BCBS Texas Downcoding Issue

  • name

    Member
    March 29, 2024 at 2:50 pm

    Hey team!
    I am Codie Moore, Director of Payor Contracting; with CarePointh Health, and just joined this group.

    We are having the same issue with Anthem BCBS in Kansas; they are calling this downcoding “pay for precision” but they cannot provide any written info on this program (your Texas info is the most we have been able to locate).

    Is there another upcoming meeting scheduled? I would love to hear more and if anyone had any success with the letter suggestion.

    Thanks; and I look forward to working with you all!

    Codie

  • name

    Organizer
    April 1, 2024 at 2:31 pm

    Welcome Codie!

    This working group meets when there is an issue where EDPMA may respond. They help determine if a response is needed and if so, recommend the messaging in the response.

    You can also post your response in the QCDC Committee channel for a broader audience.

    We are thrilled you are jumping in!

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