Bob's written before about P.A.R.E. claims (Pathology, Anesthesiology, Radiology, Emergency), wherein certain providers choose not to participate in networks, and thus are free to charge pretty much what the market will bear. While there's not much one can do about that, one can at least reasonably expect such providers to follow the rules that are in place.
Like not double-billing for the same procedure:
"Blue Cross and Blue Shield of North Carolina ... argued that radiology practices were charging double for services provided only once and wanted the opportunity to cut reimbursements. It estimated that some $16 million was improperly charged annually because of this billing method."
That's not exactly pocket change.
As one might expect, the radiologists cried foul, arguing that this was tantamount to a contract re-negotiation without, you know, negotiation. BX countered that they were simply looking to "protect consumers and our customers from unreasonable charges."
In the end, the Tar Heel State's Department of Insurance sided with the BX folks; thelosers doc's retain the right to appeal the decision in court.
[Hat Tip: FoIB Jeff M]
Like not double-billing for the same procedure:
"Blue Cross and Blue Shield of North Carolina ... argued that radiology practices were charging double for services provided only once and wanted the opportunity to cut reimbursements. It estimated that some $16 million was improperly charged annually because of this billing method."
That's not exactly pocket change.
As one might expect, the radiologists cried foul, arguing that this was tantamount to a contract re-negotiation without, you know, negotiation. BX countered that they were simply looking to "protect consumers and our customers from unreasonable charges."
In the end, the Tar Heel State's Department of Insurance sided with the BX folks; the
[Hat Tip: FoIB Jeff M]
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