Doctors Say Blue Cross And Blue Shield Pay outs Too Low - KLTV.com - Tyler, Longview, Jacksonville |ETX News

9/3/03 - Henderson

Doctors Say Blue Cross And Blue Shield Pay outs Too Low

Last week we told you about doctors in Longview who have stopped accepting Blue Cross and Blue Shield insurance. They say low pay outs end up costing the doctors.

Now a group of physicians in Henderson say Blue Cross and Blue Shield is refusing to negotiate fees with them and they can't afford to stop accepting the insurance.

Dr. David C. Craig is an Opthomologist in Henderson. He's been in practice for 25 years. He says for years Blue Cross and Blue Shield has been lowering their fees to physicians, paying not much more than Medicare.

"Very arrogant in their relationships with the doctors. We can get along with most people but when somebody gets arrogant like that and throws something at you and says take it or leave it. It's too hard for a lot of doctors," says Dr. Craig.

Dr. Craig says physicians end up accepting unreasonable contracts because they know patients would simply go to another doctor who does accept Blue Cross and Blue Shield.

Doctor Craig says he and his co-workers simply want to provide good health care. "To do that you have to sign contracts with people that are not going to make you lose money. You want to make some money so you can pay your staff and earn you some money to make your house payment and car payment and that sort of thing."

But the bottom line says Dr. Craig is who's paying and who's losing. For instance take a self employed patient who needs a colonoscopy. Each year the patient paid $4800 in premiums. The colonoscopy procedure at the hospital cost $1,754.75. Blue Cross and Blue Shield will only allow $500 to be paid for the procedure. The patient paid the $500 in a deductible. In the end, the patient paid more than $5,000 in premiums and the deductible. The hospital lost more than $1,200. The insurance company- paid nothing.

Doctors say there's only one way to change these Blue Cross and Blue Shield procedures. They say employers and employees should switch insurance companies.

We contacted Blue Cross and Blue Shield today regarding doctor's accusations their pay outs are too low . A spokesperson says, "Blue Cross [and] Blue Shield's physician networks continue to grow about 10% each year. They are confident they are able to work out arrangements with most physicians."

Amy Tatum reporting.

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