Practice Management
Blue Cross and Blue Shield says thousands of physicians continually break evolving North Carolina laws regarding prescriptions for opiates—but acknowledges the difficulties both of keeping track of those laws on the physicians’ part and enforcing them on the state’s part. The challenge may be especially great in regard to the NC STOP Act, which limits opioid prescriptions to 5 days for first-time patients with short-term pain (or 7 days if the patient had surgery). The …
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Blue Cross and Blue Shield of North Carolina is collaborating with MDLive to put more patients in touch with providers using remote hookups via an MDLive app, with an average wait time of less than 10 minutes. The insurer says it recognizes “the potential of telehealth to help providers deliver their services in a more cost-efficient setting…and facilitate value-driven care for patients.” That level of access is especially important in areas where ill patients would have …
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Going to the emergency room for a simple sore throat will cost Georgians who get their insurance through Blue Cross Blue Shield of Georgia as of July 1, when a new rule designed to cut unnecessary healthcare costs goes into effect. In a nutshell, it demands that patients choose another care setting unless they have a true emergency—urgent care being the most likely source, given the difficulty many find when trying to make timely appointments …
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Blue Cross Blue Shield (BCBS) of Michigan and Blue Care Network have apparently seen the light when it comes to the benefits of telemedicine. They’re working with physician groups on creating new financial incentives to expand member utilization. Seventeen groups, in fact, have already submitted telemedicine plans that could reap additional payments. Others are strategizing the best way to incorporate or expand telehealth offerings. BCBS says urgent care will figure prominently in its own efforts. …
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Blue Cross Blue Shield of Georgia and Empire Blue Cross Blue Shield in New York are the latest insurers to require that urgent care centers become accredited before contracting, or as a requirement to maintain in-network status. As noted in a recent posting by Becker’s Hospital Review, such policies highlight growing demand for healthcare providers in all settings to demonstrate both value and quality care—both of which have long been touted as attributes of well-run …
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The case of a Canton, MI urgent care provider charged with 22 counts of medical fraud should serve as a cautionary tale and a reminder that unethical (or even just plain sloppy) billing practices can land operators, office staff, and physicians in hot water—or even jail. The physician in the Michigan case stands accused of billing Medicaid and Blue Cross Blue Shield for services he didn’t provide, resulting in nine counts of Medicaid fraud, 12 …
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A new report from Blue Cross Blue Shield reveals that its Affordable Care Act enrollees are sicker and more expensive than its other plan members, as a whole. In fact, they’re nearly twice as likely to be admitted to hospitals. One reason will come as no surprise to critics of the ACA, or “Obamacare:” People who were uninsured and less healthy in the first place have signed up in droves. The act requires participating insurers …
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