Patient Defender is the ultimate weapon in the battle against abusive balance billing tactics……
The federal government acted unlawfully when it reneged on a commitment to shield Affordable Care Act insurers from heavy financial losses, the U.S. Supreme Court ruled Monday.
“TRS is understandably eager to point out that employers in TRS-ActiveCare pay 15 percent less than districts not in the program. In addition, TRS reports that while other plans saw a 24 percent increase in costs from 2013 to 2019, TRS healthcare plans only increased by 7 percent……………”
“Right now Medicare is determining that if you have a COVID-19 admission to the hospital you get $13,000. If that COVID-19 patient goes on a ventilator you get $39,000, three times as much. Nobody can tell me after 35 years in the world of medicine that sometimes those kinds of things impact on what we do.”
By Bill Rusteberg
Health care costs have remained essentially static over the past 15-20 years yet health insurance costs have skyrocketed. Here’s why……………
Denver Health Executives Get Bonuses 1 Week After Workers Asked To Take Cuts
I’m proud to be offering telehealth options, and Airrosti is working with insurance providers to offer these, in many cases at a low or no cost to patients. You may have great benefits in place for this, which our Patient Advocate Team (PAT) can verify for you, so do not hesitate to reach out to the PAT or me if you need anything.
The increased use of telemedicine during the coronavirus pandemic raises concerns about whether providers’ medical professional liability insurance will cover them if they use it to treat patients across state lines.
Hello,
I work for Castlight Health, and we help people navigate an often confusing healthcare landscape. With that, we developed a COVID-19 Test Site Finder, a national directory that helps people across the US find the nearest healthcare provider to perform COVID-19 testing. We hope to help assess their symptoms, determine the appropriate next steps for care, and easily find a coronavirus testing site.
Claros Analytics is an actuarial software firm that develops cutting edge software for pricing and analysis of risk in health care plans and health care systems.
By Darrell Pruitt, DDS
The Jonus Group is constantly looking to expand its network of professionals, acting as their eyes and ears in the marketplace.
By Bill Rusteberg
A few years ago we were having a few late afternoon beers, as was customary on most business days, at the CEO’s private office in West Texas. Although I was not a “regular” since I lived many miles away, when I had occasion to visit I always looked forward with keen anticipation to the late afternoon “business meeting” that would invariably take place. It was always an enjoyable time, with much banter back and forth, with an occasional visitor or two dropping by to add to the atmosphere.
Atelier Rebul, one of the oldest and most famous kolonya brands in Turkey, first opened on the streets in Istanbul in 1895 (Credit: Atelier Rebul)
For hundreds of years, this Ottoman-era cologne has been synonymous with Turkish hospitality. Now, it’s being used to fight coronavirus……………….
By Bill Rusteberg
I couldn’t resist publishing this in a moment of insanity this afternoon…………it’s therapy that’s good for me………….
Turning the Tide: Combating Uncertainty in Healthcare Reform with Captive Insurance
The future of healthcare in the United States remains uncertain – even for practitioners in private practice.
For a $2 million annual premium, the Association collected last month $141 million when the 2020 tournament was canceled as a result of the Coronavirus pandemic, otherwise leaving the Association devoid of ticket sales and television revenue…………………..
When Murrow asked him, “Who owns this patent?”, Salk replied: “Well, the people, I would say. There IS no patent. Could you patent the sun?
Employers’ Health Care Costs Expected to Rise Due to Coronavirus
Costs could increase by 7 percent this year with expanded coverage……………
The All Lines Aggregate program is a contemporary alternative to conventional insurance.
Helping Insurance Agents Build a $1,000,000 Book of Business Through Signed Broker of Record Letters………………..
Learn how to win BORs and Consulting Agreements nearly 100% of the time by providing insights and massive value!
“The illicit trade in such counterfeit medical items during a public health crisis, shows a total disregard for people’s lives,” said Interpol’s Secretary General Jurgen Stock.
Settlements have been reached in a class action lawsuit involving the oral contraceptives Loestrin 24 Fe and Minastrin 24 Fe. Defendants agreed to deposit $63.5 million into a Settlement Fund to settle all claims in the lawsuit. A claim form must be submitted by SEPTEMBER 21, 2020.
USA (Harlingen, Texas) – Professional Insurances Consultant Services – Deadline April 28,2020
San Antonio hospitals cut hours, furlough workers — even in face of coronavirus pandemic
RiskManagers.us announced today the availability of a patent pending, exclusive and proprietary self-administered Chinese Flu test that decreases the burden on providers and extends hospital resources.
Special Risk Premium Dollars
Government underwrites Special Risk Cover for uninsured Americans. This Special Risk Coverage is limited to testing and diagnosis of the Chinese Flu………Will Alien Abduction & Kidnapping insurance be next?
William Lee “Bill” Ebaugh
It’s been about a year since Bill decided to check out greener pastures. We are positive he is doing well these days………………
Many thousands of Americans rely on independent family physicians, and if we do not act boldly and quickly to save them, we risk eviscerating the heart and soul of healthcare in communities nationwide.
He ended up in a mental institution, where he died at the age of 47. It is believed he died from the thing he had sought to eradicate……………………….
We’ve seen little or no outrage over egregious hospital price gouging in years past. Consumers have remained complacent. Yet now we are seeing outrage over minor things like $60 for a bottle of hand sanitizer, or $39.95 for a pair of face masks. Why the outrage now when there was none before?
Alex Fairly
No other RBP vendor can replicate our simple, streamlined approach. Welcome to the next generation of RBP……………………
Emergency room doctors and nurses many of whom are dealing with an onslaught of coronavirus patients and shortages of protective equipment — are now finding out that their compensation is getting cut………………….
RiskMangers.us is a specialty company in the benefits market that, while not an insurance company, works directly with health entities, medical providers, and businesses to identify and develop cost effective benefits packages, emphasizing transparency and fairness in direct reimbursement compensation methods.
CHINESE FLU – Severe Acute Respiratory Syndrome Coronavirus 2
“From a risk communications perspective, using the name like Chinese Flu can have unintended consequences in terms of creating unnecessary fear for some populations, especially in Asia…….”
Plan requires members to complete the application process, in good faith, for alternate funding programs…… …
Telemedicine utilization will explode due to current state of affairs. I believe as consumers begin to get used to telemedicine they will like the convenience and continue to use it after this crisis is resolved. Smart brokers are seizing this new sales opportunity. How are they selling it? By telephone of course.
PCA is publishing RFP 3-215-19 Third Party Administration and Insurance Services, 125 Cafeteria Plans, and Related Items.
Overwhelming medical debt is the No. 1 reason Americans file for bankruptcy. In fact, according to a study out of the City University of New York, 66.5 percent of bankruptcy filings cite medical expenses as a contributing factor.
Dr. Vladimir Zelenko has now treated 699 Chinese Flu patients with 100% success using Hydroxychloroquine Sulfate, Zinc and Z-Pak. Dr. Zelenko claims he saw the symptom of shortness of breath resolved within four to six hours after treatment…………………..
By Molly Mulebriar
Brokers should be cautious yet most don’t seem to be as evidenced by the prolific offer and acceptance of “free” Cafeteria Plan administration services, especially among Texas public school districts.
Organ Donor Faces Medical Review Committee
A majority of China’s organ transplants reportedly come from harvesting those of non-consensual “donors”…………….
By Darrell Pruit, DDS
If my suspicion is correct – that aerosol driven from the mouths of patients by dentists’ high speed handpieces can carry the COVID-19 virus – we could be witnessing an alarming increase in dental office closures due to occupational illnesses in the weeks following Easter Sunday services, or even an official “all clear” signal much later.
“A buyback deductible, also called a deductible buyback, can be an add-on to an existing insurance contract or may be purchased separately.” For example, it can be a method to buy down a high deductible health plan specific to certain specified conditions.
He entered the insurance industry in 1964 when he was lured away from selling cars in Harlingen, TX……
School district cuts healthcare spending in half while reducing employee cost-sharing by $1,000. More evidence size doesn’t matter, smart risk management does…………….
Forget what you know about traditional primary care: the inconvenient scheduling, long wait times and increasing expenses. 98point6 is pioneering a new approach to primary care, using technology to bring affordable, on-demand access to everyone—because we think that’s the way it should be.
America needs to establish a Hospital System Super Fund immediately of $300 billion-$600 billion……….
Sun Tzu
Could having a local representative on the ground disguised as a punching bag, gauging and influencing perception and needs among members be the motivation?
As a fee based insurance consultancy, you can imagine our surprise when we opened a letter sent to us in February 2020 from a PBM and found an unsolicited commission check made payable to RiskManagers.
Health Insurance 101
Chapter 1 Correlation Between Provider Reimbursement & Rate Setting
Chapter 1 Takeaway: GREEN IS GOOD, RED IS BAD
By Molly Mulebriar
Provider reimbursement difference between a traditional Managed Care plan (PPO) and a Reference Based Pricing plan is illustrated in the graph above.
“Anyone know what the COVID-19 (Chinese Flu) Medicare CPT codes U0001 and U0002 Medicare payment rates are?” – Bill Rusteberg
“Bill, it’s our understanding those are old codes and fees. They have been updated and there are new fees. We’re trying to get confirmation, but it looks like Medicare will pay $305 for the test. We’ve heard hospitals will charge anywhere from $900-$3,000” – Physician
“Wow our TPA is already seeing cost of test between $2,000 and $3,600. We did decide to go ahead and cover testing under preventative so it is free for employees with our insurance” HR Director
“Our director of health services seem to think the test will run $295″ – HR Director
By Bill Rusteberg
Why do some plan sponsors settle balance bills for their members when they don’t have to in the first place? And when they do why do they often agree to pay significantly more than warranted in medical debt market rates?
YOAKUM, Texas- A male patient was seen on March 7th at the Yoakum Community Hospital who presented mild flu like illness, returning a couple days later (specifics of date was not given) with shortness of breath prompted emergency position on call for the patient to be transferred to an Austin facility to be tested for COVID-19 resulting in a positive testing……………..
“Transmission rates for diseases, and the intensity of an outbreak, are highly dependent on how the pathogen travels between people. Coronaviruses generally can travel up to six feet from an infected person, as they move through respiratory droplets produced through sneezes, coughs or conversations………..”
Hello again everyone!
My book The Great American Healthcare Scam: How Kickbacks, Collusion and Propaganda Have Exploded Healthcare Costs in the United States is now available for purchase on Amazon Kindle.
A cautionary tale where a self-insured employer health plan implemented a reference-based pricing mechanism…………………
Greg Lindberg and his consultant are continuing to fight allegations that they promised to make improper campaign contributions to the re-election campaign for the North Carolina insurance commissioner.
“Let’s say it hasn’t been tested on this strain of the coronavirus, but it’s been tested on other strains of the coronavirus, and it has been able to eliminate it within 12 hours.”
Texas-based company claims to have developed coronavirus vaccine. The vaccine will first need to be tested on animals, but could be available by the end of the year.
