Marc Abla

BCBSIL Billing for Medically Unnecessary and/or Medically Unproven Services

Posted by Marc Abla, CAE | Jul 11, 2014 | Insurance, zall | 0 |

“Effective for dates of service on or after July 14, 2014,* claims submitted to BCBSIL for services that are deemed to be medically unnecessary and/or medically unproven (experimental and investigational) will be denied with a message specifying that the member will not be financially responsible for charges associated with…any outpatient procedure or other services that are determined by utilization management to be medically unnecessary and/or medically unproven.

Tools for HIPAA Risk Assessments

Posted by Marc Abla, CAE | Mar 31, 2014 | Compliance, Frequently Asked Questions, HIPAA, zall | 0 |

Does the ICS have any tools for performing a HIPAA Security Rule risk assessment?

Employee Concealed Carry

Posted by Marc Abla, CAE | Dec 2, 2013 | Business Forms and Templates, Frequently Asked Questions, Legal, Members Only, zall | 0 |

In July 2013, Illinois enacted the Firearm Concealed Carry Act, which authorizes permit holders to carry loaded handguns, concealed or partially concealed, on their persons or in their vehicles. The law prohibits permit holders from carrying firearms into certain types of premises and establishments, including: schools of any kind; any government building or court; any hospital, mental health or nursing home; any establishment where more than 50% of the gross receipts are from the sale of alcohol; public playgrounds or parks; casinos; public transportation; sports stadiums; airports; and amusement parks or zoos.

BCBSIL Orthonet Alert

Posted by Marc Abla, CAE | Nov 5, 2013 | Insurance, zall | 0 |

The most effective method of effecting change is through the purchaser. As we have asked throughout 2013, the ICS is asking doctors around Illinois to inform their patients covered by BCBSIL health plans of the looming changes concerning physical medicine under their BCBSIL policies.

Increasing Value

Posted by Marc Abla, CAE | Oct 21, 2013 | ICS Message, zall | 0 |

The Illinois Chiropractic Society understands the current challenges for our doctors and their practices. The number of changes that have happened and are coming in the next year are simply daunting: BCBS/Orthonet, NGS taking over Medicare in Illinois, HIPAA Omnibus Rule changes, Insurance Marketplace new offerings, other Affordable Care Act implementations, EHR deadlines, license renewals, CME deadline, and sweeping changes to diagnosis codes (ICD-10). However, we will continue to make sure that our members are kept up-to-date regarding all of these coming changes.

BCBSIL/Orthonet Patients Information

Posted by Marc Abla, CAE | Oct 16, 2013 | Insurance, zall | 0 |

The Illinois Chiropractic Society continues to work diligently on...

BCBS-Orthonet: Appeal Information

Posted by Marc Abla, CAE | Oct 3, 2013 | Insurance, zall | 0 |

The ICS is receiving word from many of our members that they have now received their letters from BCBSIL identifying the tier in which they have been placed in the Orthonet utilization management program. In order to verify the information previously given to the ICS by BCBS, we will be distributing a survey next week to all chiropractic physicians in our network. We would ask you to participate when you receive the email.

BCBS and Orthonet – October 2013 Update

Posted by Marc Abla, CAE | Oct 2, 2013 | Insurance, zall | 0 |

According to BCBS, providers should be receiving their tier letters over the next few days. Additionally, they are making the announcement in the October 2013 BlueReview. As always, we continue to advocate for our doctors during this transition, and we are weighing all of our options for further action.