Blue Cross ads target hospital billing

07/20/2012 12:00 AM

12/15/2012 10:42 PM

Blue Cross and Blue Shield of North Carolina has launched an advertising campaign aimed at educating consumers about a “wasteful” medical billing practice it says is costing North Carolinians about $16 million a year.

The insurer contends that hospitals and doctors’ offices routinely overcharge for radiology services. When patients go in for multiple images, providers are billing multiple times for some services that are performed only once, such as providing a gown, setting up IV fluids and preparing the room for the procedure, Blue Cross contends.

As the Observer and The (Raleigh) News and Observer reported in a story Sunday, Blue Cross has filed a petition with the N.C. Department of Insurance, seeking permission to change the way it reimburses providers for radiology services.

Now, the insurer plans to take out a series of newspaper and radio advertisements over the next few months to educate consumers about why it is taking that step, says Blue Cross spokesman Lew Borman.

On Thursday, it also launched a website: . The headline at the top of that Web page reads: “Health care costs enough without paying for it twice.”

On that site, Blue Cross encourages customers to help reduce unnecessary charges by requesting detailed medical bills and asking their providers what they’re being charged for and why.

Visitors to the site can also download 10 tips for reducing their health care costs.

“We’ve offered a reasonable solution to end this wasteful spending and save consumers money,” Borman said. “We want people to understand what we’re trying to do.”

While Blue Cross doesn’t divulge what it spends on such ad campaigns, “we believe it’s worth a modest investment to try to recoup this $16 million in multiple billing,” Borman said.

The battle over radiology fees began in June 2011, when Blue Cross sent out a memo to hospitals and doctors’ practices that provide radiology services such as MRIs, CAT scans and ultrasounds.

The notice said the “technical component fee” for second and subsequent images would be reduced by 50 percent. Doctors would continue to be paid 100 percent for each image they analyze and interpret.

Lobbyists for hospitals and doctors cried foul, contending the insurance company is unilaterally trying to rewrite active contracts.

Under the law, those lobbyists argue, if a provider objects to a proposed contract amendment, the amendment cannot go into effect. The insurer’s only remedy is to terminate the entire contract with 60 days’ written notice.

In December, the Department of Insurance sided with the hospitals and doctors. Blue Cross appealed the decision, and the case is expected to go before an insurance department hearing officer later this year.

Officials for Charlotte-based Carolinas HealthCare System, the state’s largest hospital chain, declined to comment last week, but said they endorsed a statement issued by the N.C. Hospital Association, contending that insurers should not be allowed to change the terms of reimbursement contracts whenever they want.

Blue Cross dominates North Carolina, with 75 percent of the health insurance market.

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