Effective January 1, 2021, SecureCare is pleased to announce that it will re-tier the Blue Cross Blue Shield of Minnesota (BCBSMN) chiropractic network based on clinical performance. As part of this process, one tier will be eliminated to consolidate and properly balance the network. Additionally, providers will be given transparent and clear criteria to define placement in one of the three tiers.
Each clinic’s commercial allowed dollars per patient status on the November 2020 report card will determine its placement in the new tier structure effective January 2021. Please note, these changes have no effect on Medicare or Medicaid patients or claims. Your clinic’s performance can be tracked by viewing the monthly report cards found within SecureCare’s Provider Portal. Re-tiering of the network will occur annually based on the commercial allowed dollars per patient measurement. Each February, SecureCare will distribute the new tier parameters to allow providers to prepare for re-tiering in November.
The new tiering parameters are:
- Tier 1 if the average allowed dollars per patient is below $183.
- Tier 2 if the average allowed dollars per patient is between $183 and $388.
- Tier 3 and be identified as an outlier if the average allowed dollars per patient is $388 or greater.
In addition to the allowed dollars per patient criteria listed above, a required annual educational component must be completed by all providers in a Tier 1 clinic. This year’s education component, Establishing Medical Necessity Through Proper Coding and Documentation, is a 45-minute webinar with a short quiz to follow. Specific details regarding the webinar will be emailed to expected Tier 1 providers in the coming weeks and must be completed prior to October 31, 2020. Providers who do not complete the course in the allowed time frame will have their entire clinic dropped to a Tier 2 status.
SecureCare is also pleased to announce that effective July 15, 2020, we are moving to a simplified, flat $1.25 per- CPT rate. In addition, report cards and invoice information will now be posted on or around the 15th of every month beginning in July 2020. No action is required by providers. SecureCare will continue to send an email notification when a new invoice has been posted to your account. If you are on autopay, those payments will run between the 20th and the 25th of each month.
We are excited about these changes and will continue to advocate for additional network improvements. If you have questions about the re-tiering process or need help accessing your report card date, please contact us at email@example.com.