Benefit changes for Ford Motor Company salaried employees

Beginning Jan. 1, 2015, Ford Motor Company salaried members will have the following benefit changes:

Autism coverage
Blue Cross Blue Shield of Michigan will cover rehabilitation therapy and Applied Behavioral Analysis services for members who have been diagnosed with autism spectrum disorder. However, members must receive approval for these services through Magellan.

Ambulatory Infusion Centers are an approved provider for Infusion Therapy.
This is not a benefit change but rather an additional location for members to receive
infusion therapy.

TheraMatrix no longer handling outpatient physical therapy benefits  
Blue Cross Blue Shield of Michigan will assume responsibility of processing all claims and handling the administrative responsibilities from TheraMatrix for employees who receive outpatient physical therapy services. In order for your claims to be paid, you will have to submit outpatient physical therapy claims to Blue Cross for processing.

This change will affect Ford Motor Company salaried employees who have these group numbers:

• 87251
• 87252
• 87254
• 87261
• 87262
• 87264
• 87271
• 87272
• 87274
• 87281
• 87282
• 87284
• 87290 to 87297

If you need to file a claim for a service performed prior to Jan. 1, 2015, contact TheraMatrix. TheraMatrix currently administers all outpatient physical therapy services for Ford Motor Company salaried employees who live in Michigan.

Blue Cross expects all care to be based on medical necessity and functional outcomes, and will reimburse all services rendered by health care providers according to the member benefit packages and to Blue Cross’s reimbursement and medical policies.

Blue Cross continues to contract with Landmark Healthcare Inc. to manage use of physical therapy. Landmark, together with Blue Cross, reviews use for PPO physical therapy providers with at least 10 episodes of care and places them into A, B or C categories, based on risk adjustment and peer means.

For questions or more information about this transition, please contact Blue Cross Blue Shield of Michigan Network Management at 248-448-6371 or your provider consultant.