The Healthcare Entrepreneur Blog » Insurance

New consumer Medicare website now online – www.medicare.gov

Tannus Quatre PT, MBA — Mon, 12 Apr 2010 22:08:55 +0000

A new version of Medicare’s consumer website was released today, located at www.medicare.gov. The new site is part of a series of steps the Centers for Medicare & Medicaid Services (CMS) is taking to facilitate use of the website by seniors and those who care for them.

Among features included in the improved website are Medicare benefits summaries, coverage options, rights and protections, and answers to many of Medicare’s FAQ’s.

Take a look…

Remind patients: The end of the year is near (and deductibles will be renewing)

Tannus Quatre PT, MBA — Thu, 22 Oct 2009 16:06:11 +0000

Believe it or not, it’s that time of year again.

As we quickly approach the end of October, today marks just 70 days until calendar year medical benefits will reset for many of your patients. Renewed deductibles, expiration of existing insurance plans, and the zeroing of health savings accounts will — in very short order — mean more money out-of-pocket for your patients. As you’re aware, this has a tendency to accompany the…

Medical association fights back against RAC’s

Tannus Quatre PT, MBA — Tue, 14 Jul 2009 23:11:49 +0000

The Texas Medical Association is fighting back against RAC’s through a lawsuit that claims false assertions during a medicare recovery audit. You can bet that people on both sides of the RAC issue will be paying attention to this one.

“This is about protecting our patients’ private health information and fair treatment for physicians,” says Richard J. DePersio, MD, president of the 7,800-member TMA. “Our members complained to us about the HRI ‘strong-arm’ letters. We

…

Specialization in health care means more cost to the system

Tannus Quatre PT, MBA — Tue, 16 Jun 2009 13:58:00 +0000

It’s the unfortunate reality that while increased specialization of labor in health care can result in better care, it most certainly results in more expensive care. This is going to be an issue until we find a way to pay more for “brain time” or “cognitive medicine.”

From, the NY Times: Let Doctors Bid for Medicare Business

Researchers have observed that having one additional specialist (per 100,000 people) in

…

MGMA’s Project SwipeIT: Standardization of health insurance cards

Tannus Quatre PT, MBA — Tue, 09 Jun 2009 21:49:00 +0000

The Medical Group Management Association (MGMA) is taking on waste…IT style.

It’s a great initiative, and I recommend that we consider getting on board. The goal is to prevent up to 2.2 billion in waste that occurs each year through the use of non-standardized insurance cards. By using machine-readable cards, patients, private practice clinics, and insurers can all save. Click below to learn more about this great initiative.

MGMA’s Project SwipeIT for standardized health insurance…

Dear Doctor: Here is half your money, take it or leave it

Tannus Quatre PT, MBA — Thu, 14 May 2009 16:32:19 +0000

I recall as a student when – somewhere near the last day of school – an instructor would share the funniest things that they’d seen come across their desk throughout the year. It was usually some 5-word blooper from a student or a simple, yet funny misstatement of history that found it’s way into a writing assignment; something that managed to set itself apart from the rest, truly catching the attention of the instructor through…

Mandating medical loss ratios: Good or bad?

Bridget Morehouse PT, MBA — Fri, 17 Apr 2009 15:40:33 +0000

A recent article in HealthLeaders (April 2009) addressed the issue of regulating the commercial health insurance industry by setting provisions for medical loss ratios. Medical loss ratio is the fraction of revenue from a health insurance plan’s premiums that goes to pay for medical services. In California and other states, legislation has surfaced to force insurers to spend a given level of revenue on direct medical care. For example, last year in California a bill…

Fee schedules, RVU’s, and payer negotiation tips: The numbers are in.

Tannus Quatre PT, MBA — Wed, 04 Feb 2009 19:38:16 +0000

If you provide healthcare services, getting paid isn’t quite as easy as falling off a log.

In fact, as you already know – getting paid for services rendered is quite complicated. Out of this complex system of fee schedules, RVU’s, payer negotiation, and co-pays, the specialty of billing/coding has been borne, and with it, the cost of care has gone up, up, up. Far worse though, the complexity of the reimbursement system has left many…

Female patients not immune from economy’s impact on healthcare services

Tannus Quatre PT, MBA — Wed, 03 Dec 2008 21:44:41 +0000

We’re blogging about this quite often here at The Healthcare Entrepreneur, but in case you haven’t noticed, the souring economy is having an impact on the healthcare provided through private medical, physical therapy, and dental practices. People are delaying care, paying more slowly, and