QUESTION #604: I submitted a claim form to Blue Cross for a patient that was seen by a chiropractor that we often send our patients to. Our group is in network, but the chiropractor isn’t. Why are they reimbursing at the in-network rate?

ANSWER (03/07/2008): It turns out that you were not putting the correct information in the claim. You had the tax ID for the medical group instead of the TIN of the chiropractor. Per CMA’s Center for Economic Services, Blue Cross saw the tax ID and processed it as such. The chiropractor should be billing it out with his information. CMA advised that the physician should go back and submit corrected claims.

REFERRAL: CMA Center for Economic Services, (888) 401-5911