1. It is not all BS plans but specific PPO plans only. Note several plans currently do this but ASH is just the gatekeeper for medical necessity and does not follow ASH rates.
2. These plans will still have out of network benefits but clearly an incentive for patients to seek care with in-network for less out pocket costs
3. Regular BS participation for their standard California plans will not be affected.
4. I foresee this for plans that are self-insured entities.
5. Note ASH does allow providers to opt in or out of certain plans so it should be possible to opt into this plan only should it be a benefit for your office
6. There is no indication of their allowed rates or fee schedule and would appear to continue to be at the BS rates and not ASH


0 Comments

Leave a Reply

Avatar placeholder