Name of Manual - Blue Cross and Blue Shield of Minnesota

Claims Filing
Direct Supervision The physician must be present in the office suite and immediately
available to assist and direct throughout the performance of the
service. Direct personal supervision does not mean that the
physician must be present in the same room with the non-physician
practitioner. A physician cannot provide direct or personal
supervision via telemedicine. Direct supervision is only applicable
in the office place of service.
General Supervision General supervision refers to services furnished under the
physician’s overall direction and supervision. The physician does
not have to be physically present in the same office suite. He or
she may provide general supervision by periodic review of the
non-physician’s practice and availability either in person or
through electronic communications (telemedicine, telephone, etc.).
Collaboration/
Independent Practice
Chiropractic Doctors
and Multidisciplinary
Clinics
Certain practitioners are qualified to set up their own practice.
Although these practitioners work independently and do not
require physician supervision, they must work with or collaborate
with a physician. For example, a physical therapist may perform
therapy independently; however, the patient’s physician makes the
initial determination that the patient requires or will benefit from
physical therapy. The physical therapist works in collaboration
with the physician.
Chiropractic doctors must maintain separate provider contracts and
provider numbers when practicing in a multidisciplinary clinic
setting with medical doctors. Blue Cross does not allow
chiropractors to bill services as “incident to” a physician’s
services. Services performed by a chiropractor must bill under the
chiropractor’s own provider number.
The assignment of a chiropractic provider number is fundamental
to the appropriate processing of our member and provider
contracts. It allows Blue Cross to identify the specialty of the
individual providing the services. This is especially important to
enable Blue Cross to correctly administer those contracts that have
visit limitations, exclusions and other benefit variances.
A multidisciplinary clinic with medical and chiropractic doctors
must adhere to this requirement that independently licensed
chiropractors must maintain separate provider contracts with Blue
Cross and bill appropriately. There are no exceptions to this policy.
Any deviation from this billing requirement is a violation of the
Blue Cross participating agreement.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (05/10/12) 8-45