Blue Shield Documentation Requested from CalChiro’s Managed Care & Insurance Committee
August 2, 2018
Managed Care & Insurance Committee
CalChiro is aware that Blue Shield call center representatives are misquoting chiropractic benefits for members/enrollees of Covered California administered by Blue Shield. CalChiro acknowledges that services identified by Current Procedure Codes (CPT) 98940 to 98943 (manipulative services) are not included in the essential benefit definitions currently in place. However, services including, but not limited to, Evaluation/Management, physical therapy, rehabilitative therapy, plain film radiography, ambulatory services – all of which are included in the scope of chiropractic practice in California – certainly are covered services when performed by doctors of chiropractic.
We have initiated discussions with Blue Shield on this issue. CalChiro needs documentation to support our position that Blue Shield representatives are misquoting these benefits when in fact services provided by doctors of chiropractic are reimbursable services. Please forward any documentation to Dawn Benton at dbenton@calchiro.org, that shows the discrimination and inaccurate benefit information you receive from the Blue Shield call center representatives.