Controlling Costs

At Blue Cross and Blue Shield of Kansas, you can be confident of our on-going cost-containment efforts to keep your costs as low as possible. For instance:

• With 98 percent of the Kansas medical doctors in our service area belonging to our network, you save every time you seek services because these providers write off any dollar amounts over our contracted and agreed upon limits.
  
• The pre-admission certification requirement helps to control costs by eliminating unnecessary hospital admissions.
  
• By cross-checking all claims through our OPL (other party liability) unit, we avoid having duplicate payments made for the same services, which in turn saves our customers' money. To date, millions of dollars have been saved through coordination with other carriers and also by identifying and coordinating benefit payments for workers' compensation and no-fault auto insurance.
  
• Through our case management program, registered nurses serving as case managers identify and coordinate treatment alternatives to enhance the patient's quality of care benefits in a cost-efficient manner. This program distinguishes BCBSKS as an advocate of integrating health care services to achieve the optimum health of our clients and their communities we serve.
  
• Health management is a cost-effective program designed to enhance a patient's health and lower costs by improving the organization and delivery of care to diagnose, manage and improve services for chronically ill patients.
  
• Our focused review pre-certification program is a managed benefits tool for reviewing, on a limited basis, identified providers, diagnoses, procedures and patients. We also review cases which we feel are candidates for cost-effective services and/or case management.
• We have developed a special reimbursement program that awards providers for performing services in the most cost-effective setting. This program allows our customers to get the most benefits for their health care dollars, while rewarding doctors for better managing their delivery of services.
  
• We have a dedicated unit committed to eliminating fraudulent activity through prevention and awareness to keep the cost of health care coverage within everyone's reach.

Customers of Blue Cross and Blue Shield of Kansas can rest assured that all our benefit programs contain built-in cost containment activities that help to control costs.

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