October 2, 2020
Dear Members of the Arizona Society of Otolaryngology,
As you know, the Society has worked for years to advocate the acceptance of balloon sinus dilation codes by BCBSAZ. They have always considered those experimental/investigational.
I became President-Elect in 2015, and over the years, we have written numerous letters, sent information, and many of you have signed petitions, with the intent to have BCBSAZ cover these codes as medically necessary for appropriately selected patients. Well, we have good news! It came to our attention that BCBSAZ changed its coverage policy, and several weeks ago, our practice performed an in-office sinus procedure utilizing these codes. We did receive payment that seemed proper and consistent with non-facility payment schedules.It has always been our sincere hope that all AZ Society members are able to treat BCBSAZ patients with the same treatment options as anyone else, and that now appears to be the case. Questions regarding the prior authorization process should, of course, be directed to the plan itself.
This is great news for the patients covered by BCBSAZ and the physicians that care for them. The tireless advocacy on the Society’s behalf would not have been possible without all of your support along the way. Thank you for all that you do to care for our patients, and the Society stands behind you to advocate when challenges emerge, even (especially!) when it takes a long, long time.
Respectfully,
Daniel Charous, MD
AAO-HNS Political Action
https://www.entnet.org/content/legislative-political-affairs
AAO-HNS Regulatory Advocacy
