September 4, 2025 – Risk Managers

I’d Rather Win 66% of The Time Than Lose 83% of The Time

Sep 04, 2025

BillingNav achieved a 66 percent win rate in No Surprises Act IDR disputes – nearly four times the industry average.

Cash Isn’t King At The Cuero Community Hospital Emergency Room

Here’s another hospital pricing arrangement showing billed charges no one ever pays, cash prices few can afford to pay, lowest minimum negotiated prices with anonymous payers and the maximum negotiated prices with more anonymous payers.

Bipartisan Bill Would Codify, Strengthen Price Transparency Rules

Bill requires hospitals to publicize payer-specific negotiated charges. Secret managed care contracts will be no more.

As Insurers Struggle With GLP-1 Drug Costs, Some Seek To Wean Patients Off

Kyra Wensley’s doctor fought to keep her on the injectable weight loss medication Zepbound, but Wensley ultimately had to switch to Wegovy, a different GLP-1 agonist, to meet her health plan’s requirements

“With list prices of roughly $1,000 a month, public and private payers are struggling to keep up with ballooning demand for GLP-1 weight loss drugs and in some cases are eliminating or restricting their coverage as a result.”

Government Solution To High Cost Health Insurance? Catastrophic Health Insurance

Government Expands Access to Health Insurance: Consumers to Gain Access to “Catastrophic” Health Insurance Plans in 2026 Plan Year

Forrest Gump Hospital Agreement

”When a patient offers their right to obtain benefits from their insurance, that assignment of benefits is in and of itself consideration in full, exchanged for services and treatment. An assignment of benefits is thus not a form of access to consideration, and rather, is the consideration itself.” – Adam Russo

$5,000 Annual Dental Plan For $41.58 Per Month

NO Waiting Periods and NO Deductibles
$5,000 Dental Plan (per calendar year, per covered family member)
Large National PPO Network
Implants Covered on Major Services
For Individuals and Employer Groups of 2+
Fully insured by – A.M. Best Rated Insurance Company

Price Transparency In Healthcare Saves Money

Need a tonsillectomy and adenoidectomy? If you go to Methodist Hospital, it will cost you over $17,000.

McAllen Has The Highest Uninsured Rate In Texas

The uninsured rate is a staggering 29.7% in the most uninsured Texas metro.

McAllen, Texas, “the most expensive town in the most expensive country for health care in the world” also has the distinction of having the highest uninsured population of any city in Texas.

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