u/Lalapple

Bonus if affordable and washable. Toddler will be starting school once he turns 3yo. Shoe size currently hovering between toddler size 10 and little kids size 11. He has recurrent ingrown toenails and wide feet. At home we keep him barefoot or in sandals when going out. But school will only allow closed toe shoes.

I noticed while browsing online that as soon as the shoes transition from toddler to little kids sizes, the toe box becomes significantly narrower.

“Effective July 1, 2026, we’ll enhance our claims editing and review process for office, inpatient and outpatient evaluation and management services for our members with commercial plans. These editing enhancements for professional claims will help ensure accurate billing and proper reimbursement.

What’s changing: When we review your claim for dates of service beginning July 1, if services billed do not support the level of E&M services billed, your reimbursement will be for a lower level of service validated. We’ll follow the American Medical Association guidelines for level of service and medical decision-making.”

https://www.bcbstx.com/provider/education/education/news/2026/3-16-2026-claim-editing-changes-for-evaluation-and-management-services

How is this different from the Cigna downcoding policy?

Does anyone know if this only affects BCBS direct contracts or physicians / clinics in IPAs too?