Aetna fee schedule change.

[Adrian Cocot]

Heard this through the grapevine...

Before July 1, 2009:

88304- $79
88305- $135

After July 1, 2009
88304- $7
88305- $25

PWNED!

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[LADoc00]

Heard this through the grapevine...

Before July 1, 2009:

88304- $79
88305- $135

After July 1, 2009
88304- $7
88305- $25

PWNED!

Thats impossible, thats less than Medicaid I believe.

No matter, dump the contract and full bill. When you know about in advance, you have plenty of time to head to PF Changs, eat a big dinner and crap all over their contract the next morning to FEDEX it back to corporate.

As a future note and I hope the OP comes back to explain, these heads up are GOOD but please tell us what part of the country you are in and what type of operation (public hospital, private, academic etc).

 

[yaah]

Are you sure they're not just cutting the payments by $7 and $25?

 

[Adrian Cocot]

As a future note and I hope the OP comes back to explain, these heads up are GOOD but please tell us what part of the country you are in and what type of operation (public hospital, private, academic etc).

From what I've gathered through the CAP grapevine, it seems that this fee adjustment is for all Aetna plans in the Houston market so far.

Are you sure they're not just cutting the payments by $7 and $25?

yes

 

[Adrian Cocot]

redundant post

 

[exPCM]

If these rates are adopted by the other major insurers and are implemented nationwide then pathologist incomes will implode.

 

[pathstudent]

If these rates are adopted by the other major insurers and are implemented nationwide then pathologist incomes will implode.

patholgy departments and reference labs will also implode

 

[exPCM]

Adrian Cocot,
Are these rates published? Do you happen to have a link that you can post?
Thanks

 

[SaltySqueegee]

Seriously though. Documentation? References of such assertions?

I understand that healthcare reimbursement must change for future viability, but an order of magnitude? That's insane.

 

[MOHS_01]

I have been forewarned at specialty society meetings that we can expect a 30% drop in "pathology codes" in the next year or two. Whether this is true or not I have no idea. It was reiterated at the Mohs meeting, however, as a justification to cut Mohs codes further (again) in the immediate years ahead.

So that some won't have to look it up, for comparison, here are the Houston, TX MC fees.

88304 61.08
88305 104.14

Since I cannot see a 75-90% relative reduction in RVU values, I doubt this is true. You would have to be a f'ing ****** to work for those rates. F'ing ******. Brush up on saying as fast as you can, "Throat/ear sore? Ahhhhh.... here's some Amoxil." or "rash, huh? here's some hydrocortisone." or "low back pain? let's check an x-ray.... nope, can't tell anything from the x-ray, here's some flexeril and hydrocodone. we'll schedule an MRI."

 

[MOHS_01]

Adrian Cocot,
Are these rates published? Do you happen to have a link that you can post?
Thanks

Won't be published... fee schedules are, in large part, treated as proprietary information...