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BCBS of NY . . . Look out!

October 23, 2007 / 0 Comments / in Uncategorized / by Chip Hart

First, I just "love" messages like this:

Just met with the XXX Medicaid HMO and they may be willing to offer us fee for service...We will
see. Since 1993 we have not asked for a raise in capitation rates...

Sadly, that "1993" is no typo.

Anyway, we have immediate reports that the new fee schedules from BCBS of NY, while promising a price increase, actually represent a substantial overall decrease. It looks like they are performing the classic bait-and-switch: their E&Ms are, indeed, going up by 5%, but they are slashing other visits left and right. One PCC customer we're working with faces a 20-30% cut! [At those rates, you'd be better off simply dropping the plan.]

And here's what someone on PedTalk reports:

No Kidding! My overall well visit took a massive hit. They significantly lowered the fee for OAE (the one decent paying "procedure" we have) and dropped the fee for 99173 (vision screen) by a whopping (this is NOT a misprint) 96%, that's NINETY SIX PERCENT! Yes, they added 5% to the E&M (woohoo!) but the total reimbursement for a well visit is WAAAAAY down. :-(

Anyone else in NY with data?

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