November 2005

N.J. FEP reimbursement corrected

New Jersey chiropractors will get a bump in their reimbursement from Horizon Blue Cross Blue Shield under the Blue Cross Blue Shield Federal Employee Plan (FEP).

In September, American Chiropractic Association (ACA) officials asked the national Blue Cross Blue Shield Association to fix an improper administration of the FEP benefit in New Jersey. Within weeks, Horizon Blue Cross Blue Shield located the software error causing the improper reimbursement and rectified the problem.

While ACA was able to work toward a positive resolution on Horizon’s administration of the FEP benefit, the ACA has concerns regarding Horizon’s treatment of non-FEP chiropractic claims. The ACA will continue to address these issues.

Throughout the past year, the ACA has surveyed its membership to determine whether or not the FEP benefit has been properly administered across the country. The association has received responses from providers in 26 states and — in all but two states — found that no problems existed.

The ACA asked chiropractors experiencing problems with FEP benefits to send documentation to ACA, attention: PDR Department, 1701 Clarendon Blvd., Arlington, VA 22209, or fax the information to 703-243-2593.

For more information on the chiropractic benefit under the Federal Employee Plan and to read about the updates for the 2006 benefit, visit the ACA website at www.acatoday.com/insurance/managed_care/.

Source: American Chiropractic Association, www.acatoday.com

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