Luvssjeter
New Member
- Joined
- Apr 14, 2020
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I am just wondering how other anesthesiologists are feeling about the QPA being, basically, the sole deciding factor for out of network reimbursement. Overtime this QPA, which is supposed to be the 50% median in network rate, will drop as there is 0 incentive for the insurers to renew your contract at high rates because if they don't, well you can get a MAX reimbursement of the 50% median in network rate. As contracts get cancelled or lower that QPA goes lower and lower.
Secondly, there is no one actually holding the health plans accountable on what their QPA determination is. If they say the QPA is $30 a unit...and I don't believe this to be true...well I'm SOL as the arbitrating entities only look at the QPA not if they are accurate. Does this make sense to anyone...? Is this a race to the bottom towards Medicare for all. Looking for insight from informed anesthesiologists that understand and do their own billing, ie Arch Guillotti. Anyone have ideas on what can save anesthesia from this point moving forward so it's not medicare for all or 150% of medicare or 200% of medicare.
Secondly, there is no one actually holding the health plans accountable on what their QPA determination is. If they say the QPA is $30 a unit...and I don't believe this to be true...well I'm SOL as the arbitrating entities only look at the QPA not if they are accurate. Does this make sense to anyone...? Is this a race to the bottom towards Medicare for all. Looking for insight from informed anesthesiologists that understand and do their own billing, ie Arch Guillotti. Anyone have ideas on what can save anesthesia from this point moving forward so it's not medicare for all or 150% of medicare or 200% of medicare.