ERISA or maybe TPA?

Let’s play pretend:

Some one gives you this card and wants to make an appointment. 

They seem to want an answer right now. 

You know your physician takes Blue Choice, but have never seen this card before. How would you know?

Look at the front of the card. Blue Cross is written all over it. BCBS must be the insurer?           STOP!

Do you see any insurance regulation language? Is “TDI” or “DOI” on this card? 

NO. This is your 1st clue.  The employer may be the insurer. 

Scan the front of the card intently. Are there any other clues. Look for what you know, not what you don’t know. 

If not flip it over. What do you see? READ ALL THE TINY WRITING. 

On this card: phone numbers, addresses, where to file, prior auth info. But what else? 

“This coverage is self-funded Excellus BlueCross BlueShield, and independent licensee of the BlueCross BlueShield Association provides administrative claims payment services only and does not assume any financial risk or obligation with respect to claims.”

What does that mean: 

  • The employer is the insurer (self-funded plan) 
  • Excellus BCBS is acting as a Third-Party Administrator (TPA)

Is this a Lease Network?

Very likely — yes.

On the front of the card it says:

“To verify participation, please call the BlueCard Provider Network.”

That suggests:

  • The plan is using the BlueCard network
  • Excellus is providing network access + claims processing. The employer is leasing the BCBS network
  • That’s what we commonly call a lease network arrangement.

But — this is important — don’t assume, Verify

Why you may still get a “Yes” when you call

When you call provider services:

  • The rep may simply see “In Network”
  • They may not understand lease networks
  • They may not understand the difference between:
    • Payor
    • TPA
    • Repricer
    • Network administrator

So we need to ask better questions.

Instead of just asking “Is Dr. Smith in network?”

Tell the representative you would like to check network participation. 

Ask:

  • Is this plan self-funded? (if it is self-funded it is not a lease network)
  • Is Excellus the payor, or the administrator?
  • Is this a leased network?
  • Who bears the financial risk?
  • Is Excellus repricing the claims?
  • What network applies to this patient?

And always get:

✔ Representative name
✔ Date/time
✔ Call reference number

If the claim denies, that reference number becomes your leverage.

Why this matters

In lease network plans:

  • The employer controls the benefits.
  • The employer may carve out services.
  • The employer may override network rules.
  • The plan can be patient-specific.

Basically they can make up their own rules.

In practical terms — They have more flexibility than a fully insured DOI-regulated plan.

Protect Yourself when speaking to the patient. 

Never speak in absolutes.

Use language like:

  • “It looks like this is a self-funded plan…”
  • “Based on the card wording…”
  • “According to the representative I spoke with…”
  • “At the time of verification…”

Never say:

  • “Yes, you are definitely covered.”
  • “This will pay.”
  • “You are in network.”

 

We verify participation, not payment guarantees.

HealthSpring Plans by County

POET staff has done everything short of a full skeletal reconstruction to make the HealthSpring county page in the provider manual legible. They’ve stretched it. They’ve shrunk it. They’ve even converted it to Word and back to a PNG. It just didn’t have the backbone it needed.

If we were tibia honest, nothing worked.

So I, Sir Seymore Bones — resident WordPress writer and part-time osteo-optimizer — took pen in hand (metacarpals and all) to give everyone a little relief. When the formatting started rattling, I decided it was time to get to the bare bones of the issue.

I hope the map below helps you Sey-more, and make sense of the plans offered in our counties. We femur-ly believe this version is better. If it doesn’t… well, I promise I didn’t bone it up on purpose.

Stay humerus,
Sir Seymore Bones

CMS-1500 vs Electronic Claims (837P)

What is a HCFA anyway?

POET understands, not everyone is a biller, and we might be throwing out alphabet soup to some office personal.

What is a CMS-1500 (HCFA) Form?

The CMS-1500, often still called a HCFA, is the standard paper form used to bill insurance companies for professional services provided by physicians and other healthcare providers.

It tells the insurance company:

  • Who the patient is

  • Who the provider is

  • What services were performed

  • When the services occurred

  • Why they were medically necessary

  • How much is being charged

What is Used When Claims Are Filed Electronically?

When an office files claims electronically, the equivalent of the CMS-1500 form is an: ANSI 837P Claim

  • 837 = electronic claim format

  • P = Professional services

The 837P contains the same information as a CMS-1500, just in a computer-readable format instead of paper.

Why Staff May Not “See” an 837P

  • The billing software creates it automatically

  • It is sent through a clearinghouse

  • Insurance companies process it behind the scenes

Most staff interact with screens and reports, not the actual electronic file.

If You Need to See a “Paper Copy” of an 837P

An 837P does not have a true paper form. However, billing systems can produce a claim print image or CMS-1500-style report that shows the same data contained in the electronic claim.

This is often called:

  • Claim print image

  • CMS-1500 claim view

  • Electronic claim summary

These reports are used for: (Why POET would request it)

  • Reviewing what was sent

  • Troubleshooting rejections or denials

  • Sharing claim details with non-billing staff

Important: This is a readable representation of the 837P data — not the actual electronic file.

To see the raw 837P file itself, billing staff would need to export or view it through the billing system or clearinghouse.

Disclaimer: The information provided in this blog is for general educational purposes only. While Ink strives to explain insurance concepts accurately and clearly, payer rules, contracts, and policies can vary widely by plan, state, and provider agreement—and they change frequently.

This content should not be interpreted as definitive guidance or a substitute for reviewing payer manuals, contracts, or official communications. Physician offices are encouraged to conduct their own research and verify requirements directly with the applicable insurance carriers before making operational or billing decisions.

NEW BCBSTX fee schedule coming

ATTENTION PROVIDERS

BCBSTX has notified POET that a NEW Fee Schedule for Blue Choice and Blue Essentials will be effective May 1, 2026.

Once POET receives the new fee schedule and completes its review, OPT-IN / OPT-OUT packets will be sent to physician offices for participation decisions.

Please watch for additional communication once the review process is complete

HealthSpring has a New Payor ID

PAYOR ID: 52192

Claims Address for paper claims: P.O. Box 23456 Chattanooga, TN. 37421  

More on HealthSpring and CPL

Update: POET has been advised that the issue involving HealthSpring, CPL, and Polk County is related to a claims system error. HealthSpring has confirmed that they are currently in contract with CPL, and the issue is actively being worked on.

POET we keep you updated, as we receive information. 

CPL Labs and HealthSpring

Just in from HealthSpring!

In Polk County, CPL Labs are not in network.

HealthSpring patients in Polk County should go to Quest or LabCorp. 

BCBS Pharmacy Qtrly Updates for January 2026

Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2026 – Part 1

The Definition of G0136 is Changing

Another Great Article from CodingIntel

November 2025

Dear Friends and Colleagues,

CMS is changing the definition of HCPCS code G0136. They are keeping the code and the valuation of the code. The code is staying on the telehealth list. But there is a completely new definition.
 
Between now and 12/31/2025, G0136 is for an assessment of a patient in the areas of social determinants of health (SDoH). On 1/1/2025, G0136 is defined as the assessment of physical activity and nutrition.
 
New definition
G0136 “Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months.”

  • This service is not intended to be a screening for every patient. It is to be performed when there are known or suspected needs related to the patient’s physical activity level and nutrition.
  • The service is payable when both a physical activity and nutrition assessment are performed, “…or when either a physical activity or risk assessment is performed if there is a clinical scenario where only one is reasonable and necessary. For example, if a beneficiary has recently started a new diet but their physical activity levels have not been assessed, only a physical activity risk assessment may be reasonable and necessary.”
  • It can be billed at the same encounter as an E/M service, an annual wellness visit, 90791 psychiatric diagnostic evaluation, and health behavior assessment codes 96156, 96158, 96159, 96164, 96165, 96167, and 96168.  What about 90792? The final rule does not list it as one of the base codes for G0136.
  • When performed on the day of an annual wellness visit, there is no patient due amount. When performed on the day of any of the other visits listed, it will be subject to the deductible and co-pay.
  • There is a frequency limit of once per six months per practitioner per beneficiary. 

What’s required? In the definition, it says administration of a standardized evidence-based assessment. CMS is not requiring a specific assessment tool but gives examples of those tools. Those are listed below. Notice that it says 5 to 15 minutes. I would suggest documenting the time of the assessment, distinct from the other services. When time is listed in a CPT® or HCPCS code, document the time spent. I believe this assessment will be done by auxiliary staff, although how that is managed in the work flow when it is done after the practitioner assesses a need, I don’t know.
 
RHCs and FQHCs  G0136 may be performed in an RHC or an FQHC, but will not result in additional reimbursement when performed on the same day as another service. It is not considered a qualifying visit in an FQHC, so if it is the only service performed on that date of service, there is no reimbursement for it.
 
Examples of evidence-based tools to assess nutrition include, but are not limited to, the Mini-EAT tool, the Starting the Conversation: Diet tool, and Short Dietary Assessment Instruments. Examples of evidence-based tools to assess physical activity include, but are not limited to, the Physical Activity Vital Sign tool, the CHAMPS Physical Activity Questionnaire for Older Adults, and the Rapid Assessment of Physical Activity (RAPA) or Telephone Assessment of Physical Activity (TAPA).
 
CMS 2026 Physician Fee Schedule Final Rule, [CMS-1832-F]  Display copy, pp 459–465

Enjoy fall,
Betsy

CodingIntel by Betsy Nicoletti

Highlights for Aetna OfficeLink Updates

Claim and Code Review Program (CCRP) update

Starting December 1, you might see new claim edits

This update applies to both our commercial and Medicare members. 

Beginning December 1, 2025, you may see new claim edits. These are part of our CCRP. These edits support our continuing effort to process claims accurately for our commercial, Medicare and Student Health members. You can view these edits on our provider portal on Availity. 

For coding changes, go to Aetna Payer Spaces > Resources. In the search bar, search for “expanded claim edits.” 

Except for Student Health, you’ll also have access to our code edit lookup tools. To find out if our new claim edits will apply to your claim, log in to Availity®. You’ll need to know your Aetna® provider ID number (PIN) to access our code edit lookup tools. 

We may request medical records for certain claims, such as high-dollar claims, implant claims, anesthesia claims, and bundled services claims, to help confirm coding accuracy.

Changes to our National Precertification List (NPL)

These changes apply to our commercial and Medicare members, unless otherwise noted.

Effective January 1, 2026, we’ll require precertification for the following:

• Electrophysiological (EP) study (93654)

• Yondelis® (trabectedin, J9352)

• Docivyx™ (docetaxel, J9172) — Medicare members only

Check out the Original Publication, titles like: 

  • How to secure an authorization
  • Urgent requests
  • Changes to commercial drug lists begin on January 1
  • And More

Follow this Link.