In the news

Tuesday, December 1st, 2009 at 11:30 pm

I was quoted in a few articles recently:

“Health care cards carry same credit risks” by Sally Herigstad (CreditCards.com)

“Utah Overhauls Health Care” by Sarah McIntosh and Joe Emanuel (Health Care News)

“Skepticism of health reform effort crosses industry lines” by Clarissa French (Springfield Business Journal)

Leave a comment

Concerns about Health Care Reform Growing

Tuesday, October 20th, 2009 at 1:18 pm

Americans are concerned about the growing national budget deficit, and, in particular, how the cost of the pending health care reform legislation will add to the astronomical debt. Clarissa French interviewed Beverly and others about this concern in her article “Skepticism of health reform effort crosses industry lines” in the Springfield Business Journal.  

Leave a comment

Health insurance denial of claims widely debated

Saturday, October 10th, 2009 at 7:16 pm

We are wondering what Edward S. Kornreich and Herschel Goldfield think now after reading our post “Which health insurance carrier denies the most claims?” You see these gentlemen posted an op ed  “Medicare’s lesson for health insurance reform”  at  The Hill.com in September. Here is a quote from the piece, “ Missing from the healthcare debate is any serious discussion about a critical flaw built into our system: Insurers have an incentive to deny claims, because the more they pay out, the less they profit. Patients and doctors have the opposite incentive…….There is an alternative. In fact, it is already in place for the millions covered by Medicare.”

Kornreich and Goldfield should be pleased. Denials are no longer missing from the debate. You’re welcome.

Leave a comment

90-year-old’s Frustration with Medicare Denial

Saturday, October 10th, 2009 at 4:37 pm

 Medicare denied coverage for  ambulance rides, which had been pre-approved, for a 90-year-old double amputee. After multiple resubmissions of paperwork, trips to the hospital patient services department, and two-hour-long phone calls (reaching different Medicare representatives each time), this elderly man has not been able to resolve his nightmare.

Leave a comment

Medicare Wastes Tax Dollars

Friday, October 9th, 2009 at 10:39 am

The next time that you hear that National health care would save money because of the bulk buying power, consider this report from Fox News.  Medicare overpays for items purchased for the elderly.

Here’s an example:

“– $7,215 to rent an oxygen concentrator, when the purchase price is $600.”

Leave a comment

Medicare Denies the Most Claims, Congressman

Tuesday, October 6th, 2009 at 3:26 pm

Last month, Congressman Dennis Kucinich grilled private insurance carriers about the insurance claims they denied in an attempt to demonize them. Meanwhile, it turns out that Medicare actually denies a larger percentage of claims than any of the private insurers. See the report here.

Leave a comment

AMA Endorses Largest Denier of Health Care Claims

Tuesday, October 6th, 2009 at 10:01 am

Patrick Tuohey of Big Goverment picked up our post about Medicare being the largest denier of insurance claims. They also mentioned our findings on Sean Hannity DiscussionFox Nation,  NewsBusters, the Mark Levin Show, Pirate’s Cove, Conservative ThoughtsWake Up America,  MIHealthfacts, Stoptheaclu, moreaboutpolitics, bizzyblog, Healthcare Horserace, the News Factor, Liberty Republican Forum, Insignificant Thoughts, Beltway Blips, Freedom’s Zone, American Daughter, Scared Monkeys, This Board Rocks,Conservative Black Woman, Qando, Outloud Opinion, pharmphun, Free Republic, ShrinkwrapNo QuarterProlifeblogsNews FactorMissouri RecordFree Public, Canada Free Press, Poynter Online, No Oil for Pacifists, A Disgruntled Republican, Brookfield 7, FullosseousFlap’s Dental Blog, myspace forumStupicaCoacheP, WOWOWOW, Jeremiah Films, Collecting my Thoughts, Dana Show, Bellingham Tea Party, Widgetbox, Truckingboard, Live Journal, Argue with Everyone, Liberty’s Army, Google Groups, All Nurses.com, reddit.com, FOX Winknewsradio, Askmen.com, MacDoctor, Community.comcast, insureblog, westandfirm.com, Investors.com, Economistblog, Dailymarkets, Freemarketmojo, mjperry, NCPA, Politics Alabama, 1800blogger, fundmasteryblog, Healthcare Economist, benzinga.com, valuesvoternews, wallstreetblips, Yahoo Answers, prolifeblogs, This Blue Marble, Finheaven.com, Businessweek, topix, 2secondsfaster, macresource, sprintusers, Mrswing,

Leave a comment

Some doctors won’t meet with the President

Monday, October 5th, 2009 at 3:09 pm

Hear from the doctors who chose not to meet with the President even if invited.

Posted by Kathryn Serkes, AAPS  at the Association of American Physicians & Surgeons

DOCS AS PROPS

OOPS! President Obama mistakenly invites OPPONENT to stand up for him at White House today

AAPS doctors ask, Is he having trouble finding supporters? Read the rest of this entry »

Leave a comment

Which Health Insurance Carrier Denies the most Claims?

Monday, October 5th, 2009 at 8:25 am

According to page 5 of the  2008 Health Insurance Report Card released by the American Medical Association, the “carrier” with the highest percentage of denials is…..Medicare. Does it still sound like we need to put the government in control of (or develop a public option to compete with) health insurance companies to prevent them from denying claims?

DENIALS

Metric 12—Percentages of claim lines (i.e., records) denied Description: What percentage of records submitted are denied by the payer for reasons other than a claim edit? A denial

is defined as: allowed amount equal to the billed charge and the payment equals $0.

Source: NHXS

Payer

Count of records

Denied records

Percent of

claim lines

denied

Date range

Aetna

637,239

43,317

6.80%

03/01/2007 – 3/10/2008
Anthem

250,070

11,546

4.62%

03/01/2007 – 3/10/2008
CIGNA

263,728

9,060

3.44%

03/01/2007 – 3/10/2008
Coventry

20,487

590

2.88%

03/01/2007 – 3/10/2008
Health Net

4,975

193

3.88%

03/01/2007 – 3/10/2008
Humana

143,026

4,142

2.90%

03/01/2007 – 3/10/2008
Medicare

6,938,431

475,566

6.85%

03/01/2007 – 3/10/2008
UHC

1,127,691

30,177

2.68%

03/01/2007 – 3/10/2008
Leave a comment

The truth about COBRA subsidies

Thursday, October 1st, 2009 at 11:08 am

The eligibility rules for COBRA subsidy say “an employee who is terminated involuntarily (unless for gross misconduct)” is eligible. A client called to inform me that their company had two people who walked off the job who haven’t come back for days. Basically, “take this job and….” My client asked me if the company would have to offer COBRA and if these employees would receive the subsidy. When I called the Department of Labor office today to clarify what they meant by “gross misconduct” and “involuntary,” I was told that an employee would have to commit a felony to be considered gross misconduct and that an employee walking off the job and not coming back for days is not involuntary termination since the employer would have to make the decision to “take him off the books” for this behavior. So our tax payer dollars are going to subsidize COBRA premiums for pretty much everyone, not just those who were laid off due to the economy, as we were told.

Leave a comment