply daunting: BCBS/Orthonet, NGS taking over Medicare in Illinois, HIPAA Omnibus Rule changes, Insurance Marketplace new offerings, other Affordable Care Act implementations, EHR deadlines, license renewals, CME deadline, and sweeping changes to diagnosis codes (ICD-10). However, we will continue to make sure that our members are kept up-to-date regarding all of these coming changes.

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BCBS-Orthonet: Appeal Information

The ICS is receiving word from many of our members that they have now received their letters from BCBSIL identifying the tier in which they have been placed in the Orthonet utilization management program. In order to verify the information previously given to the ICS by BCBS, we will be distributing a survey next week to all chiropractic physicians in our network. We would ask you to participate when you receive the email.

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BCBS and Orthonet – October 2013 Update

According to BCBS, providers should be receiving their tier letters over the next few days. Additionally, they are making the announcement in the October 2013 BlueReview. As always, we continue to advocate for our doctors during this transition, and we are weighing all of our options for further action.

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A Flurry of Activity

Some people claim to like change. I believe they are more likely to embrace change. I don’t have to remind you that the volume of issues and events that we are seeing in the health care world and, more specifically, the chiropractic profession is daunting. The changes in governmental requirements, insurance demands, electronic records, patients’ expectations, and increased scrutiny can seem overwhelming to many in the profession.

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