This article is for acupuncturists caring for our members
As you may know, we launched acupuncture benefits for our members beginning in January 2020. The benefits are phased in throughout the year as the member’s employer renews their coverage with Blue Cross. This means that during 2020 we’ll have some members who are not eligible for the benefits because their account hasn’t yet renewed their coverage for the plan year. In addition, some employer groups will exclude acupuncture coverage all together.
How to check if the member is eligible for acupuncture benefits
To confirm a member’s plan has an acupuncture benefit available, you will need to perform an eligibility inquiry for ‘acupuncture’ services and verify the plan renewal date. Until a member becomes eligible for the acupuncture benefit, our online benefits system, shown below, will not display accurate information about whether the member has coverage.
Ask the member to call Member Service to determine when their account renewal date is to find out when their acupuncture benefits are available.
The screenshot below shows what an eligibility query looks like when a member does not yet have active coverage for acupuncture.
We’re reprocessing claims denied due to lack of referral
We recently became aware of a system problem causing acupuncture claims to deny due to lack of a referral. No referral is required. We have fixed the problem and we are reprocessing any claims that may have rejected because of this mistake. We apologize for this error.
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