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BCBSNC Release of Data

    Client Alerts
  • January 20, 2015

After objecting to the release of hospital reimbursement rates mandated under North Carolina’s Health Care Cost Reduction and Transparency Act of 2013 (NCGS Section 131E-214.5), Blue Cross Blue Shield of North Carolina released its own collection of reimbursement data by posting the cost of more than 1,200 non-emergency encounters and procedures, including encounters and procedures commonly performed in physician offices.

The information is reported based on historical claims data, and in in the case of treatments/procedures involving more than a physician encounter, reflects all costs (such as facility fees, physician fees, drugs and supplies) in the aggregate. As pointed out by several commentators, the difference in reimbursement rates is striking, though in some cases the data does not differentiate the site of service. The types of treatments/procedures included in the release vary widely and include: office encounters (existing patient, new patient or office consultation) in a physician’s office, imaging services, and major medical events such as knee replacements and cardiac angioplasty. Health care providers were taken by surprise and expressed concerns regarding the potential for consumer confusion.

The January 7th release is available to the public at