Call Us Now 888.512.8878

2014 DMHC/Blue Shield IFP Provider Directory Settlement Member Letter

On Tuesday, November 3, 2015, the DMHC announced a settlement with Blue Shield regarding its Non-Routine Survey of Blue Shield's provider directories for 2014 non-grandfathered Individual and Family Plans.

As part of the settlement, Blue Shield will notify certain ON and OFF Exchange Individual & Family Plan members that they are eligible to resubmit out-of-network claims for covered services received in 2014 for review if they feel that they were led to believe that their provider was in their plan's network by Blue Shield or the provider. Should their claims qualify under the settlement, Blue Shield will reprocess and pay the claims as if they were from an in-network provider.

The letter and claims review form will be mailed to eligible members only on or before December 31, 2015. Members who wish to submit one or more claims for review under the settlement must return the claims review form to Blue Shield by February 12, 2016.

If you have any questions, please contact us at 888-512-8878 or click here.

Posted 11:07 AM

Share |

No Comments

Post a Comment
Required (Not Displayed)

All comments are moderated and stripped of HTML.
Submission Validation
Change the CAPTCHA codeSpeak the CAPTCHA code
Enter the Validation Code from above.
NOTICE: This blog and website are made available by the publisher for educational and informational purposes only. It is not be used as a substitute for competent insurance, legal, or tax advice from a licensed professional in your state. By using this blog site you understand that there is no broker client relationship between you and the blog and website publisher.
Blog Archive
  • 2019
  • 2018
  • 2017
  • 2016
  • 2015
  • 2014
  • 2013

View Mobile Version
CNA Logo
The Hartford Logo
Travelers Logo
Anthems Logo
Blue Shield of California Logo
Guardian Logo
Kaiser Permanente Logo
Golden Eagle Insurance Logo
Mercury Insurance Logo
Chartis Logo