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Concierge medical care violates the terms of your provider agreement with Independence Blue Cross​

December 20, 2022

​Our top priority at Independence Blue Cross (Independence) is making sure that members have equitable access to quality care and affordable health coverage. We believe that all our members should be able to access the doctors and hospitals in our network without having to pay more than their health benefits require to receive medically necessary care.

Hence this reminder: Participating Providers who require patients, including our members, to pay a designated fee (e.g., annual membership fees and/or other surcharges) for Covered Services to remain in their care are in violation of their Independence Professional Provider Agreement (Agreement) and are subject to termination from the Independence network.

This is typically referred to as concierge medical care, or retainer medicine, and is in violation of your Agreement.

Participating Providers are required to comply with the terms and conditions of their Agreement, which requires them to accept Independence's payment as payment in full for all Covered Services.

Covered Services include:

  • well-patient visits
  • emergency telephone consultation available 24 hours a day, seven days a week
  • treatment of acute conditions
  • coordination of medically necessary care
  • referrals to appropriate specialists for treatment

Under your Agreement, it's mandatory that you provide Covered Services during normal business hours, in addition to 24/7 telephone access for consultation on medical concerns and emergencies.

This policy was updated in the Provider Manual for Participating Professional Providers – Independence Blue Cross in November 2022.

If you have any questions, review your contract or contact your Network Coordinator.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
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