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7/29/2013 at 6:59:15 PM GMT
Posts: 9
Blue Cross Blue Shield
GAMES has received reports from members across the state that they are getting new BCBS fee schedules in the mail this week.  Some say the fee schedule resembles the Competitive Bid rates for the Atlanta area.  Use this topic area to discuss what you believe the association and providers in the state should do next. Request a meeting with BCBS? A letter writing campaign? What is the best argument against the lower fees? (Remember our Antitrust policy)


Last edited Monday, July 29, 2013
7/31/2013 at 5:01:44 PM GMT
Posts: 3
Sent this message to a couple of reporters at the AJC today:

Daniel and Carrie, Just wanted to let you know that CB has had another negative impact on Georgia providers. BCBS was awarded the DCH SHBP contract and this week notified providers that they will implement the CB rates effective November 1, 2013. State Health and BCBS clients just had their benefits reduced by 50%. If you are State Employee or have BCBS insurance be prepared to see reduction in quality of care. Does anyone really believe that there is 50% profit in the HME industry or that they will receive the same level of care for half off.


7/31/2013 at 9:13:32 PM GMT

Do you mind if we steal this and start spreading the word?




8/1/2013 at 2:30:57 PM GMT
BCBS

I just spent an hour on the phone with Lori White at BCBS.  Her claim is that Competitive bidding had little do do with the reduction in rates. She also went on to say that she would be shocked if other ins. didn't quickly follow suit.

I told her that the negative impact on her members would be devastating, especially in rural areas that were not in bid areas.

I am following up in writing with Ms. White, and will link a copy of my letter in the forum, in the meantime i expect all GA providers to give her a call and politely let Ms. White know that she can expect a huge push-back from us as individual members and as a State organization.

It seems to me that the only bargaining chip we have are our customers who are BCBS members... perhaps we deal with their bureaucracy first (BCBS),  and if we don't get the concessions we desire we start a phone call/letter writing campaign from our BCBS customers. Outraged customers are the only power we have in this matter.




8/1/2013 at 3:20:54 PM GMT
BCBS Letter

attached is the letter I sent to BCBS this morning. 

Feel free to copy it and edit as needed to suit your needs.

 



 Attached Files: 
BCBS.docx (15.71 KB)

9/12/2013 at 2:28:56 PM GMT
Posts: 9
GAMES Board sends letter to BCBS of GA
Following the August 1, 2013 letter from Blue Cross Blue Shield of Georgia announcing a new fee schedule
effective November 1, 2013, the GAMES office received numerous emails and phone calls from members
asking the question "How will we be able to provide quality healthcare services to these patients with such huge
reductions in payment?” The calls were so heartfelt and distressing, the GAMES Board resolved to address
this issue with Blue Cross Blue Shield of Georgia directly.

The letter is attached here.  Please let us know if you are successful in reaching out to BCBSGa.

(Please remember GAMES antitrust policy - no discussions of price fixing, boycotts or other violations of state and federal antitrust laws will be tolerated.)

 Attached Files: 

Last edited Thursday, September 12, 2013
9/12/2013 at 8:03:12 PM GMT
BCBS rates

It really shows how much they care about their subscribers. Why don't they do the same thing with Doctors and hospitals and other providers that take care of BCBS patients?? Why only the DME providers? What math did they use to come up with these extraordinary cuts?? What choice do we have?? I applaud the letter from Teresa on our behalf but I am of the opinion that begging will not produce results. BCBS should now know for a fact that their patients will get the cheapest equipment providers can find and as little service as they can possibly provide. That is reality, no one will willfully lose money to care or provide equipment to BCBS patients??

I doubt if BCBS will even reply. I would like our association to be more united in taking action that we can all support. Severe action on our part might include not servicing BCBS patients. Let's follow the example of medical doctors, they have been able to keep their Medicare rates for only one reason. They are organized and carry a big stick.



9/17/2013 at 2:17:21 PM GMT
Posts: 3
BCBS
We have a member going out of business that has 288 PAP rental and supply patients the company acquiring their PAP patients is not in network with BCBS and rates actually 38% off Medicare allowed no one will take these patients at these rates beginning October. As for my company we have physicians that order Home Sleep Test and then Auto Titrating PAPs which cost significantly more than generic PAP. devices. This is the same for all products though whether we are talking Oxygen, PAP, DME, Apnea Monitors, etc. the rates are ridiculously low and BCBS providers will see a reduction in quality of equipment and services for sure.


9/17/2013 at 2:51:30 PM GMT
BCBS

Teresa I thought the letter addressed the major issues, many cost greater than reimbursement,

servicing the rural population with higher operating expenses, finding cheaper products that will not meet or

standards of serving the patient, not enough margins to cover a standard of care the patient deserves from their DME

provider. CMS and BCBS is not concerned with quality care. They are only looking at their shareholders and the bottom line.

There is one thing for certain, I don't know how we are going to do it, but we are going to have,( excuse me Teresa), man up and grow a pair or all of our bottom lines will be RED!

Thanks

Johnny Carroll  



9/17/2013 at 5:17:25 PM GMT
Posts: 0
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