Under the new plan, members will pay 30 percent of BCBS’s allowance for the surgery (subject to their calendar year deductible) plus the difference between BCBS’s allowance and the amount the surgeon bills.
In 2008, members paid 25 percent of the plan allowance (subject to their calendar year deductible), plus any difference between BCBS’s allowance and the amount billed by the non-participating physician.
The new plan also offers a service to members in situations when a surgeon’s bill for elective, out-of-network surgery will be $5,000 or more. In these instances, BC/BS will provide prior approval of the surgery and help the members’ estimate their personal costs, but the call for the approval must be made by the patient.
Read the Blue Cross Blue Shield 2009 benefit plan letter (pdf).
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.