Help Advocate: Blue Cross Consumers
Dear Consumers/BCBSM Subscriber:
We are asking for your help with increasing your access to quality allied health care for you and your family. Currently, independent occupational therapists (OT) and speech language pathologists (SLP) are unable to contract with and receive reimbursement for outpatient therapy services through Blue Cross Blue Shield of Michigan (BCBSM). This policy is inconsistent with their current structure which allows other independent allied health providers to bill for services.
In 1996, BCBSM added physical therapists in private practice as a provider group (IPT) without adding OT and SLP who are part of the rehabilitation “triad”. The Michigan Occupational Therapy Association (MiOTA) and the Michigan Speech and Hearing Association (MSHA) are requesting that BCBSM update their policy to add independent occupational therapists (IOT) and independent speech and language pathologists (ISLP) as provider groups returning consistency to the rehabilitation “triad” in the state of Michigan.
Additionally, this inconsistency in policy by BCBSM has resulted in:
- Restricted access to rehabilitation specialists.
- Increased out of pocket expenses to BCBSM subscribers by utilizing the IOT and ISLP who may be the most appropriate specialist for their needs. Additionally, the IOT or ISLP may be the provider that is locally accessible for the subscriber.
- Inconsistency between states. BCBSM is not aligned with other BCBS state plans which allow all three disciplines of therapy (OT/PT/SLP) to bill.
- Inconsistency between majority of other insurance carriers. BCBSM is not aligned with other insurance carriers in the state which allow Occupational Therapists and Speech Language Pathologists as independent providers (i.e., Medicare, Workers Compensation, Priority Health, Aetna, Cigna, United Health Care, Beech Street, Cofinity, Tricare, Health Plan of Michigan).
- Negative impact on small business and economic development. IOT and ISLP leave the state to practice since these businesses cannot survive without being BCBSM providers.
Please support us by writing a letter to the president of BCBSM, Daniel Loepp. Please send a copy to one of the addresses listed below. A sample letter is attached. Ask Mr. Loepp to update policy at BCBSM by adding Occupational Therapy and Speech Pathology as Independent provider groups. You make a difference!
Julie Pratt, MS, CCC-SLP Nancy Krolikowski, MS, OTRL, CHT
Michigan Speech and Hearing Association Michigan Occupational Therapy Association
790 W. Lake Lansing Rd., Ste. 500A 124 W. Allegan, Suite 1900
East Lansing MI 48823 Lansing, MI 48933
Fax: (517) 332-5870 Fax: (517) 267-3918