Archive for February, 2020

AMA: Insurers Misused CPT Codes To Hide Administrative Costs

Thursday, February 27th, 2020

Aetna Inc., Aetna Life Insurance Co. and Optumhealth Care Solutions Inc. allegedly misused CPT codes to pass on administrative charges under the guise of medical care………….

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Sleepy TRS ActiveCare Trustees & Clueless Texas Legislators

Thursday, February 27th, 2020

“Legislative inaction has now led to an insurance program for school district employees that is more burdensome than beneficial, and for many educators, it amounts to a pay cut year after year.”

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Coronavirus Highlights Chinese Drug Dependency

Tuesday, February 25th, 2020

Coronavirus has jeopardized the “domestic supply of some 150 prescription drugs, including antibiotics, generics, and branded drugs…………..”

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The Great American Healthcare Scam

Monday, February 24th, 2020

The Great American Healthcare Scam: How Kickbacks, Collusion and Propaganda Have Exploded Healthcare Costs in the United States.

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BCBSMN ASO Agreement

Sunday, February 23rd, 2020
A self-funded plan using BCBSMN as the Plan Administrator pays out-of-network providers 200% of Medicare. What do they pay in-network providers (Hint: it’s more).

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Ruben Edelstein

Thursday, February 20th, 2020

By Bill Rusteberg

Ruben Edelstein practiced managed care in his own way. The son of immigrants, he ran a successful furniture business in South Texas. An astute businessman, he grew the business with locations throughout the Lower Rio Grande Valley in deep South Texas.

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Survey Reveals “Me Too” Brokers In The Majority

Thursday, February 20th, 2020

“It’s evident that many brokers believe the (PPO) networks are not the long-term answer, but brokers and consultants continue to push business to the traditional model or utilize TPAs with carrier or independent networks because it’s the status quo, what we have always done.”

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Turning Bronze Into Gold

Tuesday, February 18th, 2020

Turning Bronze Plans into Gold Plans at Bronze Plan costs is a common but unspoken strategy……………but who is benefiting from “beating the system?”

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China Can Shut Down U.S. Pharmacies & Hospitals in Months

Saturday, February 15th, 2020

“China’s stated aim is to become the pharmacy to the world with its own companies. And what we’re seeing with Western generic drug companies, they’re collapsing because they can’t compete.”

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What’s An Actuary?

Friday, February 14th, 2020

How do we know we are doing much better this year than last year?

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The Payer You Never Heard Of

Thursday, February 13th, 2020

You won’t see recognizable logos or insurance company names on their health insurance I.D. cards. You may wonder “what kind of insurance is this?”

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Quizzify’s Surprise Medical Bills Solution

Monday, February 10th, 2020

“If a hospital (y) later turns down “two times Medicare (2x) and it goes to court, their lawyer is going to say, ‘We could lose this thing……………………..”

200% of Medicare represents a “savings” over a typical 60% PPO discount?

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TRS ActiveCare Can Be Fixed, But We’re Tired of Waiting

Saturday, February 8th, 2020

Rather than kicking the can down the road to the next legislative session, sleepy TRS ActiveCare trustees should take note and consider adoption of newer, proven risk management strategies as other risk pools have done……………………….

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Everyone Is Paying For Mary’s Deductible Because Mary Isn’t

Friday, February 7th, 2020

Lucky Mary. She has a $1,500 deductible through her employers health plan but everyone else is paying for it because she’s not…………….

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Owe Medical Bills? Don’t Pay Promptly, Pay Late & Join The 50% Club

Friday, February 7th, 2020

Members of the 50% Club subscribe to the Upside Down Economics of Health Care. They understand those who pay on time are screwing themselves and those that don’t are rewarded…………….

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TASB Issues Health Insurance Survey Results For Texas School Districts

Thursday, February 6th, 2020

Hard working Matamoros street vendors may make more than Texas school teachers………………..

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Pricing Customers Out of Health Care

Wednesday, February 5th, 2020

               You Want How Much!

As Out-Of-Pocket Health Costs Rise, Insured Adults Are Seeking Less Primary Care

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