Author Topic: Behavioral Health Reimbursements by State BCBS  (Read 709 times)

Nick D

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Behavioral Health Reimbursements by State BCBS
« on: March 06, 2020, 01:32:34 PM »
Hey guys,

I have facilities/providers looking to expand in to other states but there is limited info on what the Local Blue Cross rates are for each LoC (Level of Care). I deal strictly with Chemical Dependence. Any input would be greatly appreciated!

I can offer Florida's rates:
Detox - $798
Residential - $798
Partial - $319
IOP - $159
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Michele

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Re: Behavioral Health Reimbursements by State BCBS
« Reply #1 on: March 09, 2020, 06:46:26 AM »
Most insurance carriers, BC included do not release their rates until a provider is contracting with them.  I do not believe there is a way to get the information you're looking for.
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Nick D

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Re: Behavioral Health Reimbursements by State BCBS
« Reply #2 on: March 09, 2020, 08:31:53 AM »
Apologies, I'm speaking on strictly OON rates for each state's local!
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Michele

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Re: Behavioral Health Reimbursements by State BCBS
« Reply #3 on: March 10, 2020, 10:54:15 AM »
I'm sorry Nick, but I'm confused.  If the provider is out of network then aren't they charging the patient their full fee up front?  Why are they concerned with the out of state rates?  Is it just to get a feel for what the patient would be reimbursed?  I'm still not sure if that information is available anywhere unless another provider from that state who is out of network is willing to share.  It's kind of a long shot to hope they see this post, but maybe!


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Nick D

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Re: Behavioral Health Reimbursements by State BCBS
« Reply #4 on: March 11, 2020, 06:58:23 AM »
I'm sorry Nick, but I'm confused.  If the provider is out of network then aren't they charging the patient their full fee up front?  Why are they concerned with the out of state rates?  Is it just to get a feel for what the patient would be reimbursed?  I'm still not sure if that information is available anywhere unless another provider from that state who is out of network is willing to share.  It's kind of a long shot to hope they see this post, but maybe!

Exactly, I'm trying to see what the pt will be reimbursed. I realize it's a long shot but I have faith in the forum!
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Michele

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Re: Behavioral Health Reimbursements by State BCBS
« Reply #5 on: March 11, 2020, 08:33:11 AM »
Good luck!
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Nick D

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Re: Behavioral Health Reimbursements by State BCBS
« Reply #6 on: March 12, 2020, 10:25:22 AM »
Looks like I'll need it  ::)
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cbrant8

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Re: Behavioral Health Reimbursements by State BCBS
« Reply #7 on: November 01, 2020, 11:23:00 PM »
I think what he means is the different state suggested rates. CA is $1000 DTX, $800 RTC, $550 PHP and $250 IOP. Feel free to message me if you would like more data.