BlueLincs HMO—Licensed Professional Counselor Member Benefit Coverage
What’s the Issue?
Blue Cross and Blue Shield of Oklahoma (BCBSOK) recently discovered that Licensed Professional Counselor (LPC) services are not displaying and processing as a covered benefit for BlueLincs HMO members, even when the member’s plan includes LPC benefits. When a provider checks eligibility and benefits through a digital vendor, it may appear as if the service is not covered. That is incorrect. BCBSOK is working to fix the issue and is placing a hold on LPC claims with dates of service starting June 1, 2020 and going forward. Claims will be manually reviewed to ensure that claims for this provider type are processed correctly. We will also reprocess any applicable LPC claims that were inappropriately denied due to this issue as well.
What do I need to do?
LPC providers in the BlueLincs HMO network should call the number on the back of the member’s ID card to verify eligibility and benefits.
When will there be a solution?
BCBSOK is working to resolve the issue as quickly as possible and anticipates that the automated solution for both quoting systems and claims processing will be in place by July 31, 2020.
For Additional Questions
Contact Provider Services at 800-496-5774 and speak with a Customer Advocate.