March 16, 2023 – Risk Managers

BUCA Brokerage Monopoly Tough To Beat

Independent TPA’s, especially with those with out-of-the-box solutions, are second class citizens scrabbling for business in the insurance brokerage community.……..

It’s Coming! States Eye Hospital Price Controls As Best Health Care Fix

Hospital price caps gain traction among state governments as a means to lower health care costs………..

Another Golden Nugget From The Godfather of IRC 501r

SOURCE: Doug Aldeen, Attorney At Law & Godfather of IRC 501r

The Texas Hospital District statute takes charity care one step further: Texas places the burden ON THE FACILITY to establish the ability of the patient to pay at cost.

Nurse Navigators Rock!

By Deb Ault

Patient calls the AIMM nurse because she is in the ER. This doesn’t require precertification but the nurse asks a few questions about what landed her in the ER. She begins to tell the nurse that they want to admit her, but they don’t have any beds. They told her that she would have to be admitted in order to get an MRI because they “don’t do those for ER visits”. They told her that if they can’t find a bed for her, they would have to transport her to a different hospital via ambulance to have the MRI done and be admitted.

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