The Road Home for Health Care & Medical Benefit Solutions

The Leapfrog Group Announces Annual Top Hospitals List - Recognizes Hospitals for Their Achievement in Providing the Highest Quality Care in America

 Sixty-five hospitals have earned The Leapfrog Group’s annual “Top Hospital” designation, equaling 2010’s record-setting total. The “Top Hospital” designation, which is the most competitive national hospital quality award in the country, recognizes hospitals that deliver the highest quality care by p...

Is anybody surprised that enforcement of the "Red Flag Rule" (requiring "Creditors" to have a plan to prevent identity theft) has been postponed once again?  Link to one of many previous posts.  This time, the Federal Trade Commission postponed at the request of Congress. 

Here is the link: Friday's FTC Announcement

What charges are you supposed to pay if you have a PPO, POS. or an HMO type of insurance plan? Deductibles and copays, right? If you receive a bill from a non participating provider, you may be asked to pay more than your fair share of the bill. In some situations you may not even know you were receiving services from a non participating provider, or even had a chance to choose a provider, which is often the case when the doctor or hospital you did choose, uses the...

If nonprofit hospitals spend far less money on providing charity care for the poor and uninsured than the value of their federal, state and local tax exemptions, do they deserve those exemptions? What about if they turn away indigent patients or hound them with aggressive collection practices?

More on this...

&...

Doctors and the fee-for-service system are at the center of the health care debate. This article defines how insurance was created in 1929. A very simple concept that has been controversial since inception. Well worth reading this from the NY Times.

www.nytimes.com

Tax-exempt hospitals do not have to pay federal income taxes. The Congressional Joint Committee on Taxation estimates the value of these tax breaks at more than $6 billion a year.

Before 1969, the Internal Revenue Service required hospitalsto provide charity care to qualify for tax-exempt status. Since then,the agency has not specifically required charity care, but communitiesmust benefit in other ways.

Consumer groups and Patient Advocates can̵...

PUT YOUR CAR KEYS BESIDE YOUR BED AT NIGHT

Put your car keys beside your bed at night. If you hear a noise outside your home or someone trying to get in your house, just press the panic button for your car. The alarm will be set off, and the horn will continue to sound until either you turn it off or the car battery dies.

If your car alarm goes off when someone is trying to break into your house, odds are the intruder won't s...

As if access to healthcare wasn't already overwhelming and increasingly limited, new tactics will be utilized by hospitals beforeyou even walk through the door. Why bother obtaining and paying for a high deductible policy which you can't afford, only to discover that healthcare is still out of your reach?

Access to healthcare will be left to those who are still employed and who also work for larg...

Recently the AMA filed class action lawsuits against Aetna, Cigna and Welpoint for underpaying out of network claims. The AMA was also recently awarded $350m against United Healthcare for the same allegations.

In recent years some of these same industry giants lost litigation related to denying claims for medical necessity. In those class-action lawsuits, physicians a...

The American Medical Association is among several medical societies that have filed a class action lawsuit against WellPoint, Inc., the largest health insurer in the United States.  The lawsuit, filed earlier this week in Los Angeles federal court, alleges that WellPoint colluded with others to underpay physicians for out-of-network medical services, resulting in patients paying an excessive portion of the medical bill. 

The AMA filed similar class action lawsuits...

Excellent free tools for creating business plans, cash flow projections and more!              

Business plans & more

What treatment does my doctor recommend, and do I understand it?
What are my other treatment options?
How do I choose the right care for my needs and pocketbook?
How to do I locate doctors, facilities and pharmacies?

The law is on your side!!  Prohibitions on balance billing that have been enacted in 

many states are very supportive of consumers and will stop medical debt 

collectors. 

TeamGail can help you!!! 

Health Claim - Balance Billing Prohibited: 

The Fed is making a list and checking it twice. But, financial institutions must comply with that list well before Christmas. On Jan. 1, new regulations from the Federal Reserve Board went into effect requiring all banks and financial institutions to improve efforts to combat identity theft.

These RED FLAG RULES

As health-care costs continue to soar, millions of confused consumers are paying medical bills they don't actually owe. Typically this occurs when an insurance plan covers less than what a doctor, hospital, or lab service wants to be paid. The health-care provider demands the balance from the patient. Uncertain and fearing the calls of a debt collector, the patient pays up.

Hospital comparisons - this is a great site to compare hospitals within any radius. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is a national, standardized survey of hospital patients. HCAHPS (pronounced "H-caps") was created to publicly report the patient's perspective of hospital care. The survey asks a random s...

Critical illness coverage seen as small price to pay for peace of mind in tough times With tightened budgets a prevalent reality, employers are struggling to do more with less, including finding ways to offer the best value employee benefits packages. The increasing shift toward employees shouldering more costs, particularly for health insurance, can unfortunately leave many working Americans who face serious illnesses falling through financial c...

Did you know that your local Medicare contractor is a valuable source of news and information? They can quickly provide you with information pertinent to your geographic area, such as local coverage determinations, local education activities, etc. If you have not done so already, you should go to your local CMS website and sign up for e-mailing list. Many contractors have link...