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.