| Click to hear a disturbing phone call I received from Blue Cross (click to hear) | |||
| Blue Cross called to say that LASIK surgery was $1150.00 for a procedure*. My participation as an opthalmologist requires that I accept this fee. Or "resign from the Blue Cross network entirely [i.e. stop performing cataract surgery]". (Remember Blue Cross cover 70% of the insured in this area!)
The message goes on to say that a patient of mine was paid directly and that I had violated standards by accepting money from this patient directly. If you think Blue Cross doesn't want a piece of the action you will be happy to know that they already have an exclusive contract with LVCI in PA for a subset of patients. Because that contract expires soon they asked the Wills Eye Surgical Network and then Frederick Kremer, MD to charge $1000 for a bilateral procedure in return for exclusivity. Both organizations refused! (Hats off to Wills and Fred.) Time will tell just how blue the blues can make us feel. *if a bilateral procedure is done the total comes to $1725.00. No one knows whether enhancements will be included, pre-operative evaluations, punctal plugs, topography, pachymetry, postoperative kits, topical medications, or follow-up care after the first few months!. We can't be sure how poorly a patient will have to see in order to qualify for enhancements. In the old days a patient had to see worse than 20/70 in order to qualify for cataract surgery! Do you think they forgot how to limit care? |
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