Out of Network International insurers / health schemes Denied Workers’ Compensation Third-party liability (slip and fall, etc.) with Attorney Involvement Uninsured Motor Vehicle Accident Claims Lack of Medical Necessity Allegations that you lack proper authorization Coverage Exclusion or Exhaustion Pre-existing conditions on Travel Accident Insurance Denied vs Rejected A denied claim is one that an insurance...
Continue readingManaging Managed Care Contract Renewals
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?...
Continue reading“Medical Cost-Sharing” Plans: What Your Hospital or Practice Needs to Know Before You Agree
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 readingVertical Integration Returns to U.S. Healthcare: What You Need to Know Now
In the 1990s, during the Clinton Administration, the USA saw many attempts to achieve vertical integration in healthcare. Here we are again! New acronyms were initiated and made popular to describe Independent Practice Associations (IPAs), Physician Hospital Organizations (PHOs), which were managed and administered by entities known as Management Services Organizations (MSOs). Physicians felt the...
Continue reading63 Must Know Data Points to Bridge the Gap on Meaningful Medical Tourism Market Data
You’ve seen it time and time again. Some publisher has published yet another new report that highlights the market size and potential of the medical tourism / health travel / medical travel market size and opportunity. The cost to access this report is often more than USD $1000. And...
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