Not An Exciting Topic -- But Could Impact Our Industry

[mikeymedic1984]

http://bostonherald.com/business/healthcare/view/20220924ambulance_operatorchasing_payments_amr_claims_blue_cross_members_owe_3m

Although this is an article from Massachussets, this is happening country-wide; your billing department may not have caught on to the problem yet. Blue Cross Blue Shield has pretty much taken the position of sending ambulance reimbursement checks to the patient instead of the ambulance provider, at a very discounted rate, if you are not a "preferred provider"(which means you have to sue most of them to get your money, as they spend it right away). To become a preferred provider you must agree to drop your rates to Medicare rates, which is usually means a loss for your company. I imagine other insurance companies will follow suit if BCBS remains successful at this practice.

If you are a 911 provider that is tax-payor supported, you probably do not care, but if you work for any type of corporate or private service this is a very scary tactic that could cripple our industry (if Obamacare does not do it first). Ask your billing department if they have noticed the drop in BCBS claims being reimbursed ?

But on the flip side, is it fair for BCBS to have to pay more for the same service than Medicare pays ?

[Just Plain Ruff]

This did not happen on the two ambulance transports that my wife had during her pregnancy. The payments were sent directly to the ambulance providers at deeply discounted rates to them which left us with 600.00 bills each time. What the hell do we have insurance for if the insurance carrier will only pay 35% of the ambulance transport? I may just put her in the car next time.

[ERDoc]

Our local insurance giant did this to our group and it hurt. We fought and fought and finally got a compromise, but much than before. They are now beating all of the other local ER groups into submission and have told them that they will not get the compromise that we got because we are the biggest group in half the state. Medicine is not run by the providers, it is run by the for-profit insurance companies and the govt.

As for Obamacare, our group is currently looking to see it's impact. The problem is that no one, even health care policy experts who mentally masturbate over this day after day, understand all of the repercussions. How will ACOs affect private companies like the ER groups or private EMS? I guess time will tell.

[Just Plain Ruff]

Our local insurance giant did this to our group and it hurt. We fought and fought and finally got a compromise, but much than before. They are now beating all of the other local ER groups into submission and have told them that they will not get the compromise that we got because we are the biggest group in half the state. Medicine is not run by the providers, it is run by the for-profit insurance companies and the govt.

As for Obamacare, our group is currently looking to see it's impact. The problem is that no one, even health care policy experts who mentally masturbate over this day after day, understand all of the repercussions. How will ACOs affect private companies like the ER groups or private EMS? I guess time will tell.

When even those who supposedly wrote and run the ACO act and are the gate keepers are making this shit up on a day by day basis Doc, who the hell are we supposed to trust in telling us who to believe.

The AARP is head over heals in love with the ACO because they stand to make billions (maybe millions) in profits on the supplemental insurance plans that they will endorse that will help those supposed seniors out.

So until the ACO is fully implemented and Remember when Nancy Pelosi said "we have to pass the bill to see what's in it" she said the truth because even she who was right there in it and was one of the authors (I think but don't hold me to that), even those in congress who were bowing down to the altar of this bill and doing the dance to the bill, they didn't even know what was in it.

Listen, this bill is so huge and ginormous and there is no way that we will know how royally screwed that the american people really will be by this new law. Sure there are good things in it but I'm a pessimist and I'm very worried that the bad way way way way outweighs the good in this law.

I'm usually right in this kind of thing and I so hope not to be. but mark my words, we have not seen the true impact and won't see it for many years and by then it will be too late for many industries.

Unless your health insurer is very financially strong, unless your employer is willing to go to bat for your healthcare insurance plan that you have now, unless your ambulance service is willing to wade through thousands of pages of new regulations and billing requirements from the hundreds of insurers, you have not seen anything yet in how you do your job.

Buckle up guys, it's going to be a bumpy road.

[Resqmedic]

Speaking of Obamacare: Did anyone else have new polices set on part time workers not being able to work more than 30 hours in a week? I work at a fire department where our work week is 56 hours, and part time employees regularly pick up shifts in excess of 36 hours a week (won't hire more full time personnel obviously). In 2014 if a part time employee works more than 30 hours a week they are eligible for the employers health care benefits.

[Just Plain Ruff]

Yes

Speaking of Obamacare: Did anyone else have new polices set on part time workers not being able to work more than 30 hours in a week? I work at a fire department where our work week is 56 hours, and part time employees regularly pick up shifts in excess of 36 hours a week (won't hire more full time personnel obviously). In 2014 if a part time employee works more than 30 hours a week they are eligible for the employers health care benefits.

Yes several companies have made the news when they cut their employees hours from over 30 to 28 hours because they won't have to offer healthcare insurance if they work them less than 30 hours. Denny's in Florida(at least one owner of about 20 denny's) did this as well as he slapped a 5% surcharge on everyone's bill calling it a Obamacare surcharge.

Stryker the company who makes the ER cots and the ambulance cots we love so much has announced layoff's for next year (if the news is to be believed) due to the coming increases in premiums and other tax increases that will go into effect if the fiscal cliff is not averted(scam if you ask me the fiscal cliff).

There is more to come people. Hope some of us have a fallback plan.