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Coventry Healthcare found the error and has fixed the algorithm , which is called a “computer glitch” here, but it’s just another algorithm. I am trying my best to educate readers here on the power of those algorithms and how the automated processes control not only the information we receive...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Tue, Jan 25 2011
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Filed under: Medically Related, Insurance, healthcare, Medical Records, health insurance, Health IT, Patients, Data, Algorithms, EOB, Coventry, SQL statements, University of Missouri, identification cards
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This is a great article and in the New York Times today and it has been broken down to show the overall mathematics that are used to determine payments. We are again, back to the “A” word that you see plastered in the center of this blog, an algorithm. I just finished watching a PBS documentary...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Fri, Nov 26 2010
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Filed under: Medically Related, Insurance, My Commentaries, Medicine, medicare, medical billing, Congress, Hospitals, CMS, Doctors, Patients, Pricing, Algorithms, formulas, value, payments, MedPac
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If you have not been to the site, it s worth looking at and there’s one item in common that patients will have that is the same with doctors using medical records – too many clicks to drill down to the information, but over all it’s better than what was out there before with running analytics and giving...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Sun, Oct 24 2010
Filed under:
Filed under: Medically Related, Insurance, My Commentaries, health insurance, HHS, Patients, Pricing, Certification, Algorithms, websites, consumers, Healthcare.gov, click wars
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The website designer was found via Twitter, so any of you that don’t take value in what Twitter can do to connect, think again. Most of the people on the project had been on the committee for quite a while. Tech Crunch digs in and gets a little more information on how the creation of the...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Fri, Aug 6 2010
Filed under:
Filed under: Medically Related, Technology, Insurance, health insurance, Twitter, HHS, Patients, Pricing, Certification, Algorithms, websites, consumers, Silicon Valley, Healthcare.gov, web site
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The folks in Europe no doubt will get the banking side of the business as well. With the recent changes announced by the NHS both the analytic and health insurance folks are biting at the bit to start making some money. HIMSS acquires Medical Banking Project – Business Intelligence and Banking...
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We all have to wait until the year 2014 when the “pre-existing” conditions vanishes for all of us. In the meantime there have been some grants given to help out in a small way to states creating insurance pools to give relief to some. Reading all of this takes me right back to “Sicko” and...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Sun, Jul 4 2010
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Filed under: Medically Related, Insurance, Health IT, HHS, software, Patients, Risk Management, Algorithms, premiums, Profits, healthcare reform, denials, underwriting, scoring, community health information, high risk, healthcare claims
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With current laws in California, insurers can raise rates as long as at least 70 percent of premiums are spent on medical claims. With other carriers, Aetna is asking for a 19% increase and Blue Shield is asking for 18%. We still are not sure what the exact Medical Loss Ratios are. Health...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Thu, Jul 1 2010
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Filed under: Medically Related, Insurance, health insurance, California, Blue Cross, Patients, Algorithms, premiums, Health Insurance Reform, rate increases, consumer, rate hike
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the site looks nice and very user friendly, compared to most of the sites we see from the government. There’s a video below that explains how the site works and there are additional tabs with information across the top. As mentioned in my prior post, there’s no pricing on the page, but rather...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Thu, Jul 1 2010
Filed under:
Filed under: Medically Related, Insurance, Other Items of Interest, health insurance, HHS, Patients, Pricing, Certification, Algorithms, websites, consumers, Healthcare.gov
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I believe I am reading this correctly but if you are a member of a company, HMO or otherwise that utilizes the services of Prescription Solutions, this new format will allow the employer (or who ever is the client) to set and establish parameters in which members can function and receive information...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Fri, Jun 25 2010
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Filed under: Medically Related, Insurance, Pharma/FDA News, Prescriptions, HMO, Business Intelligence, Medications, Doctors, Patients, Algorithms, United HealthCare, websites, employer, Prescription Solutions, Clinical Vantage
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This is a big feat in indeed to meet the short deadlines of aggregating all the information with various insurance carriers to one portal site to hopefully make the process of shopping for insurance easier. Initially pricing will not be included and will not come on line until October according...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Wed, Jun 23 2010
Filed under:
Filed under: Medically Related, Insurance, health insurance, HHS, Patients, Pricing, Certification, Algorithms, websites, consumers, Healthcare.gov
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If you read here often enough you see the world algorithm quite a bit as that is what it is all about. If you read about Wall Street, it’s the algorithms there too. I do somewhat get a bit puzzled as to why we call these mathematical formulas “circuit breakers” and other strange names as...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Wed, May 26 2010
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Filed under: Medically Related, Insurance, Pharma/FDA News, health insurance, Claims, Business Intelligence, Blue Cross, Obama, Patients, Algorithms, Wellpoint, paradigms, ethics, healthcare reform, villians
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The role of the pharmacy benefit manager is indeed changing on the landscape today . In this circle we have the usual clinical information value, the cost and last but not least the marketing to the consumer or patient. DNA testing is slowing working it’s way into today’s landscape of healthcare...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Tue, May 18 2010
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Filed under: Medically Related, Insurance, Pharma/FDA News, DNA, Genomics, drugs, health insurance, Marketing, Pharmacogenomics, Doctors, Patients, Algorithms, Walgreens, treatments, pharmacists, Caremark, pharmacy benefit managers, CVS retail clinics, PBM
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This goes back to the risk management “algorithm” that was run to find areas for reasons to end policies for those who were not “cost effective” in the course of doing business. Did they run the algorithms, yes they did but it’s not nice to have to see it along with the rest of the nation and save...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Mon, May 10 2010
Filed under:
Filed under: Medically Related, Insurance, My Commentaries, health insurance, Claims, Business Intelligence, Blue Cross, Obama, Patients, Algorithms, Wellpoint, paradigms, ethics, healthcare reform, villians
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We are definitely on the search to find out what medications work and why. Just yesterday I posted about another company that is incorporating genomic research to match drugs, patients and price. Matching the Right Drugs to the Right Patient for the Right Price – Gene Network Algorithm Solutions...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Wed, Apr 28 2010
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Filed under: Medically Related, Insurance, Pharma/FDA News, Medicine, drugs, healthcare, Prescriptions, clinical trials, Patients, Data, Algorithms, healthcare reform, chronic condition, phyicians
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If you want to look up cost of admissions, this is the place to check. There’s also information available for researchers and journalists. What is visible here is the amount that Medicare pays to hospitals based on a number of formulas that are input into the system. I have not had...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Thu, Apr 15 2010
Filed under:
Filed under: Medically Related, Technology, medicare, CMS, Heatlhcare, Dashboard, Patients, Transparency, Algorithms, Web 2.0, healthcare reform, statistics, charges