Archive for January 4th, 2014

Cost Plus / Medicare Benchmarking Continues To Gain Market Acceptance – Are PPO’s Facing Extinction?

Saturday, January 4th, 2014

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“INETICO has put together a complete and effective option to the traditional PPO model……………..”

Editor’s Note: Cost Plus insurance, also known as Reference Based Pricing, is becoming a growing market phenomenon. In Texas, Cost Plus Insurance (www.costplusinsurance.com ) made a debut about 6 years ago.  A handful of employers who had the intestinal fortitude to step away from the managed care world, decided to purchase health care using common sense and traditional American business practices rather than rely on secretive managed care contracts between health care givers and their PPO partners.

The market was confined to one or two “Out-Of-The-Box” TPA’s who, much to their credit,  risked retaliation from the managed care industry. Their perseverance paid off – clients saved as much as 50% or more above and beyond managed care contracts – and TPA profits soared through a percentage of savings scheme or fees of up to 12% of billed charges that netted millions in new found wealth.

(Hospital Charge Master is an intermediary’s best friend – Hospitals Dismiss Significance Of Chargemaster Prices? – “greatest fraud foisted upon consumers since Vicor Lustig sold the Eiffel Tower in 1925″).

Markets evolve. Opportunities abound. Free enterprise rewards those who build a better mousetrap, keeping  competitors at bay through innovative strategies, good service and competitive pricing. (Xerox, Eastman Kodak And Cost Plus Insurance)

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United HealthCare Announces Agreement With DaVita

Saturday, January 4th, 2014

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Press released received from United HealthCare last week via email:

New DaVita Agreement: After months of negotiations we have a new agreement with DaVita HealthCare Partners (DaVita dialysis) allowing UnitedHealthcare members immediate access to all of DaVita’s 1,949 facilities. The new agreement also includes commercial Medicare and Medicaid business. Previously we had announced the expiration of our network agreement with DaVita effective Sept. 30, 2013.

Editor’s Note: Third party intermediaries negotiate medical care pricing for many of us. Yet, we are not allowed to see the terms of the agreed pricing until we have a claim. Then all we see is an inflated, make believe number off which is applied  a “significant discount” (designed to make us happy) leaving a net number against which we are unable to compare with other provider’s costs.

Donkey Ball Participants Win Legal Decision – Offending Donkey Banned From Future Events – Will Donkey Appeal?

Saturday, January 4th, 2014

donkey2 “I’m innocent!”

“An insurer must defend bodily injury claims filed by two players tossed off their donkeys during a “donkey basketball game” because……….”

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Reports Of UFO Sightings Across California – Alien Abduction Insurance Sales To Surge?

Saturday, January 4th, 2014

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“I seen like six bright orange colored lights,” Kaye Pinlac of Stockton told         ABCNews affiliate News 10. “They were almost like in a diamond or triangle shape. It was weird. And so they started just separating.” Pinlac captured a video of the lighted object on his iPhone.

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