All BlueCross Blue Shield plans are making a significant change to how they process claims for DME, independent clinical laboratories, and for specialty pharmacy. Beginning October 14, 2012 each of these supplier types must have a contract with the BCBS plan where the product is delivered in order to receive in network benefits.
For example if you live in Tennessee and you receive by mail an item from a DME supplier, the supplier must be in-network with BCBS of TN to be paid as in-network.
BCBS is, in effect, eliminating national chains from doing business throughout the county and requiring their insureds to purchase from local suppliers. State BCBS plans won’t contract with DME companies who do not have a presence in their state, except in border areas.
National Credentialing Solutions, nCred, provides enrollment services and other credentialing services to healthcare practitioners throughout the country. Visitwww.nationalcredentialing.com for more information about their credentialing services.
