The Association of New Jersey Chiropractors announced Monday that the state Department of Banking & Insurance has ruled the state's largest health insurer must pay chiropractors' separate claims for patient evaluation and therapy.

The association said Horizon Blue Cross Blue Shield had been bundling the claims into reimbursements for general chiropractic treatment, subjecting them to the limits of that single claim and effectively denying them.

As a result of DOBI Commissioner Neil N. Jasey's Oct. 7 cease-and-desist order, "chiropractors throughout the state can immediately begin filing reimbursement claims for these services, which must be individually reviewed and reimbursed by Horizon rather than being denied across the board," the association said in a statement.

Horizon released its own statement a few hours later: "Horizon Blue Cross Blue Shield of New Jersey has received the decision that was rendered by the state of New Jersey's Department of Banking and Insurance. Horizon BCBSNJ is in the process of reviewing and analyzing the ruling."

A spokesman for Horizon said the statement would probably be the only comment the Newark-based non-profit organization would make on the matter Monday.

The key to the ruling, the association said, was that Horizon treated other health care providers differently, which was referenced specifically by Jasey: "The fact that in other disciplines comparable services are billed separately and compensated separately is probative (ie., provides proof) on the question of whether Horizon's blanket policy of including multiple services performed by a licensed chiropractor in a single visit in one 'global fee' for (chiropractic manipulative treatment) services is appropriate."

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