Emergency Medicine Up Against the Ropes
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The specialty of emergency medicine has often found itself under attack, particularly by insurance plans and consumer advocates.  The former is understandable, the later never made much sense to me, given that emergency physicians provide more un-reimbursed care to the … Continue reading

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Anthem: Rash? Don’t Go To The ER
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According to the St. Louis Post Dispatch, in a recent letter to policy holders in Missouri, Anthem advised that: “Should members choose to receive non-emergency care in the ED [emergency department], they will be responsible for the charges incurred,” and that … Continue reading

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Are Usual and Customary Charges Reasonable?
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In State legislative offices throughout the country where the issue of out-of-network physician charges, balance billing, and plan benefits are being debated, the constant refrain from health plan representatives is that usual and customary charges are an ‘unacceptable standard’ for … Continue reading

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CMA Stumbles Over Balance Billing Legislation in California
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AB 72, a bill that is currently on the verge of being approved by the California State Legislature, represents a serious strategic loss for physicians in California around the issue of out-of-network services (OON) and the practice of balance billing. … Continue reading

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BCBS GA Walks Back Forced Contracting Policy
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Back in May of 2016 I put a post up in The Fickle Finger on ‘Forced Contracting, BCBS’s Answer to Balance Billing’, citing a policy in the policy manual that Blue Cross Blue Shield of Georgia had put out some … Continue reading

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