BCBSIL Modifier Impact

The Illinois Chiropractic Society is continuing our efforts surrounding the BCBSIL claims processing protocol that began in November 2017. When applied, this claim edit, described by BCBSIL as “code-auditing enhancement” via “clinically validating modifiers,” automatically denies some providers’ claims on codes that require the modifiers 25 or 59 (including XE, XS, XP, XU). The ICS needs the following information for our research, discussion, and consultation with industry experts, health care allies, and attorneys.

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* 1. Are you in or out of network with BCBSIL?

In-Network/Contracted

Out-of-Network/Not Contracted

I do not know

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* 2. Please identify the categories below in which BCBSIL has denied claims you have submitted since the inception of the BCBSIL claims processing protocol in November 2017 (please select all that apply).

Modifer 25 (Exams and CMT on the same visit)

Modifier 59, XS, XU, XP, or XE (Manual Therapy and CMT on the same visit)

Neither

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* 3. What is the estimated financial impact to you resulting from this BCBSIL modifier claims processing protocol?

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* 4. Would you be willing to talk to a class action attorney who is looking into this matter?

Yes

I don't know

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* 5. Address

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number