This is a clip from my first documentary feature film called King Murray. It won the Cannes Film Festival Critics Prize in 1970. Murray King was a most amazing character and ended up selling me life insurance….. at 27 years old!
Month: July 2021
Aflac Faces a Tight Labor Market
AFLAC facing distribution pressures due to the Chinese Flu………..
Former Healthcare Executive Insider Seeks Redemption
The author’s message is clear. And it’s real. But there is something else within the article that’s a condemnation of our current health care system of finance in this country – If You Can’t Pay Your Gonna die.
Continue reading Former Healthcare Executive Insider Seeks Redemption
Cheech & Chong Insurance?
Insurance Agents Cheech & Chong Out Making Cold Calls
Cheech & Chong, in their best dreams of years gone by, would have never thought possible mainstream insurance brokerage would ever promote a canabis benefits captive. Their idea of “captive” was that it was really bad and something to avoid.
Government Bureaucrats To Cut 258 ASC Procedures?
With the magical stroke of a bureaucratic pen a list of the procedure codes may be removed from the ASC payable list, including several heart and spine procedures…………….
Continue reading Government Bureaucrats To Cut 258 ASC Procedures?
Happy Birthday!
Scott v. UnitedHealth Group, Inc (Cross-Plan Offsetting)
“When United and a provider dispute whether a claim was overpaid, cross-plan offsetting allows United to act as judge, jury, and executioner.”
Continue reading Scott v. UnitedHealth Group, Inc (Cross-Plan Offsetting)
Ruben Edelstein
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.
Willis Earns $1 Billion Termination Fee
Aon will pay the $1 billion termination fee to Willis Towers Watson…………..
Dr. Hodad, M.D.
“Somewhere in the world, there is the world’s worst doctor, and someone has an appointment with them tomorrow” – George Carlin
TRS ActiveCare Under Massive Attack
Will TRS ActiveCare survive massive assaults by hordes of commercial invaders who believe victory is a given? Battle plans incorporate common sense, reason and logic geared to winning in time for the TRS ActiveCare Armistice Day deadline set for December 2021…..
Not All Patients Are Treated Equally……Or Are They?
Unfortunately health plans traditionally do not discriminate by choice of in-network provider because members pay the same no matter who they visit for health care.
Continue reading Not All Patients Are Treated Equally……Or Are They?
Swiss Re Group & Medical Summit
We are thrilled to invite you to our Group & Medical Client Summit on September 13 – 14, 2021.
USBenefits Insurance Services, LLC
USBenefits Insurance Services, LLC is a full service Managing General Underwriter, providing Medical Stop-Loss Reinsurance for employer groups through qualified Third Party Administrators and select brokers.
Phone Call Recordings May Be Requested by Claimants
Phone Call Recordings may be Requested by Claimants if They’re Deemed Relevant to a Benefits Claim
Continue reading Phone Call Recordings May Be Requested by Claimants
Private Equity Is Ruining American Healthcare
The rise of PE in medicine has resulted in a proxy war against insurance companies exclusively for the benefit of clandestine shareholders and investment fund managers rather than patients or clinicians………………..
Continue reading Private Equity Is Ruining American Healthcare
Attention Stop Loss Carriers
John Powers Rocks On…………..
Powers is an expert on reference-based pricing (RBP), having worked on RBP plans for over a decade……………..
The Taste of Success In A World of Failure Is Addictive
Those that don’t play by the rules get the same benefits they have always had but wish they didn’t because they want something better and cheaper………….
Continue reading The Taste of Success In A World of Failure Is Addictive
2021 Milliman Study
HOLY COW!
Interesting Milliman study on health care costs. A lot has changed since 1973………..
The Power of “Skin In The Game”
If this patient didn’t have “Skin In The Game” he would not have shopped for care.
Camp Coverage In A Five Minute Phone Call
Camp Coverage in a 5 minute phone call – 1-800-334-5579
DPC + CPO = Better Benefits, Lower Costs
As insurance costs continue to soar you will see a rapid growth in strategies like this among the ever shrinking community of independent PCP’s who remain adverse to the shackles of managed care contracts and hospital ownership of their practice………
How Montana Is Revolutionizing Healthcare—With Markets
Increasingly fed up with red tape, paperwork and meddlesome third-party rules—especially since passage of Obamacare—a growing number of physicians are opting to bypass both government and insurance companies.
Continue reading How Montana Is Revolutionizing Healthcare—With Markets
D.W. Van Dyke Announces Completion and Distribution of its Medical Stop Loss Industry Target Loss Ratio Survey
Survey results for the January 2020 business indicate a continuation in the favorable loss ratio trend with more than half of all participants achieving or exceeding their respective target loss ratios.
Texas Eliminates Life & Health Counselors License
Fee based insurance consultants in Texas have been required to hold a Life & Health Counselors License issued by the Texas Department of Insurance. Now anyone who claims to be a fee based consultant and holds a General Lines insurance license may provide insurance consulting services.
Continue reading Texas Eliminates Life & Health Counselors License
Insurance Consultants Make Pitch To ECISD
The Edinburg Independent School District held public job interviews for insurance consultant and five showed up to make their pitch.
Cool Hand Luke Starring Tommy Taylor
ATTENTION INSURANCE CONSULTANTS: If you have two hours of free time and want to watch one of the best insurance consultants in our industry deal with a passive aggressive school board this is it.
Where Did Our $19,000,000 Go?
“Who, me? I don’t have it!”
Edinburg ISD’s self-funded health plan lost $19,000,000 in 18 months and they want to know where it went.
Requesting Fee Increase With Insurance Companies
It’s on us as practitioners who take insurance to be assertive and request fair reimbursement rates……………….
Continue reading Requesting Fee Increase With Insurance Companies
Aflac: How To Become An Insurance Agent In Texas
By Bill Rusteberg
In March 22, 1982 I quit my job with a major insurance company to strike out on my own as an independent commissioned insurance agent. By late July I was nearly broke and worried.
Continue reading Aflac: How To Become An Insurance Agent In Texas
Ada Betty Finley
The day after college graduation, Ada Betty took the exam to obtain her Recording Agent’s Insurance License. She passed the exam and became the youngest licensed recording agent in the state of Texas, at the age of 20. Her father, J.C. Dunn, founded the American International Life Insurance Company in Harlingen in 1952 and Ada Betty served as Vice President upon obtaining her license.
Gun Insurance Mandate
California city requires all gun owners to maintain gun insurance……..Meanwhile back at the ranch, Texas enacts Constitutional Carry effective September 2020……….
Pyongyang General Hospital Demonstrates “Love For The People”
Kim was furious when he received reports that officials tried to import Chinese, not European, medical equipment. Those involved in the import of this equipment were reportedly executed……….
Continue reading Pyongyang General Hospital Demonstrates “Love For The People”
Vori Health
Vori Health Raises Additional Capital from Strategic Partners Intermountain Healthcare, Ascension Ventures, and Echo Health Ventures
Pssst….Want To Make $3.2 Million Next Year?
Godfather, The Cat’s Out of The Bag!
An aggressive insurance agent with relationships with school districts can make a lot of money by taking advantage of the Small Group definition by forming a cooperative for school districts as an alternative to TRS ActiveCare.
Continue reading Pssst….Want To Make $3.2 Million Next Year?
Insurance Brokerages Targeted For Extortion
Ransom monies are probably going to Russia to pay for Ferraris in Moscow…………………….
Continue reading Insurance Brokerages Targeted For Extortion
Texas Insurance Company In Receivership
Health Insurance Is Not Really Insurance Anymore
By Molly Mulebriar
Health insurance in the United States is no longer insurance in the traditional sense. It’s become an entitlement welfare scheme that’s fast becoming a heavily regulated government utility.
Continue reading Health Insurance Is Not Really Insurance Anymore
Why Insure Expected Risk?
If we don’t buy FAN BELT insurance then why do we buy insurance for routine doctor office visits? A routine office visit costs around $75 – $150 depending on who you see and the type of visit. Insuring a $75 benefit doesn’t make sense and ends up costing more.
How To Give Employees A Raise Without Giving One
The erosion of the American middle class continues due directly to the medical-industrial complex. It’s time to stop that by giving working Americans better health care that costs less…….
Continue reading How To Give Employees A Raise Without Giving One
Underwriting Risk Is Based On Data
“He who has data wins. He who has good data wins a lot. He who has real time data wins all the time” – Bill Rusteberg
MEMORANDUM TO RBP PLAN MEMBERS
TO: Reference Based Pricing plan members
FROM: Human Resources Department
SUBJECT: How to Avoid Egregious Hospital Balance Billing Practices
Some plan members have experienced threatening creditors clamoring for more money than our plan allowed and paid medical caregivers. As a reminder, our plan pays more than what Medicare pays. Almost all medical providers in the United States accept Medicare payment without balance billing their patients for any more money.
Upcoding is Not Uncommon – But These Guys Got Caught
Why get paid less when all you have to do is change a few numbers on a claim form and you’d be driving a cadillac by Xmas……………
Continue reading Upcoding is Not Uncommon – But These Guys Got Caught
Quizzify Earns Total Victory In Surprise Bill Dispute
Imagine having a surprise bill reduced 95.3%, from $14,269.30 to $674. And that’s without going to court, without conceding a nickel from your initial offer, without trying to qualify for an oxymoronic “financial assistance program,” without hiring an attorney, and even without agreeing to an NDA. (We’ll name the hospital on request. To name it here seems like piling on, and we’re gloating enough as it is.)
Continue reading Quizzify Earns Total Victory In Surprise Bill Dispute