Question about BlueCrossBlueShield

[Bitwit1234]

The hospitals here in Minnesota are starting to not accept Blue Cross and Blue Shield. They say that they don't re-imburse them enough to pay for the coverage.

Can anybody tell me what is up with this..If you have insurance, now they won't accept that. Most of the others cost more and you have to pay more of the total bill.

I have Medicare, with BCBS as the back up. My hospital and doctor's office is still accepting it, but I see in the news that hospitals and doctors are going to drop Medicare because they are not re-imbursed enough. What is behind all this. Dropping people from accepting their insurance so, even tho insured, they have to pay the bills them self.

Has this happened in any of you'all's areas.

[acmavm]

1. BCBS sucks. It has always sucked. A lot of doctors won't take it

either.

[grasswire]

2. not good news!

Why don't you call BCBS and ask them about it directly. I'd like to know what they have to say.

[Mend]

3. listen to what happens to me as a doctor providing service....we submit the

claim to BC/BS or Humana or Aetna. THEY DO NOT PAY IT. Medicare keeps lowering the payment so that it doesn't cover the cost of providing treatment. That is true. There is always some excuse, some delay...months to over a year to receive reimbursement. So we switch and say to the patient, "you pay us at the time of service and we will submit the claim and you wait for the check". I am sorry you don't like it, we don't either but try working for nothing with an enormous overhead and imagine what you would do in our place. If you think you would give medical care for free, go back to school. You will need straight A's starting in high school, a very high score on the MCATs, and basically no freedom to do anything for 15 years while you train. Then in your mid-30's, you open a practice and to work to pay off your enormous educational debt and try to start having a life.

[zabet]

6. Aetna sucks ass!!!!!!!!! nt

[mmonk]

4. Some decide not to accept the negotiated rate.

For example, a doctor may charge $125 for something that BCBS only pays $68 for. If the doctor is part of the BCBS network, they agree to accept $68 for the procedure. I don't run into much problems because of it here in NC probably because they are the state's largest insurer.

[emilyg]

5. I have BCBS - never had a problem.

[sailor65]

7. Hasn't happened to us yet

so far (Here in Michigan), our BC is holding up pretty well. We have BC through me and HAP through my wife. We're finding that the prescription copays through BC are still a whole lot better than HAP and many others. I hope it stays that way.

Although it's probably not much comfort to you, I don't think it's BC's fault necessarily. It sounds like it's the providers themselves that are refusing to take it, rather than BC (Or Medicare) letting you down. The dynamics are going to get even more interesting, since doctors and hospitals have already been forced to reduce what prices they take for services based on the health insurance framework. Many of them are real unhappy about it, since some of them at least seem to think that their education and time spent entitles them to more than what they are able to charge, which is way off the scale when compared to other similarly educated professionals. When the healthcare system finally changes to whatever it's going to become (Nationalized, Socialized, call it what you like), providers will probably find themselves forced to reduce their pricing even more. A nationalized healthcare system will not reliably support the kind of price structure that exists today. That's when it will get interesting, because healthcare providers are going to have to find ways to become much more efficient, the same way we in other professions have had to. What worries me is that many will simply reduce the quality of their services instead.

[sallyseven]

8. I never had a problem. United Health

is getting bad reviews in RI. I have Blue Cross Blue shield of Mass medex, and Maybe it is the state regulations.

[dflprincess]

9. This is scary as BCBSMN is the biggest insurer in Minnesota

Do you know if this just applies to the Medicare supplement?

I know it's difficult for anyone who gets assistance for dental care to find a dentist that accepts the state program because it doesn't pay enough. On some procedures the dentist wouldn't break even with the payment.