Why is the process of renewing and renegotiating #managedcare #contracts still such a challenge for providers? Are they not utilizing the tools properly? Are they not adding the contracts into their systems properly? Do the tools have some necessary features missing? Is there some other reason?...
By MARIA TODD Sublease Agreements: Hospitals cannot enter into sublease arrangements with physicians in order to host town hall meetings with Medicare, Medicaid, or otherwise insured beneficiaries in the physicians’ offices. The rental value for these arrangements must be at fair market value and cannot take into consideration the potential volume or value of...Continue reading
Internationally, the healthcare sector is particularly vulnerable to corruption. There are significant amounts of money involved and the complexities of many healthcare systems, their coding, billing, pricing, and even the verification of credentials and privileging of providers and practitioners is implicated. ...more than 85% of the people in the world highly vulnerable to the...Continue reading
By MARIA K TODD, MHA PhD Know the financial risks associated with these plan participants and prepare in advance to protect your business. What they are Medical Cost Sharing plans claim to be an alternative to health insurance. That confuses healthcare providers and their revenue management team members immediately. Learn what you need to...Continue reading
My Post (70)...
Many concierge physicians contact me because I wrote the book (literally) on Concierge Medical Practice Design. Some have not yet launched their practice while others did it themselves and realize they made some mistakes or that they had hired consultants to help them but things didn't work out as planned or the consultant failed...Continue reading
Comes now, the never-ending promotional hype of totally useless, misguided medical tourism market analysis reports. This trend of new market researcher houses preying on "wantrepreneurs" with cash burning a hole in their pocket and a desire to leapfrog ahead of competitors the easy way is actually replacing the attraction of attending the super-saturated phenomenon of...Continue reading
As a specialist in a private concierge medical practice, you’ve chosen to terminate all insurance panel agreements. Patients will pay you directly for services (out-of-pocket). You provide patients with an invoice marked with dates of service, service codes, diagnosis codes and all payments paid by the patient. Patients agree that if they have insurance,...Continue reading
Expect commercial payers, rather than government payers to lead adoption and innovation of value-based care models and strategies. Just don’t expect any uniformity. Original fee-for-service is disappearing quickly. Currently only 37% of reimbursement is paid under pure fee-for-service with no strings attached. This will continue to decrease below 26% in the coming two years....Continue reading