The only thing worse than bad news is bad news you never saw coming. It happens in healthcare with balance, or surprise, billing. Also known as a pain in the rear. In this video (3:59), Blue Cross and Blue Shield of Louisiana healthcare economist Mike Bertaut explains what balance billing is and how you can avoid it.
One of my favorite sayings that my older relatives would bat around every time we went hunting, fishing, or enjoyed a football game and meal at their houses on a fall Sunday was this:
“Mike, that’s just short-term smart and long-term stupid! Stay away from it!” Read more
Oh, yes, the headlines were blaring at me recently: “New research shows the United States’ healthcare system came in LAST compared to the 10 best in the world!”
Of course, me being me, I couldn’t let THAT stand without digging into the details. Read more
Way back in 2009, when I went to Washington, D.C. on behalf of your Louisiana Blue Plan for the first time, I discovered some amazing things. You might call me a wide-eyed, first-timer in the Big City (even though I was already 48 years old!) as I met lobbyists, legislators, staffers for a bunch of influential people, and policymakers intent on writing what eventually became the Affordable Care Act. Read more
you don’t want to allow me to use my the right to chose my own out of network doctor (that I paid Blue Cross for)
NO MATTER HOW GOOD MY CHOSEN DOCTOR IS……….and that is immoral!
Paul!
In general, when you purchase an BCBSLA insurance product, either on your own or through your own employer, we state emphatically what you are purchasing in terms of network breadth and availability. IN addition, you can, at http://www.bcbsla.com enter your product and see every doctor and facility that has agreed to protect you from balance billing. We work hard to keep that list up to date and clear.
The problem becomes, when an in-network facility allows medical providers to touch their patients WITHOUT requiring they accept the same network agreements the hospital does.
Continuing this practice is not only horrible for consumers, it guarantees that no one treated will ever be able to safely say “I’m insured for that.”
You’ve seen the video. Since the medical community is not interested in solving this problem amicably, Congress will. And I’m comfortable no one will be happy with that solution.
Thanks for playing!…mrb
PS. This is a lie, there is already a law to prevent anesthesiologists from billing more than the contracted rate at a contracted hospital.
Paul!
I’d love to receive a cite to the law you mentioned here, I cannot find it. It would certainly benefit me personally to have been aware of such a law. Please send it to michael.bertaut@bcbsla.com.
thanks!…mrb
Excellent piece! Well done.
Well done. Also, it has been said, to me, ” the insurance provider “tells us” what they will pay for procedures/test etc… which is based on medicaid/medicare rates” That’s why you receive, from us, a bill for the difference. It would sure be nice to see all charges posted on-line or in each office for each service rendered.
Let them hear our voices.
If we do not stand up & fight back… We’re finished.