Where Food Meets Nourishment

Out of network with BCBS

I do believe care should be accessible, and I was in network with BCBS for 8.5 years. When I left, BCBS was paying ½-2/3 the rate of all other plans—Medicare, Aetna, Cigna, United, etc.  They were also routinely delaying payments without reason, and had delayed payments for 6 months right before I left which prompted my exit. Some claims were delayed up to a year.

I was spending hours on the phone and over email fighting billing errors and endless delays when BCBS refused to honor their contracts. I realized I couldn’t do it any longer and still take good care of my clients.

BCBS is aware their nutrition reimbursement rates are substantially below all others, and have stated they can because it’s a big company, and stated that if providers don’t like it, they should leave. This essentially guarantees that experienced providers opt out of BCBS, and that’s fundamentally unfair to patients. But this also isn’t a game I have the time, energy or inclination to play.

BCBS members deserve better, and so do providers. It was impacting my health, and I realized I could not continue to provide quality care with such a dynamic.

I do regret the impact it has had on BCBS members, and appreciate all of the clients I had the opportunity to serve over the years.

I will continue to see clients as an out-of-network provider, and many plans do have out-of-network benefits. If you have an HSA (Health Savings Account) or FSA (Flexible Spending Account), nutrition counseling is considered a reimbursable expense.

Please do feel free to contact me with any questions you may have.

All best,

Cheryl

April 2016 (updated in May 2019)

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