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Blondie and the beast: Medical coding errors, Part 2

Posted by on September 24, 2016
Photo Credit: "Bills", © 2008 Erich Ferdinand, Flickr | CC-BY | via Wylio

Photo Credit: “Bills”, © 2008 Erich Ferdinand, Flickr | CC-BY | via Wylio

Summary: “Over the course of the past several weeks, I have been helping my friend investigate the root cause of a health insurance claim denial for her daughter’s orthopedic surgery — which has resulted in more than 50 subsequent claim denials and more than $50,000 in undue medical debt for the family — and prepare the external review appeal that is the last bastion before legal action,” writes Mandi Bishop over at, in “Blondie and the (Medical Coding and Billing Error) Beast, Part 2: Health Insurance Appeal.” “In Part 1 of this odyssey, I explored the initial findings regarding the medical coding and billing errors that contributed to the claims denial. In this, Part 2, I am providing the complete appeal letter, with providers and insurers de-identified. Developing this appeal letter was eye-opening, exposing systemic process weaknesses and lack of empathy — and limited comprehension — about the implications of errors on the very people healthcare exists to serve.”

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The Missing Debate Over Rising Deductibles: Wall Street Journal

Posted by on September 18, 2016

Summary: “While the political world focuses on the Affordable Care Act, changes have been occurring for the many more Americans who get health insurance through work,” Drew Altman writes over on The Washington Wire blog at The Wall Street Journal. While I don’t agree that the debate is “missing” on this topic, as he suggests, it is a very real issue — and an issue that we hear about daily. “The biggest change: rising deductibles, which are transforming the nature of health insurance from more comprehensive coverage to skimpier insurance with higher out-of-pocket costs. This change has happened gradually and has not been the subject of a big legislative debate, as the Affordable Care Act was. The shift is not a result of Obamacare; the trend began well before the ACA was passed in 2010. The trend is not highly politicized or covered daily by the general news media. All of which contribute to making the changing nature of insurance the most important development in the U.S. health system the public is not debating.” Drew Altman, “The Missing Debate Over Rising Health-Care Deductibles,” Washington Wire, The Wall Street Journal.

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Blondie and the beast: Medical coding errors (Part I)

Posted by on September 15, 2016
Credit: www.SeniorLiving.Org; Creative Commons license CC-BY-SA

Credit: www.SeniorLiving.Org; Creative Commons license CC-BY-SA

Summary: “When Maria spoke to the collections agency about the latest bill she’d received for her daughter’s surgery, the woman on the other end of the phone was encouraging: ‘You only owe $10,000. It WAS $44,000. You should be happy!’ Mandi Bishop writes over at Tincture. “Only $10,000. For a surgery that should not have cost Maria’s family a dime. And Maria was supposed to contritely accept this, be grateful that the bill was “reduced”, whip out her checkbook, and sign away her daughter’s college tuition savings. Not on my watch.”


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The state of the nation’s health: Giant store of federal survey data

Posted by on September 14, 2016

Summary: “The Behavioral Risk Factor Surveillance System (BRFSS) is the nation’s premier system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services,” according to the web site of the survey, conducted by the Centers for Disease Control and Prevention. “Established in 1984 with 15 states, BRFSS now collects data in all 50 states as well as the District of Columbia and three U.S. territories. BRFSS completes more than 400,000 adult interviews each year, making it the largest continuously conducted health survey system in the world.”“Behavioral Risk Factor Surveillance System,” Centers for Disease Control and Prevention.


PriceCheck: The Cost of Care in the Sunshine Economy

Posted by on September 12, 2016

Summary: We were on WLRN public radio in Miami discussing our PriceCheck work today. Have a listen to what our partner Tom Hudson describes here: “It has been four months since WLRN launched Pricecheck, an online guide to bring clarity to health care costs in Florida. Along with our partners WUSF in Tampa and Health News Florida and with input from our audience, we created a searchable database of prices of common health care procedures and supplies aiming to answer a single question: ‘How much does it cost?’ ” PriceCheck: The Cost of Care in the Sunshine Economy,” WLRN.


Have PPO Networks Perpetrated The Greatest Heist In American History?

Posted by on September 5, 2016

Summary: “Trillions have been redistributed from the American workforce to the health care industry, creating an economic depression for the middle class,” Dave Chase writes over on Forbes, introducing a lengthy interview with multiple quotes from my acquaintances Bill Rusteberg and Mike Dendy, who featured in this post I wrote three years ago. “The Washington Post and Vox have done excellent reporting that shows U.S. spends so much more than other countries for one simple reason — price. The good news is that some have found the solution to severe pricing failure, however so few have that the Middle Class is in a 20-year long economic depression that is at least 95% due to healthcare…. it is clear that the explanation for the strangest presidential election has been badly misreported. At most, immigration and globalization account for 5% of wage stagnation (on the latter, a big reason for jobs moving overseas are healthcare costs). In other words, a minuscule portion of the wage stagnation is due to foreign countries. We’ve gone to war for much less than what healthcare has done to America. In order to end the assault, one must look at the underlying drivers — not the symptoms…. There are a number of tricks the industry plays on healthcare purchasers but none is more pervasive, yet easy to fix, than PPO Networks. This has caused Americans to spend 30-50% (over $1 trillion per year) more than necessary resulting in nest eggs getting crushed and putting millennials on the path to be indentured servants to the healthcare industry.” Dave Chase, “Have PPO Networks Perpetrated The Greatest Heist In American History?”


What Obamacare’s Successes Tell About Its Failures: HuffPo

Posted by on September 4, 2016

Summary: “It’s come to be known as Obamacare. Sometimes it seems more like O-drama-care. Nearly a decade has passed since Democrats first began promoting the initiative that eventually became the Affordable Care Act. And at no point has their effort to reform America’s dysfunctional health care system gone easily,” Jonathan Cohn writes over at The Huffington Post. “Passing the law was a struggle, and then implementing it was, too. Now there are new problems. Many of the nation’s largest insurers say they are losing big money on the policies they sell through the program’s exchanges. Some of these companies have responded by jacking up rates. Others are dropping out of the markets altogether. Consumers who relied on these plans may have to pay more or switch plans next year, and they may not have many alternatives. But the focus on what’s going wrong with Obamacare makes it easy to lose sight of what’s going right. The law has ended the insurance industry’s most pernicious practices, fostered improvements in the way doctors and hospitals deliver care and brought the number of Americans without coverage to a historic low. Some state markets appear to be working just fine, and at least a few insurers are making money.” Jonathan Cohn, “What Obamacare’s Successes Should Tell Us About Its Failures,” The Huffington Post.


PriceCheck: Not All Health Care Transparency Tools Are Alike

Posted by on September 1, 2016

Summary: “Transparency is the new buzzword in health care with consumer demand fueling changes to state laws and giving birth to websites that publish prices for medical procedures,” our partner Julio Ochoa writes over at WUSF in Tampa-St. Petersburg. “WUSF partnered with WLRN in Miami to launch their own database called PriceCheck. But we’re not the only game in town. A Google search for the term “medical prices” turns up several tools you can use to look up healthcare costs. If you have insurance, you may have seen a similar tool on your provider’s website. Florida lawmakers even passed a price transparency law this year that will create a database of prices for medical procedures. But how do you know what the price comparison tools are really telling you? Let’s sort some of it out.” Julio Ochoa, “PriceCheck: Not All Health Care Transparency Tools Are Alike,” WUSF.


Are insurance companies playing hard to get with Obamacare?

Posted by on August 22, 2016
© 2016 Parker Knight, Flickr | CC-BY | via Wylio

© 2016 Parker Knight, Flickr | CC-BY | via Wylio

Summary: “We’ve been hearing stories about problems with the ACA (Obamacare) insurance exchanges lately,” Dr. David Belk writes over at The Huffington Post, in a piece that should be read with the words “narrow network” in mind. “Now patients are buying the insurance, only to find that doctors refuse to see them. Why should these patients have so much trouble finding a doctor? Is it because Obamacare is terrible insurance? Is it because they’re terrible patients?”


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Obamacare’s sinking safety net: Politico reports

Posted by on August 10, 2016

Summary: “If you’re looking to find a smashing Obamacare success story—a place where the nation’s biggest and most controversial new law in a generation has truly lived up to its promise—you might stick a pin directly in North Carolina,” writes Paul Demko at Politico in an examination of the state of play for the ACA. “The central pledge of the Affordable Care Act was to make insurance available to people who didn’t have it, creating a new safety net for millions nationwide. And in North Carolina that’s exactly what happened. People flocked to the program: More than 600,000 people there signed up for Obamacare policies in 2016, and roughly 90 percent of those got financial help to pay their insurance bills, also through Obamacare. Thanks directly to the ACA, the number of people without health insurance in North Carolina has plummeted by 30 percent in the past three years. Far more people are covered, and far more of them can afford their health insurance. But if you’re looking for a quintessential Obamacare failure story, you might also stick that pin directly in North Carolina. For the insurance companies doing business in the state–the ones issuing policies to those 600,000 people–Obamacare has turned into a financial sinkhole.” Paul Demko, “Obamacare’s sinking safety net,”


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