Anthem Blue Cross Blue Shield policy change: what does it mean for patients?
6 december 2024 в 03:13
Doctors, patients, and even politicians have reacted to the news that the major medical insurance provider Anthem Blue Cross Blue Shield is changing its policy. Apparently, the company has changed its coverage and will no longer pay for anesthesia services if the operation exceeds a certain time, according to information from various sources. This policy change will affect patients in Connecticut, New York, and Missouri. What does this mean for Blue Cross clients?
Find out more below.
If the operation exceeds a certain duration, the cost of anesthesia for additional time will not be covered. pic.twitter.com/Sniwxze8XV
— Pop Crave (@PopCrave) December 4, 2024
The policy will no longer reimburse anesthesia services for the entire duration of certain surgical procedures, preferring a partial coverage model.
Anthem Blue Cross Blue Shield announced the policy change on November 1, 2024. At that time, the company stated that this insurance update would begin in 2025.
«Starting with claims processed after February 1, 2025, Anthem will change the way it evaluates the claimed time for professional anesthesia services», - Anthem announced in a statement. «We will use CMS physician work time values to determine the number of minutes reported for anesthesia services. Claims submitted with reported time exceeding the established number of minutes will be denied».
The company also noted that its policy update «will account for anesthesia time included in the preoperative assessment, intraoperative period, and postoperative period».
«The appropriateness of billing for time before and after the operation should be documented and comply with recommendations set by the American Society of Anesthesiologists regarding appropriate time that should be accounted for and documented», - Anthem announced.
The policy will not affect patients under 22 years of age or those in medical care.
The American Society of Anesthesiologists stated that under the new policy, patients will have to pay for anesthesia services out of pocket if the procedure exceeds the established time.
However, the policy may not affect residents of Connecticut. State Comptroller Sean Scanlon acted promptly and reached out to Anthem.
«After my office received feedback from people across the state about this concerning policy, we reached out to Anthem, and I am pleased to report that this policy will no longer be in effect here in Connecticut», - Scanlon said, according to NBC Connecticut.
And all for what? To increase corporate profits?
Cancel this decision immediately. https://t.co/0x4jBVqyKi
— Chris Murphy 🟧 (@ChrisMurphyCT) December 4, 2024
Senator Chris Murphy was one of many who expressed opposition to the proposal, calling it «shameful» on X (formerly known as Twitter).
«This is shameful. To saddle patients with thousands of dollars in additional medical debt», - Murphy wrote in a tweet, adding, «And all for what? To increase corporate profits? Cancel this decision immediately».
The American Society of Anesthesiologists also reacted to Anthem’s policy change. In a statement, the ASA noted: «With this new policy, Anthem will not reimburse anesthesiologists for providing safe and effective anesthesia care to patients who may need additional attention due to a complex, unusual operation, or the occurrence of complications».
Depending on where the patient undergoes surgery, the cost of anesthesia can range from $ 200 to over $ 1000, according to various sources. My Sleep Guardian reports that the cost of anesthesia typically amounts to $ 400 for the first 30 minutes of care and $ 150 for each additional 15 minutes
Find out more below.
If the operation exceeds a certain duration, the cost of anesthesia for additional time will not be covered. pic.twitter.com/Sniwxze8XV
— Pop Crave (@PopCrave) December 4, 2024
The policy will no longer reimburse anesthesia services for the entire duration of certain surgical procedures, preferring a partial coverage model.
Anthem Blue Cross Blue Shield announced the policy change on November 1, 2024. At that time, the company stated that this insurance update would begin in 2025.
«Starting with claims processed after February 1, 2025, Anthem will change the way it evaluates the claimed time for professional anesthesia services», - Anthem announced in a statement. «We will use CMS physician work time values to determine the number of minutes reported for anesthesia services. Claims submitted with reported time exceeding the established number of minutes will be denied».
The company also noted that its policy update «will account for anesthesia time included in the preoperative assessment, intraoperative period, and postoperative period».
«The appropriateness of billing for time before and after the operation should be documented and comply with recommendations set by the American Society of Anesthesiologists regarding appropriate time that should be accounted for and documented», - Anthem announced.
The policy will not affect patients under 22 years of age or those in medical care.
The American Society of Anesthesiologists stated that under the new policy, patients will have to pay for anesthesia services out of pocket if the procedure exceeds the established time.
However, the policy may not affect residents of Connecticut. State Comptroller Sean Scanlon acted promptly and reached out to Anthem.
«After my office received feedback from people across the state about this concerning policy, we reached out to Anthem, and I am pleased to report that this policy will no longer be in effect here in Connecticut», - Scanlon said, according to NBC Connecticut.
And all for what? To increase corporate profits?
Cancel this decision immediately. https://t.co/0x4jBVqyKi
— Chris Murphy 🟧 (@ChrisMurphyCT) December 4, 2024
Senator Chris Murphy was one of many who expressed opposition to the proposal, calling it «shameful» on X (formerly known as Twitter).
«This is shameful. To saddle patients with thousands of dollars in additional medical debt», - Murphy wrote in a tweet, adding, «And all for what? To increase corporate profits? Cancel this decision immediately».
The American Society of Anesthesiologists also reacted to Anthem’s policy change. In a statement, the ASA noted: «With this new policy, Anthem will not reimburse anesthesiologists for providing safe and effective anesthesia care to patients who may need additional attention due to a complex, unusual operation, or the occurrence of complications».
Depending on where the patient undergoes surgery, the cost of anesthesia can range from $ 200 to over $ 1000, according to various sources. My Sleep Guardian reports that the cost of anesthesia typically amounts to $ 400 for the first 30 minutes of care and $ 150 for each additional 15 minutes
© Smirnova Olga
