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Dear Patient,
You are receiving this email because you may be eligible for some reimbursement of your health care claims. Specifically, legislators have recently called for Blue Cross Blue Shield of Illinois (BCBSIL) to reimburse patients who have been treated as out-of-network by BCBSIL for services provided by Springfield Clinic. These calls have come as the result of BCBSIL terminating Springfield Clinic as an in-network provider for their PPO members, and doing so without the required network adequacy to meet patient need. To be eligible for reimbursement, you may need to file a complaint with one of two regulatory agencies.
If you think your claim has been processed incorrectly by BCBSIL or if you’re having issues getting appointments with providers outside Springfield Clinic, we encourage you to take the following steps.
NOTE: Ask your HR administrator if your plan is fully-funded or self-funded so you know which path to take.
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Fully-Funded Plan
If you have a fully-funded plan, file a complaint with the Illinois Department of Insurance.
Contact via Email:
DOI.Complaints@illinois.gov
Call IDOI with questions: 877.527.9431 (Press 4 for health insurance questions.)
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Self-Funded Plan
If you have a self-funded plan, file a complaint with the U.S. Department of Labor.
Call Employee Benefits Security Administration (EBSA): 1.866.444.3272
(Press 2 to talk to your regional office.)
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REMINDER:
If you need help with this process, please contact the Springfield Clinic Patient Advocate Team at 217.391.7086 Monday-Friday, 8 a.m.- 5 p.m. with any questions about your bills or insurance claims.
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