In a previous post we wrote about two of the BUCA’s and their out-of-network reimbursement fees that are tied to a percentage of Medicare – http://blog.riskmanagers.us/?p=9455
We have now confirmed a third BUCA’s out-of-network reimbursment schedule is 110% of Medicare.
All we need to determine now is the out-of-network reimbursement model of the fourth and final BUCA.
How do the BUCA’s protect their members from out-of-network balance billing issues? They probably don’t. If that is the case, then why should employers who sponsor Medicare Plus or Cost Plus plans do any different?