Mar 20, 2015 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
In California, a survey found significant inaccuracies in provider directories posted online—may trigger action by regulators to have insurers address this problem
Transparency in healthcare is an important trend. In recent years, much attention has been given to increasing the transparency of the prices charged to patients by hospitals, physicians, and medical laboratories. But now the transparency trend is about to drive change in the provider directories that health insurance plans make available to their beneficiaries and consumers.
When choosing a health plan, many people look for insurance that includes their own physician, or at least a doctor close to home. That is why an accurate and up-to-date provider list is essential to consumer choice and access.
But many health insurers fall short in this regard. California recently released chastising reports on two of its major health plans, Anthem Blue Cross and Blue Shield (ABCBS) (NYSE:WLP) and Blue Shield of California, (BSCA) for publishing inaccurate provider lists on the state’s California Covered insurance exchange. (more…)
May 8, 2013 | Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Management & Operations
With healthcare reform likely to limit their growth, health insurers are expanding into data management to create new revenue streams
Faced with swift changes in healthcare, many of which are not favorable to the traditional business model of private health insurers, the nation’s largest payers are positioning themselves to be major players in the management of “big data.” That may have interesting implications for clinical laboratories and anatomic pathology groups, which typically generate large quantities of medical laboratory test data.
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Mar 4, 2013 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Steep increases in insurance costs may leave patients with less money to cover deductibles and copayments for clinical laboratory tests
Next year, consumers and small businesses can expect what one health insurance CEO says will be, “Premium rate shock for 2014.” As this happens, clinical laboratories and pathology groups are likely to find it even more difficult to collect co-pays, deductibles, and out-of-pocket fees from patients who had medical laboratory tests performed.
The premium rate shock remark was made by no less than Mark Bertolini, the CEO of Aetna, Inc. (NYSE: AET). In his speech at an investor conference, he predicted premiums would rise by 20% to 50% next year before the government subsidies are applied. In some markets, rates could double, he added.
Aetna is not alone in seeking steep hikes in health insurance premiums. Blue Shield of California is seeking a rate increase of 12% to 20% for more than 300,000 individuals, The Los Angeles Times reported. These new rates would go into effect in March, the company said. (more…)
