Need Help to Appeal Denied/Rejected Claims?

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...

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Vertical 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...

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The 340B reductions

As you may have heard, new 340B guidelines announced in November 1, 2017 and became effective January 1, 2018.  Since the announcement I've been working with hospitals on strategies to implement, extend, and optimize participation in the 340B program.  The back story On November 1, Centers for Medicare and Medicaid Services (CMS) issued its 2018...

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