Aren't we all who "PAR" with all blues via our local blue (you Empire, me Excellus for example) have to file all our Blues claims thru the local Blue that we contract with??? That we are not allowed to file via the clearing house with the various individual blue plans??? For Example if I see a patient with Down State Empire Blue up here, we will be paid our cheaper Upstate Excellus fee schedule not your better Down State Empire fee schedule and visa versa. So if you saw a patient with Upstate Blue you would be paid your Better Down State fees instead of the Upstate fee that are in effect up here.
So once again, if we must file thru our local Blue for any and all Blue, then for us who have our Blue over controlling 50-75% of our local market, then we must have a clearing house who is up and running with our local Blue among others, correct? Or risk having very slow, dropped to paper claims and the extra charges that go with them, defeating the the entire purpose of using a provider friendly outfit like OfficeAlly, right?
This whole need a clearing house and their associated parasitic loses and charges just piss me off to no end. It seems that everybody from the Carriers, to Big Pharma, High Tech and Software Firms (except little guys like AC), to Clearing Houses and Collection agencies all get to make good money off of the food chain that is Medicine, that always starts with Primary Care, except the folks who are providing the care. When was the last time GE or Welch-Allyn in our area of town lost money selling scopes, ECG's, MRI's and CAT Scan machines, right? There are no price controls on Big Pharma the way the Medicare Fees Schedule holds us all back.... Especially the PCP's who went thru Med School and Residency programs, then fighting against market trends to open a small practice, aquiring debt all the way.
We were just at a fancy anniversary lunch for our collection agency. Some guy who is but a businessman with an MBA (what else?) is now a Millionaire off of the loses we providers of care suffer every day... Meanwhile, Nancy and I can't afford to replace our rusting out old Jeep (180K salty miles), fix our falling down old fence or repair our roof....The present system is so out of wack it really is like a bad Monty Python skit, you just can't make this stuff up.
As I've said before; "Beware of the Medical Industrial Complex".
Paul
