Blue Shield amending physician TriWest contracts

January 11, 2013
Area(s) of Interest: Payor Contracting 

On December 31, Blue Shield notified physicians in the TriCare network that it is amending its TriWest contract effective February 1, 2013. While the Department of Defense awarded the TriCare West Region contract to United Healthcare effective April 1, 2013, according to the notice Blue Shield is amending its contract as it is “exploring other opportunities to continue to serve military and veteran customers.”

The notice does not provide specific information about which product types this may include, nor does it provide any information about the potential volume of enrollees any new products may include.

Though not stated in the notice, physicians who do not wish to be included in these new products have the right to terminate the underlying TriWest contract with Blue Shield. Physicians who wish to terminate the contract are encouraged to submit their termination notices prior to the March 31 transition of TriCare. Termination notices must be submitted in writing and the California Medical Association (CMA) recommends sending such notices via certified mail, return receipt, to:

TRICARE Network Services
Blue Shield of California
4201 Town Center Blvd.
El Dorado Hills, CA 95762

Physicians with questions about the notice can contact Blue Shield directly at (866) 296-8744.

Contact: CMA’s reimbursement helpline, (888) 401-5911 or kmarck@cmadocs.org.


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