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Nurse Practitioner Alliance of Alabama

Physical Therapy and Blue Cross Blue Shield Reimbursement

Posted over 4 years ago by Joy Deupree

Fellow Nurse Practitioners:

Last year, through legislation CRNPs were approved to write referrals for his/her patients to have physical therapy. There were reports that were forwarded to me that in some cases patients were denied reimbursement or coverage of these services unless the collaborative physician signed off on the order.

I recently made contact with one of the BCBS reps and relayed to her our dilemma. She asked that I find out specifically who the CRNPs were and where they practice so that she can find out whom the case manager of those claims might be. She felt like it was something that was a mistake in the claim and genuinely expressed desire to help correct the process if indeed the claims are being denied.

I need your help. Please forward me any information you have related to the above situation so I can forward her a short report of where this practice is happening. The sooner the better, but I will allow up until October 10th for you to send me that information. I do not need the name of the patient as that would be a HIPAA violation.

Thank you!

Joy P. Deupree, PhD, MSN, APRN-BC
President, NPAA or 205-601-4141