On Tuesday, October 25, 2011, the NCMS, the NC Radiological Society and the NC Hospital Association filed a Joint Complaint with the NC Department of Insurance expressing concerns over a proposed Corporate Medical Policy issued by Blue Cross and Blue Shield of NC (BCBSNC). The policy unilaterally reduces the fees owed to BCBSNC participating providers who perform certain imaging procedures.  

The complaint follows recent conversations between the parties that failed to resolve concerns over how the policy is being implemented. The three provider organizations argue that to change reimbursement rates, BCBSNC must follow the formal contract amendment process set out in the law.

Stay tuned for updates on this story.

To read the Complaint, click here.

To view supporting documents:

Click here to see June 2011 BCBSNC CMP Radiology Services Reimbursement Guidelines “Notification”

Click here to see October 2011 BCBSNC CMP Radiology Services Reimbursement Guidelines “Notification”

See related article:

UPDATE: BCBSNC’s Radiology Services Reimbursement Policy Revised and Reposted, Bulletin, 10-7-11