$469K in past medical claims won for members

When the TA moved our health coverage from GHI to Empire in 2011, our contract said they had to keep our benefits the same or better. But, some parts of our coverage were not the same. One by one, Local 100 has been fighting to ensure our full benefits are maintained — and we’re winning.

An important win is coverage for clinic visits. We  had always been covered for care in a hospital clinic. Under Empire, however, claims for clinic visits had been denied.

As a result of a contract grievance brought last year by Local 100, the  TA has instructed Empire to cover services provided at clinics and to reprocess all previous claims which were previously denied for this reason. They have also provided the Union with a full report.

The bottom line? 655 members have been saved bills totaling $469 thousand. Did you have a claim for clinic service denied by Empire BC/BS? If so, has it been reprocessed and covered by Empire? If not, contact the Union’s Member Services Department at 347-643-8065.