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.)

Rumor has it that the new contract was accepted by LVCI. This is yet to be confirmed. This won't be the first time for LVCI.

Time will tell just how blue the blues can make us feel. Is it time to stand up and be counted? (We can't say that!)

*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?