Blue Shield Opts-In Some Physicians to Exchange Plans November 1, 2013 Covered California, News, Physician Resource Covered California, Blue Shield 0 Blue Shield is notifying physician practices that they were being automatically included in Blue Shield’s exchange plans, the Individual Family Plan (IFP) EPO and PPO networks. According to the notice, the change is effective January 1, 2014, and affected physicians will be listed as participating providers on the exchange website under the applicable Blue Shield IFP product. Physicians who agree with the change are not required to take any action. For physicians who do not agree with the proposed change, Blue Shield has advised the California Medical Association (CMA) that there is no ability for physicians to opt out of just this IFP product. Physicians do, however, have the ability to terminate the underlying Blue Shield PPO contract prior to the effective date if they do not agree with the change (Health & Safety Code SS1375.7; Insurance Code SS10133.65). Physicians with questions can contact Blue Shield’s Provider Services at (800) 258-3091. SFMS/CMA is encouraging physicians who are uncertain if they have been opted in to check the provider database on the Covered California database when it becomes available. Physicians are also reminded to carefully review all proposed amendments to payor contracts and avoid accepting substandard contracts that are not beneficial to your practice. CMA has developed Contract Amendments: An action guide for physicians, a free resource for SFMS/CMA members available for download on the CMA website or by contacting the SFMS at (415) 561-0850 or membership@sfms.org. Comments are closed.
