PBC Changes to Reimbursement Process Reversed

Effective February 1, 2020, Pacific Blue Cross (PBC) changed their business practices to ensure the reasonable and customary (R&C) claim limits are followed when coordinating reimbursement between benefit plans. This change is to align with the Canadian Life and Health Insurance Association (CLHIA) guidelines and industry best practice. This reimbursement practice was applied to all PBC benefit plans and was not negotiated by the union.

BCNU has heard from members concerned about changes to how their claims are being reimbursed and we are working with PBC to understand the issues and impact on BCNU members. While we investigate further, PBC will delay implementation of their change in practice for all members under the Nurses' Bargaining Association (NBA) provincial collective agreement. NBA members' coordinated claims will be processed as they were prior to February 1, and members who have paid out-of-pocket as a result of the change will be reimbursed by PBC.

PBC is in the process of re-adjudicating claims for members impacted by the change made February 1. To expedite the reimbursement process for BCNU members who may have experienced significant impact as a result of the changes, members may email their contact information and PBC ID number to the BCNU Benefits team at benefitsreview@bcnu.org.