Florida Blue is expanding to allow virtual annual wellness visits for new and established patients. The expansion of the additional services for virtual visits will be in effect for the next 90 days. These visits will be reimbursed at the contracted in-office rates.
Additionally, we would like to inform you that we are monitoring telemedicine claim payments and confirmed that most of all the major payers are reimbursing evaluation and management (E/M) visits at the contracted in-office rates. However, we did notice that for Cigna and United Health Care, some claims were paid at the out-of-office rate when billed with place of service (POS) 02. At one point, Cigna and United Health Care indicated that all claims should be billed with place of service 02, but shortly thereafter, the billing guidelines changed to bill with POS 11.
- If your practice has claims for Cigna with date of service of March 2, 2020 or thereafter billed with POS 02 and received the reduced rate, please rebill by sending a corrected claim with POS 11 to receive the in-office rates.
- If your practice has claims for United Health Care with date of service March 18, 2020 or thereafter billed with POS 02 and received the reduced rate, please rebill by sending a corrected claim with POS 11 to receive the in-office rates.
Please note, it is important to verify benefits and eligibility before rendering these services. We noticed that some practices are not collecting patient responsibilities. Many patients continue to be responsible for their portion as if they would have come in for an in-person visit.
The latest changes to telemedicine billing were posted on the COVID-19 Updates for Providers landing page under “4/17/2020 Telemedicine Insurance Plan Guidelines” section. It is very important that all practices check this site periodically to obtain the most updated information.
Should you have any questions, please contact Jessica Capote, Director of Managed Care, at firstname.lastname@example.org or Elizabeth Sanchez, Managed Care Manager, at email@example.com.