Our Group has health insurance with BCBS/Anthem. I occasionally get an email from SmartShopper. SmartShopper is a program BCBS (and I guess other payers could acquire this product too) uses in an attempt to direct pts to lower cost medical services. You select the medical service you are obtaining and SmartShopper will list out the facilities where it is available. The carrot to get you to select the lower cost facility is a cash payment. Although all facilities are listed, you only can obtain the cash payment if you select one of the lower cost facilities. You call their Personal Assistant number to schedule the lower cost facility and signup to obtain the cash payment.
Our Group is in a joint venture with the local hospitals on a PET/CT only center. Couple of interesting things I see in the SmartShopper product:
- I believe it only list hospitals. We have a lower rate with BCBS than the lowest facility listed on SmartShopper. However, our facility isn't listed. BCBS is willing to pay $500 to a pt which selects a high cost PET/CT then what the pt can get within our center. A $500 payment to drive 35 miles to Atlanta. I have pointed this out to BCBS, but no one seems to care.
- You also get a listing of all the rates other facilities have with BCBS. Good tool to judge your own BCBS rates. The rates listed are directed towards the global fee (I think).
- If you got on the list of lower cost facilities and pts could receive a cash payment, this might be an excellent marketing opportunity.
I don't think the SmartShopper product is successful. I've never had anyone mention it to me. I've been on the insurance side too and we never had any success on steerage products or plans we used.
Anyone else seeing anything out of SmartShopper? Your thoughts?
Thanks for reading......Chris
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R. Christopher Sluder CPA
Administrator
Rome Radiology Group
Rome GA
(706) 291-2661
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