ICS Meets with BCBSIL about CMT Statistics Letter
The Illinois Chiropractic Society met briefly with BlueCross BlueShield of Illinois (BCBSIL) on Monday, June 28, 2021, to discuss the letter that many of you received from BCBSIL earlier this month. The letter stated that BCBSIL had reviewed Chiropractic Manipulative Treatment (CMT) claims for March 1, 2020, through February 28, 2021, and that the recipients’ practices were identified as “outliers” or above one standard deviation from the mean number of CMT claims submitted for that period.
At the meeting, we raised our concerns and questions regarding both the intent and the statistical information provided in the BCBSIL letter that they stated was sent to 1,334 chiropractic physicians in Illinois. The ICS continues to have concerns and questions surrounding both the purpose and the statistics cited in the letter. At this time, we are providing you with the information that BCBSIL gave us in the meeting. BCBSIL representatives stated that the letter’s primary intent was:
- To remind chiropractic physicians to review and understand their chiropractic standards and general medical policies; and
- To remind chiropractic physicians of documentation requirements.
We fully understand and share the concerns of many of our doctors about BCBSIL’s intent and conclusions regarding the statistical information contained in the letter. However, BCBSIL indicated that they regularly send similar letters to a wide variety of healthcare professionals across a range of healthcare professions.
The ICS awaits additional clarification from BCBSIL. As BCBSIL provides us with more information surrounding the statistics in the letter, the ICS will continue to inform our members.
Upon receiving notice of the letter, the ICS launched a survey to Illinois licensed chiropractic physicians. We have received 770 responses to date. Here are the current meaningful results:
- 78% of respondents received a letter;
- 435 respondents provided their chart “results” for “Number of Paid Units;”
- Of the 435 respondents who provided chart “results,” the average reported “Number of Paid Units” was 1,553;
- 187 respondents reported receiving “Number of Paid Units” above the BCBS stated 3rd Standard Deviation; and
- 30% of doctors who reported their “Number of Paid Units” were above the BCBS stated 3rd Standard Deviation.
During the meeting, we requested clarification as to BCBSIL’s statistical methods and population comparisons compared with the indications of our survey results. The Illinois Chiropractic Society will continue to accumulate information and advocate diligently on behalf of our members and the profession. We will provide any updates in future articles and the Illinois Practice Edge (email newsletter on Thursday mornings).
Editor’s Note: If you have not taken the survey, please take the time to complete the two-question survey anonymously.
Image by M. W. Toews.