Day: March 16, 2014
“Reimbursements Based on a Medicare Allowable Not Legally Appropriate”
“Another short-term, cheap and faddish solution is making benefit reimbursement determinations based on a Medicare allowable.”
Editor’s Note: This article will be in every salesman’s briefcase tomorrow morning. You can hear the Xerox machines warming up right now. Pro-Cost Plus Health Care Revolutionaries who sell fear (http://blog.riskmanagers.us/?p=14092) will use this article to justify higher fees for legal indemnification, while BUCA sales representatives will use it to sell against Cost Plus Insurance…………..
From a TPA:
At the root of this article is the fact that DCC is a Dialysis Cost Containment company whose lifeblood is “negotiated” reductions from providers of that service. The successful use of reference based pricing combined with use of the laws related to dialysis service facilities not being able to balance bill Medicare eligible plan members would eliminate DCC from the market. The article is built from a self-serving perspective.
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