Wiki BCBS, Covid-19 and Patient Responsibility

[kstine713]

Hello all!

I wanted to check in and see if anyone else was having trouble getting BCBS to process Covid-19 related office visits with no patient responsibility? From the beginning of this pandemic, their website has promised providers that they would pay at 100% if the correct CPT and/or diagnosis codes were appended. Their patient website has also promised their covered lives would not have any responsibility. They are not processing our claims that way. We have called provider services, opened reconsiderations, sent appeals, and reached out to several provider representatives all to no avail. We have been holding on to these claims as we don't want our patients to be responsible for something they shouldn't. But, we cannot continue to hold on to these claims. Does anyone have any ideas on what we can do, or does anyone have experience with this happening?

Thank you!
Kaytie

diagnosis codes, diagnosis coding

 

[SharonCollachi]

I would get the patient involved. Perhaps then things will change.

diagnosis codes, diagnosis coding

 

[csperoni]

No firsthand experience as we do not provide COVID-19 related services, but are you billing with -CS modifier?

diagnosis codes, diagnosis coding

 

[csperoni]

Also, this website states the TESTING is no patient responsibility, but does not state the same for the visit.

https://www.bcbs.com/press-releases/blue-cross-and-blue-shield-companies-announce-coverage-of-coronavirus-testing

diagnosis codes, diagnosis coding

 

[kstine713]

Also, this website states the TESTING is no patient responsibility, but does not state the same for the visit.

https://www.bcbs.com/press-releases/blue-cross-and-blue-shield-companies-announce-coverage-of-coronavirus-testing

These are the links we are planning to refer the patient to:

https://www.southcarolinablues.com/...tegories/Health/covid-19-cost-sharing-waived/



https://web.southcarolinablues.com/...rchives/2020providernews.aspx?article_id=1202



https://web.southcarolinablues.com/...rchives/2020providernews.aspx?article_id=1216



https://www.southcarolinablues.com/...th/covid-19-cost-covered-prior-authorization/

diagnosis codes, diagnosis coding

 

[kstine713]

I would get the patient involved. Perhaps then things will change.

That's our next step, we were just hoping to not have to do that.

diagnosis codes, diagnosis coding

 

[KRZollinger67]

Hello all!

I wanted to check in and see if anyone else was having trouble getting BCBS to process Covid-19 related office visits with no patient responsibility? From the beginning of this pandemic, their website has promised providers that they would pay at 100% if the correct CPT and/or diagnosis codes were appended. Their patient website has also promised their covered lives would not have any responsibility. They are not processing our claims that way. We have called provider services, opened reconsiderations, sent appeals, and reached out to several provider representatives all to no avail. We have been holding on to these claims as we don't want our patients to be responsible for something they shouldn't. But, we cannot continue to hold on to these claims. Does anyone have any ideas on what we can do, or does anyone have experience with this happening?

Thank you!
Kaytie

We are struggling as well with this same situation.

diagnosis codes, diagnosis coding