A BCBSNC reimbursement policy change made in 2021 resulted in several North Carolina practices inappropriately receiving recoupment letters in October of this year for visits that occurred in 2021. The NCMS partnered with practice leaders to raise concerns about the recoupment requests, and BCBSNC released a statement October 17  notifying practices they can disregard the recoupment requests for dates of service before 9/8/22.

Although the rescission of the recoupment requests is a positive first step, the underlying policy change remains an area for continued assessment. The change reduces reimbursement by 50 percent for a problem-oriented evaluation and management related service when submitted on the same date as a preventive medicine or annual wellness encounter.

The NCMS advocates for reimbursement policy changes that support access to primary care. How does this revised policy impact your practice and your patients?  If you or your practice have concerns about this change, please let us know. We want to hear your perspective!

Read full notice here.

To submit a NCMS On Point blog post on this subject click here.