Blue Cross/Blue Shield has announced that it will pay 70 percent of the fee that it permits for non-emergency surgery by out-of-network doctors. This will put the patients responsible for 30 percent of the charges, plus any difference between the allowed amount and the actual charge.
This alteration of the fee structure is in reaction to distressed Congress members as well as some upset federal workers who have the Blue Cross/Blue Shield standard option.
According to the company’s initial fee structure for 2009, 100 percent of the surgery fee, to a maximum of $7,500 per surgeon, per surgical day, would have had to be taken care of by Blue Cross/Blue Shield members. Under the office of Personnel Management, health insurance companies were allowed to change their surgical benefit and permit employees to change their insurance selections through the end of January.
In situations where the surgeon’s bill will be $5,000 or more, Blue Cross is currently offering members a better service system that will give members information ahead of time that will show them what the company will pay when concerning a procedure.
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