Blue Cross and Blue Shield of Illinois

 

 

April 19, 2013

Inquiries Regarding Wellness Providers

As part of our ongoing operational reviews, we recently identified instances where Blue Cross and Blue Shield of Illinois (BCBSIL) was billed for preventive medicine evaluation/re-evaluation and management services that, according to our records, do not appear to have been rendered to members during, or subsequent to, certain worksite screening events. These amounts appear to have been billed in addition to the blood draw and laboratory tests associated with the screenings. Internal teams have identified the appropriate billing practice for these screenings. We are working directly with impacted wellness providers to educate them on our reimbursement policies, and initiating efforts to recover amounts that may have been overpaid.

We will continue to assist employers, brokers and vendors with the scheduling of worksite wellness events. Educational materials explaining the benefits of such events will also continue to be available. 

A worksite wellness provider may contact you to inquire about BCBSIL's reimbursement or coverage. Such inquiries may be forwarded to Steven Adams at 312-653-4187 or Neal O'Malley at 312-653-7881. If you have additional questions, you may contact your BCBSIL account representative. 

 

 

 
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A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association.