Beginning January 1, 2010, the BlueCross BlueShield of South Carolina Federal Employee Plan will reward members when they complete either the adult Blue Health AssessmentSM or a child’s Body Mass Index (BMI) assessment. These programs encourage wellness and help remove barriers to health care.
If an adult member completes the Blue Health Assessment, the member will receive a certificate that entitles him or her to a preventive visit at no charge. The member will give his or her doctor the certificate instead of a copayment at his or her next annual physical exam. If the member has already had a physical exam, he or she can use the certificate for an individual preventive counseling visit at no charge. The member must use a preferred provider.
The second incentive targets children who complete a BMI assessment. After completing the BMI assessment, the member will receive a certificate. The certificate will cover copayments for up to four nutritional counseling visits. This incentive is limited to children ages 5 through 17 whose BMIs fall in the 85th percentile or higher, according to the Centers for Disease Control and Prevention (CDC) standards. Only children who meet these requirements will receive certificates.
If a member presents a certificate, please do not collect the copayment amount from the member at the time of visit. Our reimbursement for these visits will include the member’s copayment amount.
You can keep the certificate for your records. You do not need to submit it with the claim. Be sure to file the claim with the appropriate evaluation/management procedure code and diagnosis to reflect that the visit was a routine annual examination for adults. File claims for the children’s nutritional counseling visits with the appropriate nutritional counseling and diagnosis codes.
For more information, visit www.fepblue.org.