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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Why America’s Rural Hospitals Suffer under Shared Risk and Full-Risk Payer Contracts

In managed care agreements, payers regard rural and urban hospitals as “hospitals”, all uniform in character. But in reality, huge variations in the demography, economics, culture, and environmental characteristics of different rural places make them very different from their urban counterparts and distinctly different from their other rural competitors. Large rural and suburban bedroom...

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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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