BCBS Covid-19 Claims & Patient Responsibility

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!

You should definitely fill out a Hassle Factor Form with the AAP!

Also, I’d encourage you to engage your families in this fight. Give them the names/email/phone numbers of the various BCBS personnel (go all the way up to the CEO) and ask your families to call or send an email. And if there’s a big employer with a lot of these patients, call their H/R department and get THEM to pick up the phone. Afterall, they’re paying for all this (bad) coverage.


There is also a disclaimer that employer paid plans can opt out. This is likely what is happening. They are acting as a third party administrator. If you keep track, see who the employers are for these plans. I bet you’ll find a common denominator. Then, go after the employer like @Chip suggested.

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