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Is it true that insurance companies are hiring nurse on their behalf to go to a subscribers home for evaluations and follow up on behalf of the company? I am not speaking of skilled care or something that benefits the patient, its something strictly for the insurance company.

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Well, I have spent time researching this this afternoon and found out that bcbs took close to a 51 million dollar loss in 2015. They have identified a "top 5 percent" of subscribers who have an excessive amount of medical claims or er visits for non-emergencies. People who also fit in this program are people with diabetes or other conditions which require long term care, who if they receive proper care, will decrease long term costs if they follow a proper health maintenance system. They have been monitoring recent er visits and are contacting people who went to the er with non emergencies. Since the program was implemented in michigan, they have saved close to 567 million dollars in costs for unnecessary treatments in the er and tests. The first few years of the program, it was only in the Detroit Metro area and has expanded rapidly since 2014 and the Affordable Health Act.
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Vit B6 was dx'd by a neurologist after a blood test. She was not taking it (other than what is in her multivitamin). She got another multivitamin formulation (w/only 100% of RDA of B6 instead of the 300% in the previous formulation), and took it once every 3 days. Follow-up testing just a few months later had B6 in normal range (actually closer to bottom limit). Either that first blood test was incorrect, or her body metabolizes (or doesn't metabolize) B6 correctly. She called up the vitamin company to tell them about it. She is on a mission now that everyone should know about it.
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CT, I'm writing this just from memory and without doing any further updated research, but as I recall, there are serious issues with excess dosages of B6.

Did she decide to take B6 on her own? If it was suggested or advised that she take this by a doctor, I'd contact that doctor and ask that she be tested for toxicity. However, it sounds as if she does plan to manage this issue by herself.

I'm wondering if this doctor is affiliated with any of the ACOs, rather than an insurance company?
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Now that you mention BCBSM, I do recall reading something in one of their solicitations about this service.

I'm guessing they subcontract with a home care agency for nursing help. The auto companies typically have an industrial nurse on staff, but I'm not aware that this is a practice of other companies, including BCBSM.

I've found that tree cutting companies will represent that they're DTE contractors but when I ask them specifically will admit they're retained on contract by DTE to do tree cutting.

One of those ACO outfits pulled this on me, with their employees stating that they worked for x hospital. I kept probing until I got them to admit that they are not part of the hospital, that they're a Michigan for profit corporation and have their own staff.

B/c I have no use for these companies latching onto patients when doctors provide the follow-up data, I pushed them on HIPAA and privacy issues. The interesting aspect is they're provided information by medical professionals, but have no direct contractual relationship with the patient.

And I learned that the referring doctors share in the revenue garnered from Medicare for their so-called services.

I suspect they, and the nurse in question, have found it easier to just say they work for the specific company with which their firm has been contracted.
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Funny you should mention this...my mother told me last week that a doctor from her insurance company is coming to her condo! An MD? She has plans to discuss one of her medical obsessions with the MD (Vit B6 toxicity), so we'll see how that goes (if she even tells me; she's really cut down the contact with me since deciding that I was "taking advantage" of her).
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It is bcbs of michigan. It was odd because the nurse said they were from there but the badge did not identify the company but had that brownish Michigan on the badge but said she was from the insurance company.
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I think it depends on the specific medical insurance company. I vaguely recall reading something about some companies that provide additional follow-up for home care, but don't recall which companies, how limited the care was, etc. I suspect they're trying to cut the frequency and cost of hospitalizations by being proactive in identifying potential re-hospitalizations or other acute episodes.
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