Blue Card

[Anonymous]

How is your lab getting around this ?????

 

[Anonymous]

suck it up and get your resume ready

 

[Anonymous]

How is your lab getting around this ?????

The only way to "get around" it is to convince each Blues plan that your services are medically necessary AND unavailable from any of their currently contracted labs. You don't do that, you aren't going to be in-network.

Speaking as the eprsonat one of those Blues plans that's hearing from dozens of you labs, I can say that I'm turning away all of you, as I have yet to see any lab offering necessary testing that can't be offered by LabCorp, Quest, Myriad, and Genomic Health combined.

Why do you think we started enforcing that BlueCard rule in the first place? We were sick of labs doing unnecessary, expensive testing and never having to justify their behavior to us as the Plan (and members) that ultimately had to pay your bills.

It's a brave new world - best to go find employment with a lab that knows how to justify its value to the payers...

 

[Anonymous]

Wow, it sounds like you really understand the BlueCard rules. Explain this: most of the employer groups have PPO or are self insured, which means they have out of network benefits. Generally, being out of network pays more. So you are saying you would rather pay more? (Then create an admistrative nightmare to patients, doctors, claims and network people). I've seen that some network people calling doctors, does that make sense? Someone should do a cost benefit on this practice. In most states, the Blues are on equal footing with the national Plans, therefore redirection efforts are usually unsuccessful. But good luck.

This doesn't address the fact that physicians have selected a lab based on the information it provides for their patients. The health plan is only to manage benefits and costs. My guess at the end of the year your lab costs will have increased because of the out of network payments. Also, you'll get tired of the national labs calling you every day because they want you to call an office on their behalf. (Insead of competing on products and service).

 

[Anonymous]

United Healthcare, Cigna and Aetna will be the next ones to drop the axe on this company! They will being going after them big time, look out the end is near once the offices get the heads up from these plans. No offices will be able to send to them in fear of getting hit hard by the insurance companies.