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Opdivo

R

relong

Guru
Messages
134
Location
Coralville, IA
Did anyone bill out for Opdivo to Wellmark BCBS from 01/01/16 until 6/30/16? We are having a problem and are wondering if anyone printed off a copy of the fee schedule for that time period. Currently if we go back on the website and view the fee schedule from that time period, its been changed.
 
what i found out

Wellmark BCBS pharmacy dept miscalculated the billing unit for Opdivo so their fee schedule was based on a 10mg unit instead of 1mg. Since they don't list the billing unit on their fee schedule for most drugs no one noticed. The drug company did catch the mistake and informed Wellmark, but Wellmark insisted they were correct. Now they've realized they were wrong and they're trying to recoup dates of service from over a year ago.
 
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