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Insurance issues dealing with CMS to private insurance.

If you can’t find the information you are looking for or need help with a question, contact the FCA Insurance and Legal Liaison Office.



How to File an Insurance Complaint
Tuesday, 28 October 2014

Learn how to file a provider or consumer complaint with the Florida Office of Insurance Regulation online, by telephone or email.

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Florida Blue Network Changes
Wednesday, 22 October 2014
The FCA was recently notified by Florida Blue that those doctors currently participating in the Florida Blue networks have received or will soon receive a notice  informing that, effective April 1, 2015, American Specialty Health Group, Inc.(ASH) will manage chiropractic network services for Florida Blue.  This applies to most, but, not all of the Florida Blue networks. The notice is posted on fcachiro.org for your reference.
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Decision-making about networks: Always know what you are signing
Thursday, 02 October 2014

Insurers and networks are constantly revising contracts and agreements.  Your decision on whether to participate/sign an agreement is strictly an individual one and  you should not consult or discuss whether to participate with any other practice, or inform any other practice whether or not you intend to participate or sign any insurer/network agreement. Some members have sought FCA recommendations as to whether or not they should sign various network contracts:  Please understand that the FCA is prohibited by federal anti-trust laws from advising you in your individual decision-making process.


Be Aware: "Grandfathered" Plans Not Subject to All PPACA Provisions
Tuesday, 15 July 2014
(From the ACA "Week in Review" of July 10, 2014) The Patient Protection and Affordable Care Act (PPACA) defines a grandfathered healthcare plan as those, "that were in existence on March 23, 2010 and haven't been changed in ways that substantially cut benefits or increase costs for consumers." A grandfathered plan can be job-based or individual. As a result, a clinic could have some patients with plans that are grandfathered, and other patients with the same insurer whose plans are not grandfathered depending on when they enrolled. Patients can determine if their plan is grandfathered by contacting their benefit administrator or reviewing materials that describe plan benefits.
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Optum Changes Policy on Using Modifier with 98943-51
Tuesday, 15 July 2014
In Optum's most recent quarterly newsletter, Optum Physical Health News, the company announced a change to its long-standing policy requiring modifier -51 be appended to 98943 when billed with spinal CMT codes 98940-98942
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