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Medicare Federal Investigators Getting Algorithms to Analyze And Find Fraud-Good Move as Contractors Efforts Are Weak With Risking Loss Of Transaction Revenue

This is a good deal if in fact it is available for use for the government and not outsourced to contractors as when you read the news , they are not making any waves when handling claims for Medicare in finding fraud as fraudulent claims as well as legitimate...

Published Thu, Dec 12 2010 4:42 PM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, My Commentaries, EMR, healthcare, medicare, EHR, Claims, Fraud, Non Profit, Algorithms, incentives, Contracts, Ingenix, healthcare reform, shareholders, United Heatlhcare

Medicare Data Base–It Is Not Ready for Prime Time To Expose to the Web Due to Errors Factors and Consumer Credibility In It’s Present State Relating to Physician Records

We are all working to make as much data as possible public but sometimes until we are ready for prime time it may not be in our best interests to display data that is riddled with errors until audits are done and a certain amount of credibility can be...

Published Tue, Oct 10 2010 1:45 PM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, My Commentaries, EMR, healthcare, medicare, EHR, Physicians, Claims, Fraud, Medical Claims, Non Profit, Algorithms, Contracts, Ingenix, healthcare reform, shareholders, United Heatlhcare

Grassley Asking About Fraud and Waste from HHS-Where’s the Incentive for Contractors to Fight Fraud They Lose Transaction Income From Processing Claims-Legit or Fraud Its Income

When it comes to fighting fraud, we are back to the fact that some Medicare contractors are owned by health insurance subsidiaries, who make transaction money from medical claims, the goods one and the ones that are fraudulent, so where’s the incentive...

Published Tue, Oct 10 2010 1:55 PM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, My Commentaries, EMR, healthcare, EHR, Claims, Fraud, Wall Street, Non Profit, Algorithms, Contracts, Ingenix, healthcare reform, HealthNet, shareholders, United Heatlhcare, false positives

California Legislation Bill on Breached Data Should Be Vetoed by the Governor-He Did It Before and Should Do It Again-Legislature Not in Touch With IT and California Still Needs Infrastructure Updates to Be Compliant–Unrealistic Law

I hate to sound like a broken record here but the provisions of what is on this bill are enough to make a CIO commit suicide. Our Governor gets is and is a big user of technology but for those who are not living in the real world today with technology...

Published Thu, Aug 08 2010 4:00 PM by The Medical Quack

Filed under: Technology, Other Items of Interest, My Commentaries, EMR, healthcare, medicare, EHR, Claims, California, Fraud, Non Profit, Algorithms, Laws, incentives, Contracts, Schwarzenegger, security breaches, healthcare reform, shareholders, algorithms fraud, infrastruture

Medicare Contractor Gets Deal to Monitor Physician Incentive Payments–Same Folks Earlier This Week Admonished For Not Doing Enough for Fraud Prevention?

Ok that was just on Monday I posted about the disappointment with fraud prevention and I guess it has earned this this bit big of business, is this all there is to this? I realize the contractors have the data but like commercial insurance carriers...

Published Thu, Aug 08 2010 6:55 PM by The Medical Quack

Filed under: Medically Related, Technology, Insurance, My Commentaries, EMR, healthcare, medicare, EHR, Claims, Fraud, Non Profit, Algorithms, incentives, Wellpoint, Contracts, Ingenix, healthcare reform, shareholders, United Heatlhcare

Performance Reviews at the Hospital Means Pay for Performance for the Facility – Are the Quotas Being Met

This is probably not the first time you have heard this but these conversations are going on all the time at hospitals and other health care facilities due to economic times. Hospitalists are graded on their return admissions and each case is scrutinized...

Published Tue, Jun 06 2010 7:30 PM by The Medical Quack

Filed under: Medically Related, Insurance, My Commentaries, Hospital, healthcare, health insurance, Pay for Performance, Budgets, Doctors, Hospitalists, Patients, Contracts, goals, City of Hope, peers

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