Blue Shield of California has sent a notice for affiliation with ASH January 2020 for some select PPO plans and are encouraging joining ASH
- It is not all BS plans but specific PPO plans only. Note several plans currently do this but ASH is just the gatekeeper for medical necessity and does not follow ASH rates.
- These plans will still have out of network benefits but clearly an incentive for patients to seek care with in-network for less out pocket costs
- Regular BS participation for their standard California plans will not be affected.
- I foresee this for plans that are self-insured entities.
- Note ASH does allow providers to opt in or out of certain plans so it should be possible to opt into this plan only should it be a benefit for your office
- There is no indication of their allowed rates or fee schedule and would appear to continue to be at the BS rates and not ASH