Blues contracts?

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Gonna need to get Blue contracts.

Starting in Oct 2012, all Blues plans are being required by the BCBSA to reject any lab claim involving specimens that were drawn outside of that plan's service area. For example, if Bostwick's Virginia lab bills the Virginia blues plan for testing on a specimen drawn in Nevada, that Virginia plan will reject the claim, and insist that Bostwick bill the Nevada blues plan.

If Bostwick doesn't have a contract with that Nevada Blues plan, their NV claims will pay at a substantially reduced out-of-network rate, and the patient will be stuck with a large balance billing.

So - getting Blues contracts is job #1 right now for labs that have relied on billing all their services through 1 or 2 Blues plans. And unfortunately, the Blues plans are shutting the door on adding path or clinical labs that are offering essentially the same services as their currently contracted labs are offering.

A piece of advice - bring these facts up to your management and see what they're doing to deal with the situation. You've got a right to be very concerned if they aren't getting Blues contracts in your sales area.
 
Hello, Genoptix people. Speaking as the contracting person at one of those Blues you're so desperately courting right now, I can tell you that our Plan (and most of the others) will not be bringing your company into our lab network. The reason is simple: your company is not offering any medically necessary testing that we can't already get from our larger labs and their subsidiaries. Even worse, Genotpix insists on billing its claims with the stacking codes - big problem, as those codes don't allow us payers to identify exactly what tests we're paying for.

So ask yourselves: why would an insurance company want to bring a lab in-network that isn't offering unique tests, and bills their claims in such a way that we can't tell what we're paying for?

Y'all can try to put faith in whatever marketing gimmicks you use to sell to the docs, but they ain't the ones that need to be convinced of your value. The payers are.

And like the earlier posters say, Genoptix is dead in the water if they can't land Blues contracts in the next few months.

Good luck with that.
 
Anonymous said:
Au contraire!

Might want to ask your market access director in the West with the initials of SG. He'll tell you that us Blues Plans monitor this site...
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You are right we at Blue Cross Blue Sheild do monitor Cafepharma and based on this thread we are not going to contract with Genoptix. You all blew it. Especially SG for disclosing that we monitor Cafepharma. We only do business with Cafepharma free Labs
 
Anonymous said:
You are right we at Blue Cross Blue Sheild do monitor Cafepharma and based on this thread we are not going to contract with Genoptix. You all blew it. Especially SG for disclosing that we monitor Cafepharma. We only do business with Cafepharma free Labs
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F****U Blue, go F******yourself. We are going down by the wonderful deeds of FAT ASS LH. We can take care of ourselves....no worries!!!
 
Anonymous said:
Gonna need to get Blue contracts.

Starting in Oct 2012, all Blues plans are being required by the BCBSA to reject any lab claim involving specimens that were drawn outside of that plan's service area. For example, if Bostwick's Virginia lab bills the Virginia blues plan for testing on a specimen drawn in Nevada, that Virginia plan will reject the claim, and insist that Bostwick bill the Nevada blues plan.

If Bostwick doesn't have a contract with that Nevada Blues plan, their NV claims will pay at a substantially reduced out-of-network rate, and the patient will be stuck with a large balance billing.

So - getting Blues contracts is job #1 right now for labs that have relied on billing all their services through 1 or 2 Blues plans. And unfortunately, the Blues plans are shutting the door on adding path or clinical labs that are offering essentially the same services as their currently contracted labs are offering.

A piece of advice - bring these facts up to your management and see what they're doing to deal with the situation. You've got a right to be very concerned if they aren't getting Blues contracts in your sales area.
Click to expand...

Still no Blues contracts....
 


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