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Tag: Blue Cross Blue Shield


News

Private pay rates below bid rates

October 25, 2013Theresa Flaherty, Managing Editor

BlueCross BlueShield in several states plans to implement new payment rates this fall that look a lot like the Round 2 bid rates, and in some cases, worse.“They cut rates about 40%,” said Todd Tyson, founder of Hi-Tech Healthcare in Norcross, Ga., where the new fee schedule goes into effect Nov. 1. “In some cases, the rates are 6% to 8% below the Round 2 bid rates.”The single payment amounts for Round 2, implemented July 1, are, on average, 45% lower than the Medicare fee...

Blue Cross Blue Shield, private pay, Round 2 competitive bidding


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Also Noted

Insurer, provider take 'new approach' to care

August 6, 2013HME News Staff

MINNEAPOLIS - Blue Cross Blue Shield of Minnesota and the Allina Integrated Medical Network of Allina Health have partnered on a new health plan focused on greater patient engagement, collaborative clinical care management between the plan and providers, and guided patient care services. Care options for the plan, called BluePrint, will encompass the extensive services available through the Allina Integrated Medical Network, including specialty care practices providing oxygen and home medical equipment....

Allina Health, Blue Cross Blue Shield, Home Medical Equipment


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Lesser of two evils

May 17, 2013Liz Beaulieu, Editor

YARMOUTH, Maine - Some Medicare Advantage (MA) plans are starting to look more and more like traditional Medicare, industry sources say.In the wake of CMS's announcement of the Round 2 payment amounts, a Blue Cross Blue Shield MA plan in one state, for example, has shaved 10% off its reimbursement for HME. Another plan going in that direction: Windsor, says Tyler Poole.“We anticipated this,” said Poole, vice president of operations for Benefits365, a company that helps providers shift...

Banner Home Care, Benefits 365, Blue Cross Blue Shield, CBO, CMS, dme, hme, Medicare Advantage, MiraVista


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News

Blue Cross draws billing boundaries

November 26, 2012Theresa Flaherty, Managing Editor

A policy change by one of the nation's largest insurers has some HME providers feeling the blues, say industry stakeholders.In October, Blue Cross Blue Shield (BCBS) began requiring providers to bill the insurance plan for the state in which the subscriber—the patient—is located.“Historically, providers have always billed their home state for every patient they service, but now they are not allowed to do that,” said Sylvia Toscano, owner of Professional Medical Administrators....

Blue Cross Blue Shield, durable medical equipment, Home Medical Equipment


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Alabama: Providers roll with changes

November 23, 2010Liz Beaulieu, Editor

MONTGOMERY, Ala. - HME providers in Alabama are taking in stride recent changes to Medicaid and Blue Cross Blue Shield. In October, the state's Medicaid program became the second in the country to require that certain HME providers obtain surety bonds, according to Michael Hamilton, executive director of the Alabama Durable Medical Equipment Association (ADMEA). The first: Florida. "We negotiated exemptions for most of our members, so we did good," he said. Exemptions include HME providers who...

Blue Cross Blue Shield, surety bond


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Tennessee: New BCBS contract shocks providers

September 26, 2010Liz Beaulieu, Editor

NASHVILLE, Tenn. - Tennessee is the latest state where BlueCross BlueShield (BCBS) is wreaking havoc on HME providers. To cut costs, Volunteer State Health Plan, a subsidiary of BlueCross BlueShield of Tennessee and one of three managed care organizations to administer benefits for TennCare, the state's Medicaid program, recently signed a contract with CareCentrix to handle DME claims. In turn, CareCentrix wants to pay DME providers, on average, 15% less than they're currently getting paid, according...

Blue Cross Blue Shield, CareCentrix, reimbursement cuts


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