The following files contain information regarding the Blues Settlement.  Download the files by right clicking and choosing SAVE TARGET AS... and then choose the location you wish to save them. 

 

-------------------------------------------------------------------------------

November 2008:  The Blue Cross Blue Shield Settlement Billing Dispute External Review Board (BDERB) will be operational beginning November 21, 2008. The dispute process is available to MDs and DOs who are class members (and did not opt out) of the Love, et al v. BCBSA, et al Settlement dated April 27, 2007.

 

For the relevant instructions and forms, please click here beginning Friday, November 21, 2008.

 

The BDERB is a national independent review organization contracted to review billing disputes submitted by an MD or DO. You do not have to participate with a settling Blue Cross Blue Shield Plan to submit a billing dispute to BDERB (for a complete list of settling Blue Cross Blue Shield Plans, please click here; however, your billing dispute must arise from services provided to members of a settling Blue Cross Blue Shield Plan.

 

Requirements To Dispute A Blue Cross Blue Shield Decision Using the BDERB:

• You must be a class member who did not opt out of the Love, et al v. BCBSA, et al Settlement.

• You must have exhausted all internal billing dispute processes of the settling Blue Cross Blue Shield Plan including appeals.

• Your dispute must arise from denial of payment for services provided to members of a settling Blue Cross Blue Shield Plan.

• Billing dispute amount must:

a)      exceed $500 as a single dispute; OR

b)      be multiple disputes filed within a 1-year period from the filing of the original billing dispute must exceed $500 as an aggregate amount (for more information about this process, see section 7.10(c) of the Settlement Agreement – click here for Settlement Agreement).

• You must have initiated a provider billing dispute with your Blue Cross Blue Shield Plan and received a written response that you wish to have reconsidered.

• The dispute must be filed within 90 calendar days of the date of the final Blue Cross Blue Shield denial notification letter.

• You must complete the Blue Cross Blue Shield Dispute Form and the BDERB Dispute Resolution Agreement for each dispute and return to the settling Blue Cross Blue Shield with all required documentation including the original denial notification.

• You must submit the proper filing fee (payment methods include American Express, MasterCard, Visa (debit or credit), and check). Please note the filing fee will not be charged until the $500 threshold billing dispute amount is reached.

-------------------------------------------------------------------------------

Court Orders & Settlement Agreement Documents

• Oder Approving Settlement (April 20, 2008)
• Preliminary Order of Approval
• Motion of Approval & Joinder in the Settlement Agreement
• Order Approving Joinder in the Settlement Agreement
• Joinder in Settlement Agreement
• Settlement Agreement
  • Exhibit A: Claim Form
  • Exhibit B: Claim Form Instructions
  • Exhibit C: Compliance Dispute Form
  • Exhibit D1: Settlement Order
  • Exhibit D2: Judgment Dismissing Certain Defendant Blue Parties with Prejudice
  • Exhibit E: Notice of Proposed Settlement to Class Members
  • Exhibit F: Preliminary Order and Setting Form & Content of Notice
  • Exhibit G: Notice of Proposed Settlement
  • Exhibit H: Party Specific Provisions
  • Exhibit I: Implementation Dates of BCBS Obligations
  • Exhibit J - Settlement Agreement
  • Exhibit K: Settlement Fund Amounts
  • Exhibit L: List of Charitable Organizations
  • Exhibit M: List of Parties Making Payments to Representative Plaintiffs in Other Actions
  • Exhibit N: Tag-Along Actions
  • Exhibit O: Agreed Terms of Potential Discovery from BCBSA
  • Exhibit P: List of Blue Parties Utilizing Individual Compliance Dispute Program
  • Exhibit Q: List of Blue Parties Utilizing Individual Compliance Reporting Program

Mailed Notice & Documents

• Notice of Proposed Settlement / Spanish version
• Claim Form
• Claim Form Instructions

 

For additional information and/or documents, please visit:
HMO SETTLEMENTS.COM