Guest guest Posted May 23, 2004 Report Share Posted May 23, 2004 Have other states recently been hit with a new BC/BS contract? In Tennessee BC/BS has requested a new contract (sign or get out) which is now at the medicare fee schedule minus one penny. I have contacted our states reimbusement chairman who informed me that only a few PT's had called and voiced their opinion. BS/BS covers more than 30% of the insured in the area. Any comments/suggestions? Newton, PT, CWS Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2004 Report Share Posted May 23, 2004 TX BCBS changed to 2003 Medicare rates last year. Interestingly, they did not increase their rates with this year's fee schedule? They did not adopt the schedule for everything though - i.e. no longer pay ionto, pay a little for hot/cold packs, do not pay biofeedback for urinary incontinence, etc. We did not get a contract - rates just changed. We see about the same percentage BCBS patients you do, but the overall rate change was not that significant for us - seems like one code balanced the other out. Lott, MN, RNC, FNP-CS Rural Rehab Providers, LLC Re: BC/BS Have other states recently been hit with a new BC/BS contract? In Tennessee BC/BS has requested a new contract (sign or get out) which is now at the medicare fee schedule minus one penny. I have contacted our states reimbusement chairman who informed me that only a few PT's had called and voiced their opinion. BS/BS covers more than 30% of the insured in the area. Any comments/suggestions? Newton, PT, CWS Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2004 Report Share Posted June 2, 2004 In Tennessee prior to 2002 they paid " resonable and customary " , athough they would not produce how they came up with the numbers. This equated to approx 40% above the medicare fee schedule. In approx late 2002 they switched to a fee schedule of which some codes were paid at medicare fee schedule and some slightly above. Now they are using the conversion factor for Tn as per medicare. Newton, PT, CWS PS Your state chairperson is Baron at _baronjohnson@..._ (mailto:baronjohnson@...) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2004 Report Share Posted June 3, 2004 It seems everyone was " chosen " to be on the BC/BS panel. I received the exact same letter for each of our therapist OT and PT. It appears we were all " recommended. " I called the number and left a message for each therapist on 4/26 and guess what--no one has returned our call. Newton, PT, CWS Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2004 Report Share Posted June 3, 2004 > Okay, off of my long winded soapbox. Hope this post might help at least one > individual. > Jim Hall, CPA <///> Jim. Wow. Let us hope it might MOTIVATE at least one individual. Joe Ruzik... let us hope it might <i> motivate</i> you. Dont just join the APTA. GET INVOLVED. Show up. Go to meetings. <b>Run for offices.</b> The APTA responds not to the needs of the PT but to the needs of the active and involved memberhsip, just like every association that has ever been created. Simonetti, DPT Chestertown, MD Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.