Blue Shield of California is being sued for allegedly issuing a wrongful blanket denial of all requests for coverage with the Coflex titanium implant to treat lumbar spinal stenosis....
Continue reading2020 Revenue Cycle Trends To Know
Mounting pressure on patients and medical providers due to increased patient financial responsibility. What can you do to help accelerate cash? Read on!...
Continue reading2020 Outlook: Value-based Care (VBC)
2020 Outlook: Value-based Care & Reimbursement MARKETING & REIMBURSEMENT AskMariaTodd™ …for more information about what’s been mentioned in this article or something else you’d like to learn more about Maria Todd is frequently engaged as a consultant to prepare physicians, hospitals and ambulatory surgery facilities for value-based care marketing and reimbursement strategies. Over the...
Continue readingAbout Medicare for All
What Should You do About Medicare for All? CONTRACTED REIMBURSEMENT STRATEGY AskMariaTodd™ …for more information about what’s been mentioned in this article or something else you’d like to learn more about Some consultants like to up the drama of the industry by telling scary tales about change and Medicare for All. While Medicare for...
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Nearly 36% of payments tied to FFS Alternatives
Offering alternative value-based payment options to payers differentiated you and delivered competitive advantages. Now, if you don't, you'll be left out. Are you ready to risk that?...
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High-Value Health Care: The Intersection of Quality, Affordability and Outcomes for Employers
Employers are uniquely positioned to positively influence the quality and cost of health care through direct-with-employer contracting. But they aren't sure whom to call and how to proceed. Neither are the providers......
Continue readingConsidering a Cash Pay Program? Check Your HMO/PPO Contracts for Conflicts!
A checklist for providers considering cash pay discounts for payment in full on the day of service might conflict with the payor contracts....
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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?...
Continue readingLooking Back Ten Years: Managed Care, Medical Tourism, and more
Looking Back at the Past Ten Years: Managed Care, Medical Tourism, Concierge Medicine and Bundled-priced Surgery Case Rates...
Continue readingNeed 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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