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Challenging the NPI Requirement of Blue Cross Blue Shield of Texas Again

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How Far Can They be Pushed?

By D. Kellus Pruitt DDS

Command-and-control organizations like BCBSTX find Facebook difficult to control. Even a small nidus of a complaint posted by a client named Mark about poor service can attract a huge bolus of payback by a dentist, and nobody respects anonymous gatekeepers for huge, unresponsive companies like BCBSTX anyway:

https://www.facebook.com/bluecrossblueshieldoftexas

Mark, as a dentist, I’m very familiar with BCBSTX’s inconsiderate behavior in our communities. At least the anonymous moderator invited your feedback. When I sincerely asked her on Wednesday what federal employees are told about BCBSTX’s NPI requirement, she acted as if the absurd policy hadn’t already wasted enough of my time that day when she provided me an irrelevant link to nowhere – just to get rid of me.

Secret Requirement?

I would actually love to treat federal employees who have BCBSTX insurance because they are some of the nicest people I’ve met. But, BCBSTX’s secret requirement that their clients see only dentists with arbitrary NPI identification numbers (not required by law) makes their employment benefit purchased with taxpayer money worthless if they receive treatment in my office. My office has been told that it has become impossible for paper claims to enter BCBSTX’s modern, computerized system without NPI numbers, and nothing humanly possible can be done to correct the unfortunate problem for dentists who choose not to be HIPAA covered entities.

Evasion?

The moderator’s evasion confirms that even though BCBSTX’s federal customers are led to believe that they can use their dental benefits to help pay for treatment at any licensed dentist’s office, they are not being informed of the NPI requirement, and if they pay the dental bill in full for work done by a dentist without an NPI number, BCBXTX pockets the reimbursement. It just cannot be helped. That’s technology. Tough-luck!

BCBSTX executives naturally prefer that my office manager tell their clients about the obscure restrictions of the dental plans they sell. She catches most federal employees before blocking out time in our schedule to treat them, but nevertheless, one got through on Wednesday morning. It wasted my time as well as the federal employee’s.

Congressional Action?

It’s troublesome to know that the government callously encourages such waste of small business owner’s time and money, not to mention the inconvenience to patients. I’m simply fed up with open appointments for uninformed BCBSTX clients. What’s it take to force BCBSTX to take some responsibility in the community and warn their customers about the limitations of their dental policy before they call my office? Congressional action?

Assessment

I do hope the anonymous BCBSTX employee doesn’t choose to delete this post. Since it seems obvious that their windfall profit is a powerful disincentive for BCBSTX to warn their clients about the NPI restriction any time soon, the more federal employees I can ethically warn through BCBSTX Facebook, the fewer open appointments I’ll have, and less taxpayer money will be wasted on silliness.

cc: Senator John Cornyn

Conclusion

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Consumer Confidence and Savings Rates

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Are Doctors Just Like the Rest of Us?

By Rick Kahler CFP® MS ChFC CCIM

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After a short period of saving more of their disposable income at the depths of the recent recession, Americans are returning to recent historical patterns of spending more and saving less.

Usually this trend indicates “happy days are here again” as the decline in savings means consumers’ confidence is rising. That is not the case today. Consumer confidence is just half of what it was at the peak of the “good old days” of 2007. That year our national savings rate was 2.1%, just above its post-WWII low in 2005 of 1.5%.

A Jobless Recovery?

As millions of jobs disappeared and consumers hunkered down during the 2008-09 recession, our savings rate almost tripled. In 2008 it was 6.2%. This thriftiness didn’t last long; by the fall of 2011 our savings rate was back to a paltry 3.6%.

American Not Always Big Spenders

We were not always such spenders. During the four years of WWII we saved over 20% of disposable income annually. Between 1974 and 1992 the savings rate often bounced between 7% and 11%. Since 1992, the beginning of the unprecedented 18-year bull market in stocks, our personal savings rate reflected the good times in the economy and averaged just 4%.

Savings Rate Decline

One possible reason for the decline in the savings rate in the past three years may be that we’re paying off all the consumer debt that got us into trouble in the first place. In 2000 our individual debt load (including student loans and mortgages) was $19,750 per person. In the fall of 2011 it was $36,420, 8.6% less than the 2008 high but 85% higher than the 2000 amount.

Running out of Money?

While Americans are not substantially reducing their debt, their equity in home ownership plunged from $12.9 trillion in 2006 to $6.2 trillion in 2011. No wonder consumer confidence is so low.

It appears our return to low savings rates isn’t the result of renewed optimism, paying down personal debt, or a surging economy, but rather that Americans are running out of money in the face of staggering personal debt and declining net worth. This leaves them incredibly vulnerable to another downturn in the economy.

Ironically, Americans’ personal finances are a reflection of our government’s fiscal woes. Washington also finds itself compromised to respond to a national emergency because of a debt that exceeds our national income.

Personal Three-Pronged Approach

There isn’t much you and I can do about our government’s over-indebtedness and overspending except to vote for politicians that promise to end the insanity and hold them accountable. But, we can take better care of our own affairs with a three-pronged approach.

1. Get out of debt. We may not be able to earn more or work harder, but I’ll guarantee you that we can spend less.

2. Start saving for emergencies. You need one savings account for periodic expenses like medical deductibles and car repairs. A second is for bona fide emergencies like losing your job or the death of a spouse. It should represent six to 12 times your monthly expenses.

3. Start investing for financial independence. Ideally, you need to put aside 15% to 35% of your income for the time you no longer can or want to work.

Assessment

The hardest part of this approach is becoming willing to downsize your lifestyle. Too many of us say we are willing to cut spending and economize until it actually comes time to do it. In the two decades before the recession, Americans got out of the habit of making hard decisions in our own best interests. However, as our historical patterns show, we’ve treated ourselves with “tough love” in the past. When we have to, we can do it again.

Conclusion    

And so, your thoughts and comments on this ME-P are appreciated. When it comes to consumer confidence and savings rates, are doctors and medical professionals just like the rest of us?

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