photo of Maria Todd reviewing managed care contracts with a client

Price Transparency: Ready Set Go!

New and significant hospital price transparency rules are proposed for hospitals in the USA. Will you be ready in less than 4 months?...

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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Data Blocking and its Effect on Physician Integration and Alignment

CMS Administrator Seema Verma has warned that data blocking will not be tolerated. Healthcare data can be exchanged, but software and applications providers have been accused of hoarding it because for many, their business model has been designed on deriving profits from data hoarding. But if Seema Verma’s admonitions are any indication, them days...

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Hospital Wayfinding Within Medical Tourism Facilities

We help a limited number of ambitious and extraordinary clients to grow and scale their unique game-changing medical, dental, rehabilitation and wellness businesses Will your business be our next success story? By Maria K Todd, MHA PhD CEO & Founder, The Mercury Healthcare International group of companies As a former hospital administrator, and now...

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Reference-based Pricing Gets Put to the Test in Virginia

Reference-based pricing in healthcare is an interesting concept. What it is and how it works: Reference-based pricing is a relatively new healthcare reimbursement model where employers contract with a company to negotiate payment rates outside a traditional HMO or PPO contractual relationship and pay hospitals a negotiated amount based on a multiple of Medicare’s...

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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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