Blue Cross, Fairview at impasse over doctors' fees

Tough negotiating between Minnesota's largest health insurer and the state's third-largest health system has patients scrambling to find new doctors and worrying about disruptions to their medical care. Read more
Archie Anderson

AOL

#22 Jul 24, 2008
And how much did the fairview group pay Minnesota taxpayers when they were handed title to the University of Minnesota Hospital, lock stock and barrel? The typical $1.00 legal binding payment?
Frustrated patient

Minneapolis, MN

#23 Jul 24, 2008
I am scheduled for surgery just days before the deadline. The physicians/surgeons are billed separately from the hospital, so after August 23 I'm out of luck. Because of their expertise, this is the only surgeon in the Twin Cities who is willing to take on my risky procedure. Thanks Blue Cross, am I now stuck?
Robert

Saint Paul, MN

#24 Jul 24, 2008
I agree with Balance above. Fairview needs to get its costs in line with the competition and stop whining. I have BCBS and they are a great company compared to most, even local providers.
st paul girl

Palo Alto, CA

#25 Jul 25, 2008
I hate Fairview and my breast cancer experience was a nightmare w/ them. I finally found out that the dr they set me up w/ was a pediatrician. I bailed so fast. They have a mission statement you listen to when you call there and none of it they hold up to...for example, same day appts. I called after 3rd degree burns to the cancer area trying to find relief w/ a heating pad. They told me at 7.00 am to drive to edina from west st paul. I wouldn't go there again for anything.
The oncologist they referred me to was great but my experience w/ fairview itself was horrible. A pediatrician has no business treating a bariatric and oncology patient and to not inform the patient she is a peds dr is not ethical.
She either had me on no pain pills or so messed up on valium and hard core drugs that it's amazing i didn't od. Never again. They take too many patients and can't handle it.
Sarah

Saint Paul, MN

#26 Jul 25, 2008
yup wrote:
Health Care Insurance is for profit... this is wrong. The CEO's are stealing the money and nobody can ever convince me they are worth the millions they siphon off the top. Health care needs a total overhaul.
Doc's do need a check and balance, SOME of them are greedy and unethical and will do surgery without the necessary testing or therapy beforehand. Surgery gets them more money. Remember the hysterectomy's and c-section stories? people were getting these when they didn't need it because the doc's were getting rich off of them.
I have an Aunt who works at the company who does these checks and balances..... she explained how many surgery's she has saved people from having and how important it is to have checks on these people.
Not all doc's are like this, but some are..
Umm...All HMO's in Minnesota are non-profit entities. I'm not sure how CEO's are siphoning off all of these millions?
Balance

Saint Paul, MN

#27 Jul 25, 2008
I would strongly suggest you contact BCBS customer service. I believe the only care affected by the 8/23/08 date is chiropractic, medical suppliers, and behavioral health. Hospitals and clinics are not affected until a later date.
Frustrated patient wrote:
I am scheduled for surgery just days before the deadline. The physicians/surgeons are billed separately from the hospital, so after August 23 I'm out of luck. Because of their expertise, this is the only surgeon in the Twin Cities who is willing to take on my risky procedure. Thanks Blue Cross, am I now stuck?

“Charity is a Personal Choice”

Since: Mar 08

Saint Paul, MN

#28 Jul 25, 2008
As a customer of both BC/BS & Fairview, I think I feel like a Christian in the Roman Collessium (sp?) right between the Lion and the Tiger.

Has anyone ever heard of "For Profit" Management Companies?

You can't put enough lipstick opn these 2 pigs. HMO's have devolved into arguably the biggest oxymoron EVER. First, they set their profit margin, second they avoid paying claims by stalling and short paying claims.

HealthCare Providers, not to be confused with Doctors, are caught up in the practice of CYA medicine to prevent frivilous lawsuit.

Doctors and Nurses are paid with the meager scraps left. It's no wonder that the best and the
brightest that used to go into medicine now go to law school. Who do you think is t the top of the food chain in these pyramid schemes?....Lawyer (said with disdain and digust).
no kidding

Minneapolis, MN

#29 Jul 25, 2008
Sarah wrote:
<quoted text>
Umm...All HMO's in Minnesota are non-profit entities. I'm not sure how CEO's are siphoning off all of these millions?
Two words, "United health"

check out how much the CEO's are making at these big HMO's... you will be surprised.
No Country For Old Men

Saint Paul, MN

#30 Jul 25, 2008
To No Kidding--- United Health is not allowed to sell plans in Minnesota. Sarah is right.

Let me guess the government should decide how much CEOs should make. We tried that in the 90's--that is how stock options became such a popular method of compensation.

Maybe DFLers like Lois Quam (aka Mrs.Matt Entenza) and Clinton cabinet member Donna Shalala should give up the millions they received in UNH stock options.
health guide

Mankato, MN

#31 Jul 26, 2008
Our phones ARE ringing and most members do understand BCBSMN's stand on pricing; Fairview is asking to be paid the same rates as the doctors at the Mayo Clinic!
health guide

Mankato, MN

#32 Jul 26, 2008
to Balance---The 8/23/08 deadline is for Fairview clinics (professional fees); hospitals term on 10/28/08 if no settlement met.
health guide

Mankato, MN

#33 Jul 26, 2008
Chris wrote:
Mr. Banks, CEO of BCBS MN, must be in the market for a multi-million dollar bonus.
I say, let all the plumbers, auto-mechanics, etc. that Mr. Banks relies on make him find new providers for those services.
Mr. Banks, CEO of BCBS MN is always in for a "multi-million dollar bonus", while his service employees barely make a livable wage and many on gov't assistance.
Renee

Saint Paul, MN

#34 Jul 29, 2008
BCBSMN isn't disputing that they do a great job, they are disputing the fact that they charge higher prices then they should. This in turns drives up the cost of premiums for everyone.
Labrat wrote:
The letters that I got from both parties implied that it was a "done deal" and I should look for a different provider. If there is still hope, I feel that every effort should be made to work things out. Fairview recently "reassembled" me after a bad bicycle accident, and they did a great job, and provided great follow-up.
Informed Consumer

Saint Paul, MN

#35 Aug 6, 2008
Since you want fairview to get the payment they are demanding, I assume that you are willing to pay the increase in cost for your policy. The money has to come from somewhere. BCBS is not a bottomless pit of money. Fairview is unwilling to budge on this issue because they are looking to make a profit. By demanding more money than any other health system fairview is sending the message that they are better than other health systems which is not true. BCBS does not dictate to members where or what type of care they receive the choice is yours. BCBS is also responsible for controlling healthcare cost for all members not just the one's who use fairview clinics. In the future before you make comments dictated by emotions please take a minute get all the facts and them make an informed comment.
just me wrote:
<quoted text>
Blameless?!? What are you talking about? Fairview has settled with all other Insurence Providers, it is BCBS that is refusing to pay a fair price to the Doctors and Care Facilities that are trying to save your lives. Of course ,if you side with BCBS, feel free to pay out of pocket for any uncovered expenses and let BCBS tell you what kind of care you can recieve for any given illness. God help us, if we allow a Mega Insurence company to dictate our medical future,we won't stand a chance.
1 Who Knows

Saint Paul, MN

#36 Aug 6, 2008
How about a lottery? If you draw a winning number, you get free medical care for the year.
1 Who Knows

Saint Paul, MN

#37 Aug 6, 2008
There are a lot of totally useless tests. The archaic and bestial colon checker is one. They nearly had it where an x-ray would show what you got inside your poop shute. The rectile docs scotched it.

But I'll be MY ass that a 3-D x-ray would see through shit and be BETTER than the camera up our butts do. And NON-invasive.

Check into that Nurse Smedley. And bring me the results in my private office, baby.
Pragmatist

Burnsville, MN

#38 Aug 6, 2008
st paul girl wrote:
I hate Fairview and my breast cancer experience was a nightmare w/ them. I finally found out that the dr they set me up w/ was a pediatrician. I bailed so fast. They have a mission statement you listen to when you call there and none of it they hold up to...for example, same day appts. I called after 3rd degree burns to the cancer area trying to find relief w/ a heating pad. They told me at 7.00 am to drive to edina from west st paul. I wouldn't go there again for anything.
The oncologist they referred me to was great but my experience w/ fairview itself was horrible. A pediatrician has no business treating a bariatric and oncology patient and to not inform the patient she is a peds dr is not ethical.
She either had me on no pain pills or so messed up on valium and hard core drugs that it's amazing i didn't od. Never again. They take too many patients and can't handle it.
I was doing some home remodelling in 2004 and cut my thumb on the tip deep enough to need stitches. It was 1 in the morning, so I went to Fairview and waited in line in the emergency room. I had misplaced my Blue Cross card, so I filled out the paperwork with the promise to pay, etc. Two hours and 5 stitches later I went home. 1 week later, I received a bill in the mail for $1500 for five stitches in the emergency room. I got Blue Cross involved, and they got paid $126. How is it that those with the least ability to pay, the uninsured get socked by Fairview with a $1500 bill, and those probably best able to pay with health insurance pay less than 10% of that? Fairview garners no sympathy from me.
City woman

Saint Paul, MN

#39 Aug 6, 2008
Pragmatist wrote:
<quoted text>I was doing some home remodelling in 2004 and cut my thumb on the tip deep enough to need stitches. It was 1 in the morning, so I went to Fairview and waited in line in the emergency room. I had misplaced my Blue Cross card, so I filled out the paperwork with the promise to pay, etc. Two hours and 5 stitches later I went home. 1 week later, I received a bill in the mail for $1500 for five stitches in the emergency room. I got Blue Cross involved, and they got paid $126. How is it that those with the least ability to pay, the uninsured get socked by Fairview with a $1500 bill, and those probably best able to pay with health insurance pay less than 10% of that? Fairview garners no sympathy from me.
Didn't the AG's office negotiate an agreement with all MN hospitals last year to prevent them from charging the uninsured more than they charge their largest insurance companies for the same service? I think you just missed out on that by a couple of years, unfortunately...
Pragmatist

Burnsville, MN

#40 Aug 6, 2008
City woman wrote:
<quoted text>
Didn't the AG's office negotiate an agreement with all MN hospitals last year to prevent them from charging the uninsured more than they charge their largest insurance companies for the same service? I think you just missed out on that by a couple of years, unfortunately...
Not sure if I missed out, but how does that make Fairview an ethical organization, one way or the other, being forced to do the right thing by the state Attorney General's office?
City woman

Saint Paul, MN

#41 Aug 6, 2008
Pragmatist wrote:
<quoted text>Not sure if I missed out, but how does that make Fairview an ethical organization, one way or the other, being forced to do the right thing by the state Attorney General's office?
Oh, I wouldn't claim that it does. But I'm glad that the bad PR forced them to go along with it, and that other people won't be in that position.

I think BCBS and FV are both feeling the karma right now - I just got an email from someone I know at BCBS who just got laid off, and he said that there are a lot of people getting cut due to financial difficulties.

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