Nourishing Your Body for Better Health

Out of network with BCBS

To my clients with BCBS insurance,

After May 31st, 2016, I will be an out-of-network provider for BCBS. I still will see BCBS clients, but will no longer be directly covered under the plan.

This has been a difficult decision for me to make, and yet it’s been a necessary change. Since December 2015, numerous payments have been delayed or denied despite clear coverage based on the client’s plan.  It was not until mid-May 2016 (6 months later) and after many months of inquiries and requests that claims were finally paid.

If you’ve ever had to appeal a claim with insurance, you know that months of calls with no response is a huge stress and time drain. For over a month, I was seeing clients and without any assurances from BCBS that I would receive any payment, which was extremely stressful, and simply not a reasonable or workable situation.  The FEP BCBS plan is still written without a specific number of covered sessions, so I had no guarantee that this situation wouldn’t happen again.

I love my job, and I’m lucky to have a job I love. It’s also my income. I also can’t work for a company that won’t honor the terms of their contract, and in the time frame required by law (30 days).

I’ve been in-network with BCBS for 8 years, and greatly appreciated the opportunity to help and support so many clients. 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 2016)

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