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Ok, so what’s the reason for this title? The only leg apparently there is to stand on here is to prove that Blue Shield paid less than 70% on healthcare. Guess what you need some audit algorithms and not take them for their word as there might be mistakes and errors. If you read the...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Fri, Jan 14 2011
Filed under:
Filed under: Insurance, Microsoft/Windows News, My Commentaries, healthcare, health insurance, California, Non Profit, Algorithms, Blue Shield, premiums, audit, healthcare reform, medical care, rates, CIOs
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HealthNet increases are said to average around 4% but actual increases for individuals will vary. HealthNet was slated to have met the 70% requirement for spending on healthcare as is the law in California as it stands today. Blue Shield’s proposed increases are the ones that seem to be the...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Wed, Jan 12 2011
Filed under:
Filed under: Medically Related, Insurance, healthcare, health insurance, California, Non Profit, Blue Shield, premiums, United HealthCare, healthcare reform, HealthNet, medical care, PacifiCare, rates, Atena
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In reading this some policy holders had contracts that guaranteed no raises for a year and those are going to be the ones hit with the highest increase all at one time. Now compared to Blue Cross, Blue Shield is a non profit and quite a bit smaller but it’s still a lot of people. The only...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Thu, Jan 6 2011
Filed under:
Filed under: Medically Related, Insurance, healthcare, health insurance, California, Non Profit, Blue Shield, premiums, healthcare reform, medical care, rates
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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 claims all add up to transaction fees, the...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Thu, Dec 16 2010
Filed under:
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
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Here’s a screenshot below from a prior post that gives one a Wellpoint email address if your have “Congressional concerns” and I don’t know about you, but if I had issues I think I would send my issues direct to Congress as a citizen, right? Again, I come back to the same statement I have made...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Fri, Oct 29 2010
Filed under:
Filed under: Medically Related, Technology, Insurance, EMR, healthcare, medicare, EHR, Claims, Fraud, Non Profit, Algorithms, incentives, Wellpoint, Contracts, Ingenix, healthcare reform, Grassley, shareholders, United Heatlhcare
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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 shown. I have been reading along a bit with...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Tue, Oct 26 2010
Filed under:
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
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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 here? I don’t feel there’s an overcoming concern...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Tue, Oct 12 2010
Filed under:
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
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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 do they run the work to a 3rd party a lot of...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Thu, Aug 12 2010
Filed under:
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
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I guess it’s time to revisit a post I made back in January asking the question of how can a for profit company, traded on the stock exchange, be a solution to efficiently help prevent fraud when stockholder profits are the #1 priority? There are a ton of companies providing audit services for medical...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Mon, Aug 9 2010
Filed under:
Filed under: Medically Related, Technology, Insurance, EMR, healthcare, EHR, Claims, Fraud, Wall Street, Non Profit, Algorithms, Contracts, Ingenix, healthcare reform, HealthNet, shareholders, United Heatlhcare, false positives
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This is interesting to know that premium payments in New Jersey might be going to support a blimp to fly over and advertise. The purpose of this article is to question and take on CEO compensation while laying off other individuals. Layoffs in health insurance though are for the most part...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Mon, Jun 14 2010
Filed under:
Filed under: Medically Related, Insurance, Other Items of Interest, healthcare, health insurance, Blue Cross, Non Profit, CEO compensation, Horizon Blue Cross, legislature New Jersey
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This is moving pretty rapidly in healthcare with private equity. I just posted about a related story a couple days ago, HealthcareofToday, a big grouping of investors adding a medical tourism company to their group. With such investors too, we get layers, in other words this company is a...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Fri, May 21 2010
Filed under:
Filed under: Medically Related, Insurance, healthcare, Investors, health insurance, HHS, Non Profit, Investments, Profits, healthcare reform, private equity, revenue, trade associations
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It certainly could come to fruition if we keep seeing the agreeing to disagree that have been on public display for the last year. There are a lot of good things in the healthcare reform bill and what is odd is that the states under GOP leadership are protesting the mandatory insurance that came...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Tue, Mar 23 2010
Filed under:
Filed under: Medically Related, Insurance, healthcare, health insurance, Government, Politics, Non Profit, Lawsuits, healthcare reform, public system, singlle pay, private system
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This decision was made by the Illinois Supreme Court that yes the hospital system can pay taxes if they are not giving enough charity care. Where does running a business and charity care cross the line? We need charity care, but then those complain that they don’t make any money with charity...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Fri, Mar 19 2010
Filed under:
Filed under: Medically Related, Insurance, healthcare, Charity, Non Profit, Hosptials, healthcare reform, taxes, Tax benefit, Provena
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Health Insurance and preventing fraud need to work together and you almost need some non profit organizations to have this be successful and truly look out for the consumer interest. What are we doing here, awarding contracts to companies that have created a backlog of legal court cases and potentially...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Fri, Jan 29 2010
Filed under:
Filed under: Medically Related, Technology, Insurance, EMR, healthcare, EHR, Claims, Fraud, Wall Street, Non Profit, Algorithms, Contracts, Ingenix, healthcare reform, HealthNet, shareholders, United Heatlhcare, false positives
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The data base will be run by a number of New York universities in New York, and a website will be developed so consumers will have an idea as to what the out of network charges will be instead of having a surprise element that we have seen over the years that paid physicians less and demanded more money...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Wed, Oct 28 2009
Filed under:
Filed under: Medically Related, Technology, Insurance, healthcare, Lawsuit, data bases, Non Profit, Algorithms, United HealthCare, Ingenix, Chiropractor, breach of contract, corrupt data base, Out of Network charges, Cuomo, Fair Datatebase