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Blue Cross Blue Shield Requiring Authorization

Posted Jul 02 2009 5:23pm

According to the article, “Blue Cross requiring psychiatrists to get prior authorization before treating patients” by Liz Freeman on naplesnews.com, Blue Cross Blue Shield health insurance of Florida implemented a new rule taking effect this fall which will require psychiatrists to get authorization before treating patients in their office or out patient locations.

Blue Cross sent letters to psychiatrists which outline the new rule that goes into effect on Oct 3.  A contract amendment must by signed by the mental-health providers by June 24 if they accept Blue Cross Insurance.  The pre-authorization will be required to treat patients for office based visits, inpatient admissions, and for partial psychiatric and substance abuse care.  Emergency visits are covered but the provider will need to request authorization.  This is all outlined in the notice from Blue Cross.

Blue Cross officials state the new authorization rule is partly because of the Mental Health Parity Act of 2008 which intends to end inequity between medical treatment and mental health care for plans with 50 or more employees.  The David Lawrence Center, a private nonprofit mental health center in Golden Gate, Florida, believes its expenses may rise with the new rule, but their patients will not face any fee increases and they will not turn anyone away because they have Blue Cross.

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