Blue Cross Blue Shield Program Cuts Healthcare Costs
A Blue Cross Blue Shield program email appeared in my email inbox last week. The email pointed out that I could have a well-being appointment and pay no co-pays or deductibles. The program even covered the labs at 100%.
The Affordable Care Act contained the same type of language. The health insurance carriers covered any yearly check-up at 100%. The concept likely originated with well-baby care appointments. I just had my yearly physical, so the appointment seemed unnecessary for me.
The Blue Cross Blue Shield program does not represent
I do realize many companies practice pre-employment job physicals. Those physicals address the employee at the beginning. What happens after they have been working for five years?
The Blue Cross Blue Shield program starts with a 15-minute assessment where they will provide a $25 gift card. Do you think that the health insurance carrier would offer to pay $25 per person if it was not an important assessment of a policyholder’s health condition?
Would Workers’ Compensation carriers and self-insureds benefit from a well-being appointment? The worst claims I have ever handled started as
- Medical only claims ignored by the employer and claims staff – leaving the closure to an algorithm -see claims festering
- Work-related medical conditions where the employee worked with the condition to keep their job.
- Serious unknown preexisting condition at the time of hire. I will leave this one alone due to ADA/HIPPA other than to say an aggravation of a preexisting condition counts just like an on the job injury. I have one on my screen out of WV where a bad knee at the time of hire is a worse knee now that the condition has been aggravated by another accident.
- Loss of medical control at the beginning – where the $400 claim turns into the $750,000 claim over two years. I used to have the claim on a flowchart for presentations to governmental organizations.
A recent WCRI study proposed that a person with health insurance has better workers’ compensation outcomes. The study points out the need for well-being appointments with the employees’ healthcare provider. We have come full circle back to the reason for my email from the Blue Cross Blue Shield program.
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