By Staff Reports
(Victor Valley)– Blue Shield of California is working with financial service partners to provide up to $200 million in direct support to healthcare providers and hospitals through financing guarantees, advance payments and restructuring of contracts. This much-needed cash infusion will support health professionals dealing with the pressures of the coronavirus (COVID-19) pandemic.
Blue Shield is planning to accelerate an innovative new, high-tech patient billing solution that was introduced in a pilot program in northern California last fall, offering it to more in-network medical providers across the state. The nonprofit health plan also has taken steps to ease prior authorizations for member care to lessen administrative barriers for providers so they can spend more time and resources devoted to patient care.
“We are arranging hundreds of millions of dollars of support to clinicians and hospitals that are heroically serving Californians on the front lines of this fight,” said Paul Markovich, president and CEO of Blue Shield of California. “We are providing financial solutions, reducing administrative barriers and offering new digital tools to help them face this unprecedented challenge.”
Blue Shield is working with two financial institutions to help providers with guaranteed loans and to make advance payments to them on anticipated healthcare costs. The plan is to offer favorable repayment terms to help providers get through the next six months. Details for its medical providers (clinicians and hospitals) will be confirmed this week and communicated in greater detail as it is finalized.
Blue Shield also has been working on a patient billing solution with San Francisco-based technology startup OODA Health and northern California providers such as Hill Physicians and Dignity Health. The payment pilot program was launched in the Sacramento region last year.
The initiative enables a provider to receive the patient’s portion of the bill at the time of claim adjudication, eliminating the time and expense providers experience to receive payments for member out-of-pocket costs.
Additional steps to help remove administrative burden for providers include:
- Extending new and existing prior authorizations for elective procedures from the usual 120 days to 180 days.
- Streamlining initial clinical concurrent reviews to reduce provider documentation requirements.
- Waiving prior authorizations for patient transfers of post-acute patients when a member is moved to a different site of care, including skilled nursing facilities and extended acute rehabilitation facilities.
Blue Shield has taken several other steps to support providers and the public since the pandemic began.
It is participating in Gov. Gavin Newsom’s COVID-19 Testing Task Force that aims to boost coronavirus testing for all Californians, so medical and public health experts can better treat, track and prevent the spread of the virus. Markovich is co-chair of the public-private initiative announced Saturday.
In addition, the taxpaying nonprofit health plan has taken the following steps to further support healthcare providers throughout the Golden State. They include:
- Offering a digital tool at no additional cost for its nearly 350 in-network hospitals to help them triage the influx of patients seeking advice on coronavirus or other medical care via their websites.
- Donating $500,000 to the Oakland COVID-19 Relief Fund to support, among its projects, pop-up coronavirus testing sites organized by Brown & Toland Physicians that will prioritize medical providers and first responders.
- Providing $100,000 support to MedShare, a San Francisco Bay area nonprofit organization that donates personal protective equipment (PPE) supplies to nonprofit community healthcare providers.
- Blue Shield of California Promise Health Plan, which serves Medi-Cal and Medicare beneficiaries, giving $100,000sponsorship funds to community health providers in Los Angeles and San Diego counties.
Click here to read more about how Blue Shield of California is responding to the coronavirus outbreak to ensure we can continue to deliver on our nonprofit mission.
About Blue Shield of California
Blue Shield of California strives to create a healthcare system worthy of our family and friends that is sustainably affordable. Blue Shield of California is a tax paying, nonprofit, independent member of the Blue Cross Blue Shield Association with over 4 million members, 6,800 employees and more than $20 billion in annual revenue. Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have an impact on California communities.