Posts Tagged ‘blue cross blue shield florida’

Tuesday, February 23rd, 2010

A Florida health insurance provider has filed a lawsuit against Blue Cross Blue Shield Florida for not paying the correct reimbursement rates for treating patients. The lawsuit suggests that the carrier is artificially deflating the cost of the treatment. Other carriers have been recognized to use the same practices like Aetna, CIGNA, and United Health One.

When a Florida health insurance member goes out of network, the physician has to persuade the patient to pay the rest as the current reimbursements are to low from the carrier. The charges are called usual and customary, but they are anything but that according to the lawsuit.

This does not put the patient at any risk. But this Florida physician is not willing to be bullied anymore by big corporations. Now he is taking action.

Tuesday, February 9th, 2010

The insurance office says a 30% increase to Florida’s affordable, accessible alternative to expensive Florida health insurance plans is not acceptable. Blue Cross Blue Shield of Florida explains losses have been projected at 23 cents for every dollar until the increases can be approved.

The Florida health insurance plan is not pulling in enough members. As of November 30, 2009 the Cover Florida plans attracted only 5,246 beneficiaries. Over half of these participants are on the Blue Cross Blue Shield Florida plan. In addition, there has been no word from United Health Care on any rates increases on their Cover Florida plans. Blue Cross Blue Shield Florida and United Healthcare are the only two insurers that offer plans statewide.

The reason the Florida health insurance plan is failing is because people are going to use these plans. The sick people that cannot get Florida health insurance anywhere else in the state. This is a perfect example of how a mandated guaranteed issue coverage brought on by health care reform can hurt America.