Consider Crafty Psychology Careers

Posted by:  :  Category: Medicare

Congressman Brad Sherman, California’s 27th District (D) by cliff1066™Nearterm Corporation, a privately-held Texas corporation established to provide nationwide search and selection consultation exclusively to the Healthcare industry currently has an opportunity for a Medicare Accounts Receivable Specialist (A/R Specialist). This position is located in the state of Louisiana for a 200-Bed Hospital. Medicare A/R Specialist (Accounts Receivable): •    Medicare and Medicaid billing and rebilling. •    File and re-file claims •    Work Billing edits •    Working with re-submittals and follow-ups •    Working EDI transactions and ERA files, including reconciling carrier submissions, edits and rejection reports. •    Experience with accounts receivables for ACUTE CARE hospital. •    HBOC, E-Premis Billing experience. Source: careers.org
Source: medicaresupplementalco.com

Video: Protect Medicare Now, Universal Healthcare for California

LocumTenens.com Survey: Just 7% of physicians favor upcoming Medicare reforms

The 2011 LocumTenens.com Salary Survey publishes information about the annual full-time compensation of physicians and certified registered nurse anesthetists (CRNAs), as well as salary breakdowns by region, years in practice, and gender. Survey respondents represent physicians who practice on a locum tenens basis as well as those with permanent salaries. Respondent demographics included in the reports include region of practice, board certification, and time frame for making the next job change. This year’s survey also includes physicians’ opinions about Medicare and the reforms put in place by the Affordable Care Act.
Source: careerfind.asia

ASHA Career Center: jobs, Topeka jobs, Kansas jobs, Case Manager

About Peoplefirst At Kindred Healthcare, our mission is to be the nation’s leading provider of skilled nursing and long-term hospital services. We will set the benchmark for professional excellence and commitment to the residents, patients and employees we serve, making Kindred Healthcare synonymous with quality, service, compassion, integrity and sound fiscal stewardship. We provide the highest quality care and services possible to more than 36,000 medically complex patients and residents in 370 faciliti….
Source: asha.org

Medicare Accounts Receivable Specialist (A/R Specialist)

Nearterm Corporation, a privately-held Texas corporation established to provide nationwide search and selection consultation exclusively to the Healthcare industry currently has an opportunity for a Medicare Accounts Receivable Specialist (A/R Specialist). This position is located in the state of Louisiana for a 200-Bed Hospital. Medicare A/R Specialist (Accounts Receivable): •    Medicare and Medicaid billing and rebilling. •    File and re-file claims •    Work Billing edits •    Working with re-submittals and follow-ups •    Working EDI transactions and ERA files, including reconciling carrier submissions, edits and rejection reports. •    Experience with accounts receivables for ACUTE CARE hospital. •    HBOC, E-Premis Billing experience.
Source: careers.org

Medicare chief steps aside in political impasse: Rutland Herald Online

WASHINGTON

Innovative Healthcare Consultants

Posted by:  :  Category: Medicare

OBAMAS DEATH PANEL------ GUESS WHAT FOLKS IT'S ALIVE AND WELL---"CRAZY PALIN" NOT SO CRAZY NOW by SS&SSIn addition to restructuring the timeframe for enrollment (during which existing members can also change prescriptions and health plans), Medicare is also initiating a quality rating system this year, as well as implementing reforms to the program’s infamous gaps in prescription drug coverage. According to Consumer Reports editor Nancy Metcalf, the rating system is “star-based,” with 4 or 5 star-rated health plans constituting those with the most funding as a reward for superior service. Members who can choose a 4 or 5-star plan will receive more benefits; but for those on lower-rated plans, there are still some new, guaranteed benefits across the board that seniors can look forward to in the coming year.
Source: delmartimes.net

Video: Spring Medtrade 2009 VistaCast Episode 1

No Deal is Better Than a Bad Deal

There are ways to strengthen Medicare and reduce costs – such as requiring Medicare to negotiate drug prices, never paying private Medicare plans more than traditional Medicare, adding a drug benefit to the traditional program, lowering the age of Medicare eligibility, and letting the Affordable Care Act do its job. The Center for Medicare Advocacy has long advocated these ideas, and others like them, that would achieve real cost-savings without harming beneficiaries or ending Medicare altogether.
Source: cmahealthpolicy.com

Anesthesia Business Consultants Discusses the Supreme Court Ruling on the Affordable Care Act

Unraveling some of the changes already made under the ACA would be complex. The White House estimates that one million more young adults under the age of 26 have health insurance because of the law. Would their premiums skyrocket and make continued coverage unaffordable? Other segments of the population have already become accustomed to having certain preventive health services paid for. The American Medical Association endorsed the healthcare reform legislation in part because of the promise of near-universal insurance. Whatever is left of physicians’ support is likely to vanish if the Medicare payment formula, including the Sustainable Growth Rate formula, survives but universal coverage does not.
Source: virtual-strategy.com

Consultants: Medicare Part D Works

Ed Jacobson, Ph.D. is a coach, consultant, public speaker, and writer based in Madison, Wisconsin. He works with financial planners to help them to attain greatest effectiveness, satisfaction, and meaning for both clients and themselves. He is the author of Appreciative Moments: Stories and Practices for Living and Working Appreciatively (iUniverse, Inc., 2008)). To learn more visit www.EdwardJacobson.com.
Source: lifehealthpro.com

VIP Medicare bariatric surgical patient aftercare

All of us in the bariatric surgical field realize the importance of good postoperative follow up. Those patients who have access to good bariatric surgical aftercare have lower risk and better outcomes. Our Medicare patients are particularly at risk postoperatively in part due to their higher rates of underlying health issues, poor nutrition, limited mobility, isolation, difficulty accessing the healthcare system, limited incomes and confusion over postoperative orders. That’s why I was so impressed when I met Shannon Abbott and her colleagues at the Almost Family home Healthcare agency.
Source: americanbariatricconsultants.com

blog.innertag.com: Why Hire a Consultant?

  Good consultants have valuable experience in one or more areas of specialty, and they can use this experience to your advantage.  Consultants, by the nature of their business, frequently work on more projects than employees in the same field and generally do so across many more organizations.  As a result, they may have seen more successes and more failures, enabling them to learn from both.  They also interact with many different types of people and learn to adapt quickly to new situations.  Finally, consultants must keep up with industry trends in order to maintain their expertise.
Source: innertag.com

Anesthesia Business Consultants Urges Anesthesia Providers to Revalidate Their Medicare Enrollment as Soon as Their Carrier Asks

CERECONS is the Healthcare division of Anaheim Hills, Calif.-based Unlimited Innovations Inc. Through the pioneering use of Internet and related technologies, the company has engineered breakthrough solutions that meet real-world healthcare management needs. CERECONS offers a new paradigm in physician network management by allowing all care-chain participants to seamlessly connect and collaborate on patient health. CERECONS’ flagship software offering of the same name dramatically increases the efficiency of healthcare delivery and creates compelling value for participants in each regional healthcare community. In addition, CERECONS software reduces the cost and time associated with day-to-day healthcare management and administrative procedures. Health plans, medical groups, hospital administrators, physicians, and patients benefit from simplified healthcare transaction processing and communications.
Source: cerecons.com

Medicare chief steps aside in political impasse: Rutland Herald Online

WASHINGTON

An Overview of the Medicare Surtaxes

Posted by:  :  Category: Medicare

DAMN!! -- I THINK WE'RE F*%KED by SS&SSThis .9% surtax applies to wages and income from self-employment in excess of $250,000 for married taxpayers filing a joint return ($200,000 for single taxpayers). Employers are required to withhold the surtax tax once an employee’s wages exceed $200,000 (regardless of whether or not the spouse is also a wage earner.) Any additional surtax liability must be taken into account by quarterly estimated tax payments or by the original due date of the return.
Source: wordpress.com

Video: Jobs: 16.2% Real Unemployment

Ask The Experts: Retirement

Q.  I will be 68 next year when I retire as a CSRS annuitant.  Like all feds, I currently pay into Medicare. Will I continue to pay into Medicare from my annuity check?  I currently receive a small Social Security payment because, when I reached 66, I had sufficient credits to qualify because of prior years of  nonfederal work.  I am eligible now (at no cost) for Medicare Part A, although I have federally sponsored medical insurance. So will I continue to pay into Medicare when I retire?
Source: federaltimes.com

Vigilant Counsel News Blog

Can an employer reduce or eliminate benefits for a current employee when the employee becomes eligible for Medicare? No, because doing so is probably a violation of the federal Age Discrimination in Employment Act (ADEA) and also a violation of the Medicare rules, according to a recently released informal discussion letter from the federal Equal Employment Opportunity Commission (EEOC) (ADEA: Coordinating Medicare with Current Employees’ Benefits, August 2, 2011). In the discussion letter, the EEOC reminds employers that the ADEA exemption that allows employers to drop employer-sponsored health coverage upon Medicare eligibility applies only to retiree coverage, not to current employees. And, because dropping coverage for current employees upon Medicare eligibility is an age-based action, the employer must meet the ADEA’s “equal benefit or equal cost” defense to pass muster under the ADEA, meaning that the employer must provide older employees the same benefits as are provided to younger employees, or else they must incur the same cost to provide benefits, even if the benefits that may be purchased for that cost are less than what may be purchased for younger employees. Finally, the EEOC noted, the Medicare program itself requires employers to offer current employees, who are Medicare-eligible the same benefits under the same conditions as those employees who are not Medicare-eligible.
Source: vigilantcounsel.org

Get Medicare Advantage Plans Until December 7

You only have until December 7 to decide whether you want one of the Medicare Advantage Plans to provide your Medicare benefits. This year the open enrollment period is earlier than last year. This way, they can make certain that those who sign up will have benefits in place by January 1. If you find that your new plan doesn’t work as well as the Medicare coverage you left, you can switch back to traditional Medicare between January 1 and February 14 next year. You can add a stand-alone prescription drug plan at the same time to get your prescriptions covered.
Source: articlecupboard.net

Thinking about terminating employee health insurance benefits based on Medicare eligibility to save money? Not so fast!

(e) Benefits provided by the Government. An employer does not violate the Act by permitting certain benefits to be provided by the Government, even though the availability of such benefits may be based on age. For example, it is not necessary for an employer to provide health benefits which are otherwise provided to certain employees by Medicare. However, the availability of benefits from the government will not justify a reduction in employer-provided benefits if the result is that, taking the employer-provided and Government-provided benefits together, an older employee is entitled to a lesser benefit of any type (including coverage for family and/or dependents) than a similarly situated younger employee. For example, the availability of certain benefits to an older employee under Medicare will not justify denying an older employee a benefit which is provided to younger employees and is not provided to the older employee by Medicare. (EEOC’s emphasis)
Source: employmentlawdaily.com

Doeren Mayhew Blog Spot: The tricky distinction between employees and independent contractors

Doeren Mayhew The tricky distinction between employees and independent contractors In light of the IRS’s new Voluntary Worker Classification Settlement Program (VCSP), which it announced this fall, the distinction between independent contractors and employees has become a “hot issue” for many businesses. The IRS has devoted considerable effort to rectifying worker misclassification in the past, and continues the trend with this new program. It is available to employers that have misclassified employees as independent contractors and wish to voluntarily rectify the situation before the IRS or Department of Labor initiates an examination. The distinction between independent contractors and employees is significant for employers, especially when they file their federal tax returns. While employers owe only the payment to independent contractors, employers owe employees a series of federal payroll taxes, including Social Security, Medicare, Unemployment, and federal tax withholding. Thus, it is often tempting for employers to avoid these taxes by classifying their workers as independent contractors rather than employees. If, however, the IRS discovers this misclassification, the consequences might include not only the requirement that the employer pay all owed payroll taxes, but also hefty penalties. It is important that employers be aware of the risk they take by classifying a worker who should or could be an employee as an independent contractor. “All the facts and circumstances” The IRS considers all the facts and circumstances of the parties in determining whether a worker is an employee or an independent contractor. These are numerous and sometimes confusing, but in short summary, the IRS traditionally considers 20 factors, which can be categorized according to three aspects: (1) behavioral control; (2) financial control; (3) and the relationship of the parties. Examples of behavioral and financial factors that tend to indicate a worker is an employee include: The worker is required to comply with instructions about when, where, and how to work; The worker is trained by an experienced employee, indicating the employer wants services performed in a particular manner; The worker’s hours are set by the employer; The worker must submit regular oral or written reports to the employer; The worker is paid by the hour, week, or month; The worker receives payment or reimbursement from the employer for his or her business and traveling expenses; and The worker has the right to end the employment relationship at any time without incurring liability. In other words, any existing facts or circumstances that point to an employer’s having more behavioral and/or financial control over the worker tip the balance towards classifying that worker as an employee rather than a contractor. The IRS’s factors do not always apply, however; and if one or several factors indicate independent contractor status, but more indicate the worker is an employee, the IRS may still determine the worker is an employee. Finally, in examining the relationship of the parties, benefits, permanency of the employment term, and issuance of a Form W-2 rather than a Form 1099 are some indicators that the relationship is that of an employer-employee. Conclusion Worker classification is fact-sensitive, and the IRS may see a worker you may label an independent contractor in a very different light. One key point to remember is that the IRS generally frowns on independent contractors and actively looks for factors that indicate employee status. Please do not hesitate to call our offices if you would like a reassessment of how you are currently classifying workers in your business, as well as an evaluation of whether IRS’s new Voluntary Classification Program may be worth investigating. Contact Doeren Mayhew for more information. If and only to the extent that this publication contains contributions from tax professionals who are subject to the rules of professional conduct set forth in Circular 230, as promulgated by the United States Department of the Treasury, the publisher, on behalf of those contributors, hereby states that any U.S. federal tax advice that is contained in such contributions was not intended or written to be used by any taxpayer for the purpose of avoiding penalties that may be imposed on the taxpayer by the Internal Revenue Service, and it cannot be used by any taxpayer for such purpose.
Source: blogspot.com

Medicare and Jobs: Not Mutually Exclusive!

Continuing to tie health insurance to employment only continues a system that COSTS jobs. It creates a disincentive for employers to hire.  It creates an incentive for the new employment reality:  Freelance, contract work, part-time, whatever you want to call the newly underemployed who do not have benefits and for whom employers do not pay into Medicare, Social Security, Unemployment, or Workers Comp.  This is a big problem for everyone involved, including individual workers, their families, AND the solvency of important programs that Americans value and that have lifted generations out of poverty and provided fair access to health care. 
Source: cmahealthpolicy.com

Medicare Premiums and Deductibles for 2012 Mostly Sweet

However, some enrollees age 65 and over and certain persons with disabilities who have fewer than 30 “quarters of coverage” obtain Part A coverage by paying a monthly premium set according to a statutory formula. This premium will be $451 for 2012, an increase of $1 from 2011. Those who have between 30 and 39 “quarters of coverage” may buy into Part A at a reduced monthly premium rate which is $248 for 2012, the same amount as in 2011. The Part A deductible paid by a beneficiary when admitted as a hospital inpatient will be $1,156 in 2012, an increase of $24 from this year’s $1,132 deductible. The Part A deductible is the beneficiary’s cost for up to 60 days of Medicare covered inpatient hospital care in a benefit period. Beneficiaries must pay an additional $289 per day for days 61 through 90 in 2012, and $578 per day for hospital stays beyond the 90th day in a benefit period. For 2011, per day payment for days 61 through 90 was $283, and $566 for beyond 90 days.
Source: indoamerican-news.com

Medicare Primer for the “New Boomers”

 Starting in 1997, Medicare beneficiaries were offered the option of signing up for care provided by certain private insurers that are approved and under contract to Medicare. Best known as the Medicare Advantage Plan,  Part C is designed to close some of the “gaps” in Medicare coverage. By combining parts A and B (and possibly D) under a private wrapper, it effectively becomes Part C. It can include HMO, PPO, fee-for-service and special needs plans. These policies provide extra benefits, helping to pay certain fees such as co-pays and deductibles and a portion of your doctor bills that Medicare may not cover. Premiums for Medicare Advantage plans can vary considerably.
Source: rwroge.com

California Medicare Insurance: Anthem Medicare Preferred PPO Replaces Freedom Blue for 2012

Posted by:  :  Category: Medicare

One of the newest Medicare Advantage plan in California for 2012 is the Anthem Medicare Preferred Standard PPO or AMP. The Anthem Medicare Preferred is the newest successor to the Freedom Blue Regional PPO plan that became very popular over the past few years. The plan offers significant freedom of choice in regards to your medical service providers. The AMP PPO plan is only available in select counties throughout California and the benefits are different from county to the next. The plans are grouped below by counties that share the same benefits:
Source: blogspot.com

Video: GETeHealth.com-Health Insurance,Individual,Family,Group,Senior,Medicare Supplements,Lake Forest,CA

New City Medicare2012 Anthem Freedom Blue Plan

The California Anthem Medicare Preferred Standard PPO plan offers the best of both worlds.  Quality coverage with no monthly or annual premium.  It’s hard to beat.  The coverage allows you to see any physician in the United States, although if you see an Anthem Blue Cross PPO doctor, specialist or hospital you copays will be less.  The Anthem Medicare Preferred PPO Plan has an “Out-of-Pocket-Maximum” of $3,400 which means if you combine all of your copays, percentages and deductibles (out of pocket amounts) throughout the year and your total reaches $3,400, from that point on your plan will cover you 100% of qualified medical expenses for the remainder of the year.  So if you have major medical and or hospital expenses the most you will have to pay in any given year is $3,400.  That amount is the same even if you see a physician, specialist or hospital anywhere in the United States, in the Anthem Blue Cross of California network or outside the network.
Source: newcitymedicare.com

Review of the New Anthem Medicare PPO

The original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

Review of the New Anthem Medicare PPO

“Lasik Surgery Washington DC. People are searching the best services of Lasik Surgery. LASIK is similar to other surgical corrective procedures such as photorefractive keratectomy, PRK, (also called ASA, Advanced Surface Ablation) though it provides benefits such as faster patient recovery.”
Source: lasiksurgerywashingtondc.org

Review of the New Anthem Medicare PPO

This entry was posted on Friday, October 28th, 2011 at 12:46 pm and is filed under Articles, News, Video. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.
Source: healthinsurancefreequotes.com

Affordable Balance New Kids KJ573O1Y Silver Blue

the New Balance Kids KJ573O1Y SilverBlue Footwear Rivers forests and trails oh my Theres no place this shoe cant go Lightweight synthetic and mesh upper for breathable comfort. Lace closure and pull tab for a secure fit. EVA midsole and padded tongue and collar wrap your feet in soft comfort. N-FUSE midsole technology features dual foam layers for cushioning and shock absorption. AT-Tread all-terrain rubber outsole combines running and trail lug configurations for all-day wear. Weight 8 oz Product measurements were taken using size 2 Youth. Please note that measurements may vary by size.
Source: pinkynation.info

The Delaware County Daily Times Blogs: The Delco Delivery: County council ratifies submission of grant

Posted by:  :  Category: Medicare

Delaware County Council ratified the submission of a grant application Tuesday in the amount of $20,000 to the Centers for Medicare and Medicaid Services for the Innovation Advisors Program. “We’re going after this grant,” said Delaware County Executive Director Marianne Grace during a county council agenda meeting Monday. “It will be great if we can get it, but we’ll have to see what happens.” Grace said that if the Centers for Medicare and Medicaid Services (CMS) awards the grant to Delco, Dr. George Avetian would be the county’s designated representative. Avetian, the county’s senior medical adviser, said he submitted the application to CMS last week. “The Innovation Advisors Program is designed to broadly help individuals refine, apply, and sustain managerial and technical skills necessary to drive delivery system reform for the benefit of Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries,” states a CMS fact sheet about the program. Back in October, CMS announced it was accepting applications for the Innovation Advisors Program. The Innovation Center was created through the federal Affordable Care Act.
Source: blogspot.com

Video: Delaware Medicare Supplements

News Release: Medicare Covers Intensive Behavior Therapy for Cardiovascular Disease, Focus on the 5 A’s

•Assess:  Ask about/assess behavioral health risk(s) and factors affecting choice of behavior change goals/methods. •Advise:  Give clear, specific, and personalized behavior change advice, including information about personal health harms and benefits. •Agree:  Collaboratively select appropriate treatment goals and methods based on the patient’s interest in and willingness to change the behavior. •Assist:  Using behavior change techniques (self-help and/or counseling), aid the patient in achieving agreed-upon goals by acquiring the skills, confidence, and social/environmental supports for behavior change, supplemented with adjunctive medical treatments when appropriate. •Arrange:  Schedule follow-up contacts (in person or by telephone) to provide ongoing assistance/support and to adjust the treatment plan as needed, including referral to more intensive or specialized treatment.
Source: hearttruthdelaware.org

Delaware Way: Free Counseling Available From ELDER Info Program During Medicare Open Enrollment

They will decide whether their 2011 Medicare health plan will be Original Medicare or Medicare Advantage. Those choosing Original Medicare will also choose a Medicare Prescription Drug Plan (Part D). Additionally, Original Medicare beneficiaries may choose a Medigap policy (Medicare Supplement coverage) that will cover medical co-pays, deductibles, and in-patient hospital fees. The Medicare Advantage plan, an all-inclusive plan that usually includes prescription drug coverage, is an alternate health plan choice to Original Medicare. Commissioner Stewart urged citizens to review Medicare Advantage plans closely, since occasionally these plans may not include prescription drug coverage. In that case, a Medicare Prescription Drug Plan should be chosen, along with the Medicare Advantage Plan.
Source: blogspot.com

Arkansas, Delaware, Montana, New Jersey, New York, North Dakota Launched Their Medicaid EHR Programs This Month

, the Medicaid Electronic Health Record (EHR) Incentive Program launched in Arkansas, Delaware, Montana, New Jersey, New York and North Dakota. This means that eligible professionals (EPs) and eligible hospitals in these six states will be able to complete their incentive program registration. More information about the Medicaid EHR Incentive Program can be found on the Medicare and Medicaid EHR Incentive Program Basics page of the CMS EHR website.
Source: medipro.com

Health Informatrix: Update to State Medicaid Launches Message

They will decide whether their 2011 Medicare health plan will be Original Medicare or Medicare Advantage. Those choosing Original Medicare will also choose a Medicare Prescription Drug Plan (Part D). Additionally, Original Medicare beneficiaries may choose a Medigap policy (Medicare Supplement coverage) that will cover medical co-pays, deductibles, and in-patient hospital fees. The Medicare Advantage plan, an all-inclusive plan that usually includes prescription drug coverage, is an alternate health plan choice to Original Medicare. Commissioner Stewart urged citizens to review Medicare Advantage plans closely, since occasionally these plans may not include prescription drug coverage. In that case, a Medicare Prescription Drug Plan should be chosen, along with the Medicare Advantage Plan. Source: blogspot.com
Source: medicaresupplementalco.com

Free Health Insurance U.S.

Free Health Insurance is owned and operated by Barry White, a former Health Insurance Specialist with 16 years experience in the health insurance industry. Mr. White now dedicates his time to helping families find affordable insurance in a quickly changing marketplace. He provides this quoting service free of charge to consumers, and makes no commissions from any insurance company or agent.
Source: freehealthinsurance.us

The Centers for Medicare and Medicaid Services: Consumer Alert

A message from the National Family Caregivers Association: The Centers for Medicare and Medicaid Services (CMS) has recently become aware of a website that has the appearance of being an official government website for the Pre-Existing Condition Insurance Plan.
Source: wordpress.com

How to get EFFEXOR XR PURCHASE EFFEXOR XR MEDICARE ONLINE,WITHOUT PRESCRIPTION!Fedex Delivery Overnight FREE Pills IN ESTONIA

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Source: standuppatriots.com

Open enrollment for Medicare

“Open enrollment is a chance for Delawareans on Medicare to review their choices and find the plan that works best for them,” said Congressman Carney.  “I encourage all Delawareans enrolled in Medicare to take advantage of the next several weeks by evaluating their healthcare needs, learning more about the new benefits available this year, and choosing a plan that provides them with quality, affordable coverage.”
Source: wgmd.com

Blue Cross of Idaho to refund insurance overcharges to some

Blue Cross of Idaho to refund insurance overcharges to some employers Blue Cross of Idaho has agreed to refund about $876,000 to small employer groups that paid more for Celebrate on the Waterfront — Party Opportunities at Blue Cross RiverRink at Penn’s Landing PHILADELPHIA, PA– – With panoramic views of the Delaware River, Philadelphia City Skyline and the majestic Benjamin Franklin Bridge, the Blue Cross RiverRink is the perfect location for a unique winter … Sweetheart Skate at the Blue Cross RiverRink PHILADELPHIA, PA– – It may be cold this Valentine’s Day, but ice skating next to your sweetheart at the Blue Cross RiverRink at Penn’s Landing is sure to keep you warm! The Blue Cross RiverRink at Penn’s … Tufts Medical Center and its doctors may stop accepting Blue Cross insurance in January Blue Cross Blue Shield of Massachusetts has started sending letters to about 55,000 employers and other customers notifying them that Tufts Medical Center and its doctors group is ending its contract with the state s largest health insurer, effective Jan. 17. If the contract is terminated, about 88,000 Blue Cross members who have Tufts-affiliated primary care physicians would have to change …
Source: medicare-news.com

#Fail : Delaware Liberal

● $3.3 trillion from letting temporary income and estate tax cuts enacted in 2001, 2003, 2009, and 2010 expire on scheduled at the end of 2012 (presuming Congress also lets relief from the Alternative Minimum Tax expire, as noted below); ● $0.8 trillion from allowing other temporary tax cuts (the “extenders” that Congress has regularly extended on a “temporary” basis) expire on scheduled; ● $0.3 trillion from letting cuts in Medicare physician reimbursements scheduled under current law (required under the Medicare Sustainable Growth Rate formula enacted in 1997, but which have been postponed since 2003) take effect; ● $0.7 trillion from letting the temporary increase in the exemption amount under the Alternative Minimum Tax expire, thereby returning the exemption to the level in effect in 2001; ● $1.2 trillion from letting the sequestration of spending required if the Joint Committee does not produce $1.2 trillion in deficit reduction take effect; and ● $0.9 trillion in lower interest payments on the debt as a result of the deficit reduction achieved from not extending these current policies.
Source: delawareliberal.net

Delaware lawmakers seek end to Washington gridlock DFM News

The bill seeks to boost the depressed housing market and deplete the current national glut of unsold homes by helping new homeowners save for a down payment on their first home at a time when rising down payment requirements of 20 percent can be out of reach for many potential home buyers. It would create a pre-tax savings program similar to a Health Savings Account (HAS), with a contribution cap of $10,000 a year by participants.
Source: delawarefirst.org

Medicare Supplemental Insurance and Medicare Advantage Plans in Delaware

2012 advantage plans in illinois, medicare advantage plans nh, Medicare open enrollment period, medicare supplement connecticut providers, medicare supplemental plans michigan 2012, wyoming medicare advantage plans, 2012 medicare plan c plans kansas, 2012 kansas supplemental plan prices, massachusetts medicare supplement plans 2012, medicare supplement plans for iowa retirees 2012, medicare advantage plan problems 2012 nc, medicare supplement plans 2012 az, 2012 medicare advantage plans nh, medigap rates in alaska for 2012, 2012 massachusetts medigap, 2012 medicare supplemental insurance nj, ga medicare part c, www medicaresupplementadvantageplans com, medicare supplement 2012 sc, ct 2012 medicare advantage plans
Source: medicaresupplementadvantageplans.com

More State Medicaid Programs, HIPAA Delays, REC Participation

One-half of the providers now working with an REC come from small group or consortia practices. The other half make up is 18% in community health centers, 11% in public hospitals, and 21% in other underserved settings (CAHs, rural health clinics, practices in medically underserved areas).
Source: hitechanswers.net

Some information on Medicare Supplement Plans

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSAs it is known the Medicare Supplement Plans are the supplementary insurance policies that help in bridging the gap that is left behind the original Medicare policy. Actually the fact is that the original Medicare policy covers almost all the medical costs that you may be in need of. But besides that there still remains some gap between their policy coverage and the original cost payable. Therefore there is the need of having a Medicare Supplement Plan, which would help you to get cleared of your medical bills completely. Actually the Medicare Supplement Plans are the health insurance plans that are completely administered and sold by the private insurance companies and the government doesn?t have much of say in it. But besides that the insurance companies are allowed to sell only 12 standard Medicare Supplement Plans under the letter cover hr support for small businesses s from A through L. All these plans provide different benefits and coverage. But along with that it should also be remembered the plans under the same letter cover is bound to provide the same benefits irrespective of whatever insurance companies may sell them. Though the cost of the premium may differ for different companies. Therefore it is always advised to go through the offer documents of all the plans from A through L before deciding to choose the one right for you.Now if you are interested to buy a Medicare Supplement Policy for the first time or if you want to replace your current policy with another one, it is really easy. You can also obtain the rates by simply completing an online quote on the Internet. And after receiving an email back with quote comparison you can decide the one most suitable for you with the help of your agent.
Source: thosepeabodys.com

Video: Medicare Supplement | Questions about Medicare Supplement Plans

Make the Best Deal by Comparing Medicare Plans

Medigap Insurance Plans are always a better option available with the people who want to have a health care insurance which serves all well for his retired life. If a person takes up medical insurance it is always a wise decision made by him but many a times it is also seen that the original medical plan that is taken up by the individual does not serve everything well when comes to paying all the expenses that are made by the individual in his medical treatment. It is often seen that at last the person has to spend a lot of money form his own pocket since many medical services are not covered by the original medical policy. Therefore there is the presence of the Medicare Supplement Insurance which is introduced to bridge up the differences between the original payments that are needed to be spent by the individual and the insurance money that is given by the Medicare policy to the individual who has taken up by the individual. It is a very noble idea to have supplemental Medicare Insurance plan beside an original one in order to fill up the gap that exists by the original Medicare. It is very evident form the name itself that the medigap policy works clearly as its name implies. It is very important to have a medigap insurance plan with original Medicare policy to claim the whole amount of money that is needed for your treatment. The California Medigap Plans have a lot of hidden advantages part from the original Medicare Plan for which an individual needs to remain informed and educated. In order to get the advantages of the Medicare Supplementary Plans it is very important to remember that an individual has to enroll his name first for the original Medicare and only then can he get the supplementary Medicare plan. Without the original it is seer impossible to get enrolled for the later. It is not independent and the entire supplementary Medicare is controlled by various private companies and no government body is concern about the supplementary one. But all the private companies have to follow some specific rules and they are bound to follow those rules. It is also advisable for an individual to consult an insurance agent before deciding on taking insurance plans and also to decide the priority to book for a special one. It is very essential to book that particular plan that will give you the maximum benefits concerning your health issue and go for that definite plan. It is therefore very important to read the details and then go for the Medicare plans. Before choosing a particular Medigap insurance you can compare Medicare Plans and choose the Best Medicare Supplement Plan. Medicare Supplement Comparison will help you to find out the Best Medicare Supplement. It is important because it is a thing dealing with your future and health. Among all the available medigap insurance plans Medigap insurance California is one which is secured and good to pay attention. To cover the gap left behind by the original Medicare it is essential to get the Medicare Supplemental Plans and also to get the maximum benefits out of Medicare Supplement it is essential to learn the Medicare Insurance Rates.
Source: articleswide.com

Medicare Supplement Plans

Unlike Plan M, Plan N uses co-pays to help lessen monthly premium payments. The cost of co-pays is fixed as follows: * $20 for doctor’s visits * $50 for emergency room visits. Compared to plan F, plan M is projected to be 15% lower while plan N is 30% lower. In able to take advantage of the benefits of Medicare plan N, the co-pay system will only take effect after the deductible requirement in Medicare Plan B is met. These plans are also a good alternative for those who wish to come off the Medicare Advantage Program. According to experts, premiums and charges are expected to increase so for those who are under this program may cancel their plan either by choice or necessity. But it is also noteworthy to compare both options and see which one will benefit you and your family the most. For those who wish to learn more about Medicare Supplement plans, you may browse the internet to get details about medical insurance plans. You can see the pros and cons of these plans online, and may even provide you with the insurance quotes that you need. If you are serious to provide medical insurance, then this is one way to compensate for the financial needs when it comes to medical emergencies.  
Source: ezinemark.com

Best Medicare Supplement Premiums

We are often able to save our clients money by placing them in the same exact plan letter with  another insurer.  We can do this because Medicare Supplements are standardized by the federal government, guaranteeing that if you keep the same plan letter but change companies you will not notice any difference in your benefits and coverage.  Typically, the only differences one would see are paying less money, paying that premium to a different company and a different company name on your membership card. You may possibly see a slight difference in claims processing, but this is something you should discuss with your broker when looking at your options.
Source: e-medigap.com

Medicare Supplement Insurance for 2012

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Source: vancouverfinder.org

Medicare discontinuation sends seniors scrambling

Wellmark will provide guaranteed acceptance into any Medicare supplement plan for affected members. That means companies cannot turn down an applicant; cannot charge higher premiums and cannot enforce a waiting period.
Source: thegazette.com

Medicare Supplement Insurance for 2012

Learning about 2012 Medicare advantage plans, is essential for all purposes. Part A: This deals with your hospitalisation expenses. You can also make use of this for house nursing or even hospice, if directly related to your condition. Part B: This particular relates to the Outpatient expenses. You are to pay for premiums right here. Part D: Deals with health insurance programs. They are being offered through private insurance agencies in 2012, as approved by the Government to provide such services. Part Deb: Covers prescription medications. If the medications are covered here, you can use this program to repair it.
Source: 10kadayonline.com

UPDATE: Medicare Revalidation: What FQHCs Need to Know

Posted by:  :  Category: Medicare

after such providers or suppliers receive notification from their MAC.  Once contacted by a MAC, suppliers and providers have 60 days from the date of the letter to submit complete enrollment forms. Please note that failure to submit the enrollment forms as requested may result in the deactivation of Medicare billing privileges. Additionally, the $505 Medicare enrollment fee that we told you about here also applies to revalidation.
Source: nachc.com

Video: Philadelphia: Medicare Fraud Summit Sharing Data Panel

Medicare Enrollment Revalidation and the Revised CMS 855 Forms : Healthcare Integration Advisors : New York Attorneys & Lawyers for Health Care Providers, Hospitals, Insurers : Iseman, Cunningham, Riester & Hyde LLP

In July of this year, CMS published revised Medicare enrollment forms for all provider and supplier types.  CMS revised the enrollment forms in an effort to implement a more rigorous program of integrity standards.  CMS’s theory is that by keeping bad people out of the Medicare system, most of the fraudulent activity that has plagued federal health care programs can be halted before it even begins.  The most substantial revisions were made to the Form 855A for institutional providers and the new Form 855O, which is for physicians and non-physician practitioners who enroll in Medicare for the sole purpose of ordering or referring items for Medicare beneficiaries.
Source: healthcareintegrationadvisors.com

Recent Changes to Medicare Part A Enrollment Forms

Consistent with the Paperwork Reduction Act of 1995, CMS published an Agency Information Collection Activities Notice, on May 20, 2011, consisting of a summary of the proposed revisions to the enrollment forms, with public comments due by June 20, 2011.[4] The final, revised forms became effective July 1, 2011.[5] The revised CMS 855A now explicitly requires disclosure of any entity whose mortgage, deed of trust, or other security interest in the Part A provider is equal to five percent (5%) or more of the total property and assets of the Part A provider.[6] This includes investment funds, holding companies, banks and financial institutions, and charitable and religious organizations.[7] The Part A provider must report the entity’s name, address, tax identification number, type of organization, percentage of interest in the provider, and an organizational chart identifying all of the owning or controlling entities and their relationship to each other and the provider. Dates of birth and social security numbers are additionally required for individuals who hold security interests.
Source: ebglaw.com

Revalidate Your Medicare Enrollment

If you have had to submit a form to CMS in order to accomplish either of the above three items you would find that it could take no less than 30 days and up to six months for this to happen. If for some reason you accidentally miss an item on the form, after the form has been reviewed, it is then sent back to you with the items that are missing and you need to resubmit the form once again corrected. Now somewhere between 30 and 40 days has passed and you are now resubmitting the form only to start the process once again.
Source: medbillingncoding.com

Medicare Provider Enrollment Revalidation

Providers and suppliers should submit revalidation only after receiving the request from their MAC to do so. Providers and suppliers will have 60 days from the date of the letter to submit the required completed enrollment forms. Failure to submit enrollment forms as requested may result in the deactivation of Medicare billing privileges. Revalidation can be completed through the Internet-based Provider Enrollment Chain and Ownership System (PECOS) or a paper application; currently, federally qualified health centers only may submit paper enrollment applications. Please note: CMS forms 855A, 855B, 855I, 855O, 855R and 855S all have been revised as of July 1, 2011, and should be used for the provider enrollment revalidation. The new forms can be found by searching “855” on the CMS website.
Source: healthcarereforminsights.com

SLP and Audiology Medicare Providers Must Revalidate Enrollment

All speech-language pathologists (SLPs) and audiologists who enrolled in Medicare prior to Friday, March 23, 2011, will need to revalidate their enrollment at some point between now and March 2013. This is due to new risk screening criteria required under the Affordable Care Act (ACA) which was implemented by the Centers for Medicare and Medicaid Services (CMS) in March 2011. The new risk screening criteria places providers and suppliers in one of three screening categories – limited, moderate, or high. These categories represent the level of risk to the Medicare program and determine the degree of screening that will be done by the Medicare Administrative Contractor (MAC) processing the enrollment application that will be submitted for revalidation. SLPs and audiologists enrolled as individuals or group practices are placed in the limited category. The enrollment process for providers and suppliers in the limited category remains unchanged.
Source: wordpress.com

seMissourian.com: Blog: APPLE Offers Paperwork Assistance & Counseling

As we spoke, Jean’s 2 o’clock appointment arrived — a retired teacher from Jackson whose husband will turn 65 in January and she’ll do the same a few months later. The woman said she heard about APPLE through the Jackson Senior Center and explained that she and her husband have been deluged by letters and “official-looking” documents in the mail about Medicare and she needed help figuring out the Medicare maze. The meeting lasted about two hours, during which Jean and the client discussed all aspects of the Medicare program and related issues — Part A, Part B, supplemental insurance, secondary insurance, enrollment periods, Medigap policies, veterans’ benefits, and on and on. Throughout the session the client asked dozens of questions and took copious notes. “You’re so knowledgeable!” she tells Jean at the end of the appointment.
Source: semissourian.com

Revised Medicare Provider

Medicare Provider-Supplier Enrollment Applications (CMS-855).  While the revised forms may be used immediately, the previous 2008 versions may be used through October 2011. In addition, CMS has released a new CMS-855O application form to be used for the sole purpose of enrolling to order and refer items and/or services to Medicare beneficiaries; this form must be used immediately. 
Source: healthindustrywashingtonwatch.com

Medicare Providers Application Made Easy

Mail the completed application accompanied with all the required documents to a Medicare fee-for-service contractor, who is also termed as National Supplier Clearinghouse, Medicare Administrative Contractor, Fiscal Intermediary or Carrier working for your geographic location or state. Do not mail your application to the Center for Medicare and Medicaid Services at Baltimore, Maryland as it will delay the processing. If you have registered in Medicare, but haven’t submitted CMS-855 since 2003, you will need to send a complete enrollment application. Once you submit Medicare providers application, your enrollment will be recorded in PECOS, if you are a supplier or physician provider. If you are a non physician practitioner or physician, your National Provider Identifier and name will be recorded to the referring and ordering report during the next update cycle.
Source: canadiandrugsaver.com

Providence Health Plan to Offer Healthways SilverSneakers® Fitness Program to Medicare Advantage Members

Posted by:  :  Category: Medicare

Healthways is a heading provider of specialized, extensive solutions to assistance millions of people say or urge their health and contentment and, as a result, revoke altogether costs. Healthways’ solutions are designed to assistance healthy people stay healthy, lessen or discharge lifestyle risk factors that can lead to illness and optimize caring for those with ongoing illness. Our proven, evidence-based programs yield rarely specific and personalized interventions for any particular in a population, irrespective of age or health status, and are delivered to consumers by phone, mail, internet and face-to-face interactions, both domestically and internationally. Healthways also provides a national, entirely accredited interrelated and choice Health Provider Network and a inhabitant Fitness Center Network, charity available entrance to people who find health services outward of, and in and with, a normal medical system. For some-more information, greatfully revisit www.healthways.com.
Source: ahealthplan.info

Video: (Silver Sneakers Locations) ~ Bodyplex Gym Cumming Georgia

Providence Health Plan to Offer Healthways SilverSneakers® Fitness Program to Medicare Advantage Members

RENTON, Wash., & NASHVILLE, Tenn.–(BUSINESS WIRE)–In an effort to promote well-being and prevention to its older-adult members, Providence Health Plan (PHP) and Healthways (Nasdaq: HWAY), the leading well-being improvement company, have agreed to offer the award-winning SilverSneakers® Fitness Program to PHP’s eligible Medicare Advantage members beginning January 1, 2012. SilverSneakers is the …
Source: slimvibess.com

Silver Sneakers Fitness Program for Seniors: Physical Activity Bonus for Senior Citizens in Some Medicare Plans

Queens Rose, I think that Silver Sneakers is a great program for seniors and I’m very happy to have it! I am now 66 and althought I can not think of myself as a senior, am going to Silver Sneakers because my insurance is paying for it and My family and doctor think it will be good to get rid of my Colesterol! I really like Silver Splash although I must wash my hair every time I go and take one of those classes, to get rid of the choreine in the water! All and all it gives me something to do and the people are wonderful!
Source: suite101.com

Dave Fluker’s California Health Insurance Blog: Blue Shield CA Continues ‘New to Medicare’ Supplement Discount

Blue Shield of California currently offers a discount of premium for the first 12 months to those who are turning 65 or otherwise “new to Medicare”. The discount is $20.00 per month off of the premium for each of the first 12 months. For those who wish to use the checking deduction payment options (EFT), an additional $2 discount is available. In addition, Blue Shield CA Medicare Supplement plans include Silver Sneakers at no additional cost. Blue Shield is planning to continue the discount for those “new to Medicare” into 2012. This discount combined with the free Silver Sneakers benefit makes Blue Shield Medicare Supplements very competitive in California. For more information, give me a call, e-mail or use the Information Request Form on my web site. Dave
Source: blogspot.com

Holiday Gift Boxes For Seniors Are Now Being Collected

The SilverSneakers® Fitness Program is offered by Healthways, an industry leader providing specialized, comprehensive Health and Care SupportSM solutions to help people maintain or improve their health.  SilverSneakers was founded in 1992 and is the nation’s leading exercise program designed exclusively for older adults, offering an innovative blend of physical activity, healthy lifestyle and socially-oriented programming. The unique program is available at no additional cost (other than any medical plan premium) to eligible Medicare health plan members and group retirees at more than 10,000 participating fitness and wellness centers, YMCAs, and Curves® locations in all 50 states, Puerto Rico and D.C.  For more information on SilverSneakers, call 888-423-4632 or visit www.silversneakers.com.
Source: hvinsider.com

SilverSneakers Offers Free Gym Memberships: Seniors Benefit From Quality Group Exercise for Older Adults

People who wish to improve their health through focused exercises specially designed to meet the needs of older adults may wish to participate in the SilverSneakers Fitness Program. Those who qualify may enjoy a free membership to a participating fitness center, but other members of the gym may also take SilverSneakers classes at that facility. With a variety of group exercise classes offered on land and in the water that are taught by certified instructors, participants can enjoy exercising in a positive social atmosphere that can meet the needs of seniors of varying levels of fitness.
Source: suite101.com

Providence Health Plan to Offer Healthways SilverSneakers® Fitness Program to Medicare Advantage Members

RENTON, Wash., & NASHVILLE, Tenn.–(BUSINESS WIRE)–In an effort to promote well-being and prevention to its older-adult members, Providence Health Plan (PHP) and Healthways (Nasdaq: HWAY), the leading well-being improvement company, have agreed to offer the award-winning SilverSneakers® Fitness Program to PHP’s eligible Medicare Advantage members beginning January 1, 2012. SilverSneakers is the …
Source: myeuroplate.com

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Source: silverpricestoday.cc

Enterprise Brokers Tampa Bay for buyers and sellers of small businesses: Price reduced for Established Curves Franchise, Tampa Bay Business for sale $49,000.00

Price reduced for Established Curves Franchise, Tampa Bay Business for sale, owner currently works 26 hours a week. Has 400 Members with 150 members that are on ‘Silver Sneakers’ Medicare Supplement Plans, these Seniors get reimbursed for their Curves Membership. Very low overhead, Great location, Great lease, nice facility.
Source: blogspot.com

Does Medicare Offer Gym or Fitness Benefits?

For example, Aetna Medicare Advantage Plans may offer a range of fitness benefits. According to Aetna, the company’s Medicare gym benefits plans cover gym memberships, along with yoga and Pilates classes offered by gyms. With some plans, the benefits may also be used toward the cost of seeing a nutritionist or registered dietician, as well as toward the cost of certain fitness-related periodicals. Finally, Aetna offers the online SeniorPHIT program, which allows seniors to track their fitness goals and to access information about nutrition, fitness and wellness.
Source: suite101.com

Obama’s Medicare Administrator Berwick to Resign on Dec. 2

Posted by:  :  Category: Medicare

Congressman Kendrick B. Meek by cliff1066™Berwick formerly led the Institute of Healthcare Improvement, a nonprofit in Cambridge, Massachusetts, that advised hospitals and health systems on ways to improve efficiency and quality. As Medicare chief, he encouraged government bureaucrats and health-care providers to focus on improving care for individuals and the overall health of the U.S. population while lowering health costs.
Source: thecre.com

Video: Would Those Hoping to Replace Heller in Congress Also Vote to End Medicare?

Obama’s Medicare Administrator Berwick to Resign on Dec. 2

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Source: g7finance.com

“The Basics” Chiropractic Medicare: Understanding Medicare “Replacement” Plans ~Newsletter October 24, 2011

Medicare and not paying Medicare premiums each month, this person is now in the same category as the rest of your patients.  You do not have to bill the replacement insurance and your fees are the same as your non-Medicare patients….Unless….you bill this replacement insurance one time.  Now you are on contract with the Medicare replacement insurance company to follow ALL the Medicare guidelines, fees and billing. Even though the replacement company has a $35.00 co-pay, and pays nothing on the claims, you must file for your patient.
Source: blogspot.com

Medicare Replacement Insurance

To get Medicare Replacement Insurance when using a service, you simply need to fill out a basic questionnaire.  You will review the different quotes from all the providers by seeing their policy figures.  You can pick out those insurance plans that give you exactly what you need and that are within your financial reach.
Source: otolaryngologist.com

Medicare administrator Donald Berwick resigns in the face of Republican opposition

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Source: wordpress.com

Medicare Advantage and Medigap: What is the difference?

You must be eligible for Medicare A and B to enroll in this plan. It is easiest to think of Medicare replacement plans as a private insurance policy that provides all Medicare A and B services (except Hospice services, which Medicare will continue to cover) and then some. You will likely have to choose a physician from those listed as in-network and use agencies such as home health agencies and rehabilitation facilities approved by the insurance provider. This is typically different from having Medicare A and B, where most physicians, home health agencies and rehabilitation facilities accept Medicare and your provider selection is not limited by Medicare itself.
Source: hubpages.com

Officials Looking To Cut Federal Spending Eye Medigap Policies

But some budget experts say “first-dollar” Medigap plans like the one Fisher has, which cover nearly all such deductibles and co-payments, may make it too easy for seniors to decide to seek medical care they may not need. The thinking goes that, for example, instead of waiting to see if their condition gets better or if a nonprescription medicine might help, seniors with these Medigap policies seek more care than those without the coverage. Getting seniors to delay or forgo some care or find cheaper alternatives could save the government billions of dollars — as much as $53 billion over 10 years, according to the Congressional Budget Office.
Source: kaiserhealthnews.org

Obama names Berwick replacement

“The only way to stabilize costs without cutting benefits or provider fees is to improve care to those with the highest health care costs,” she said. Tavenner also said she opposed Republican efforts to turn Medicaid into a block grant that would limit the amount of federal funding states can receive for the program. “That approach would simply dump the problem on states and force them to dump patients, benefits or make provider cuts or all the above,” she said.
Source: localnewssanantonio.com

Louisville Medicare Advantage Plan, KY, Change, Switch, Compare, Replace

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist) and these rules can change each year.
Source: bradeninsurance.com

What the 2012 Medicare Physician Fee Schedule tells us about the future : Getting Paid

Posted by:  :  Category: Medicare

The final rule for the 2012 Medicare Physician Fee Schedule went on display this week. Of course it includes the all-too-familiar fee cut (27.4 percent) – the result of the Centers for Medicare & Medicaid Services’ (CMS) flawed formula for calculating physician payment that Congress has been patching annually since 2002 but which needs a permanent fix. This year’s fee schedule is notable for another reason as well. The PDF file is 1,235 pages long, and that’s without the appendices that will be included when the final rule is published in the Federal Register later this month. The fact that it requires so many pages to describe one year’s changes to one part of one government program is mind-boggling, but the additional bulk is partly because this year the rule also provides a forecast for how CMS plans to carry out government mandates for the program over the next five to 10 years. It is not a crystal ball, but the rule leaves no doubt that Medicare payment to physicians will be changing and that today’s initiatives and incentives are intended as the basis for tomorrow’s payment.
Source: aafp.org

Video: Medicare Fee Schedule

CMS Issues Final Medicare Physician Fee Schedule Rule for 2012 : Health Industry Washington Watch

has adopted a controversial policy to expand its multiple procedure payment reduction (MPPR) policy for advanced imaging services (computed tomography scans, magnetic resonance imaging, and ultrasound), which now applies to only the technical component (TC) of the service, to the professional component (PC) of the service. Effective January 1, 2012, the advance imaging procedures with the highest PC and TC payments will be paid in full, but the PC payment will be reduced by 25% for subsequent procedures furnished to the same patient, by the same physician — including physicians in the same group practice — in the same session on the same day (CMS initially had proposed reducing the PC by 50%). The TC payment will continue to be reduced by 50%.
Source: healthindustrywashingtonwatch.com

As Joint Committee Struggles, CMS Releases 2012 Fee Schedule

Dr. Christopher Fisher, Managing Editor for The Behavioral Medicine Report, received his PhD in Clinical Health Psychology & Behavioral Medicine with an emphasis in biopsychosocial approaches to health and wellness, Cognitive Behavioral Therapy (CBT), neurofeedback, biofeedback, cranial electrical stimulation (CES), and QEEG from University of North Texas. He is Board Certified in Neurofeedback (BCIA). Dr. Fisher also received a master’s degree in Clinical Psychology from Texas A&M-Corpus Christi. Dr. Fisher maintains a private practice in Corpus Christi, Texas, and offers individual therapy, group therapy, and neurofeedback. You can learn more here: http://www.christopherfisherphd.com Dr. Fisher enjoys spending time with family, watching sports and movies, and bicycling on rugged terrain.
Source: bmedreport.com

AMA Reports; Supercommittee Stalemate Leaves SGR 27.5 Physician Fee Schedule Decrease Intact : Med Law Blog

Supercommittee failure leaves 27 percent Medicare payment cut in place With the Joint Select Committee on Deficit Reduction failing to reach agreement on a deficit-reduction proposal, physicians still face a 27 percent cut in Medicare physician payments scheduled to take effect Jan. 1. Congress has missed an opportunity to address the nation’s fiscal problems, stabilize the Medicare program and permanently repeal the sustainable growth rate (SGR) formula. "The deficit committee had a unique opportunity to stabilize the Medicare program for America’s seniors now and for generations to come," AMA President Peter W. Carmel, MD, said in a statement. "Once again, Congress failed to stop the charade of scheduled annual physician payment cuts and short-term patches that spend more taxpayer money to perpetuate a policy all agree is fatally flawed. A decade of uncertainty and repeated threats of steep cuts threaten access to care for seniors and military families who rely on the Medicare and TRICARE programs." Proposals to repeal the SGR fell victim to disagreement over fundamental principles for achieving deficit reduction. Sharp partisan division over the mix of entitlement cuts and tax hikes prevented the supercommittee from reaching any agreement on a deficit-reduction package. Sen. Max Baucus (D-Mont.), Sen. John Kyl (R-Ariz.) and Senate Majority Leader Harry Reid (D-Nev.) were among the leading advocates for SGR repeal in the supercommittee negotiations. Earlier this year, Sen. Pat Toomey (R-Pa.) had also offered a deficit-reduction package that included SGR repeal. Congressional action expected to avert 27 percent cut on Jan. 1 Democratic and Republican leaders in Congress have publicly stated their commitment to take action this year to avert the 27 percent cut. Options for SGR relief outside of the supercommittee process have ranged from short-term patches of a year or two to longer-term relief that provides for transition to a new Medicare physician payment system. The scope of the next SGR intervention will not come into better focus until Congress returns from its Thanksgiving break. Congress has a number of items of unfinished business that require action before departing for the Christmas holidays. Stay tuned for future updates via the Physicians’ Grassroots Network and other AMA communications.
Source: medlawblog.com

Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline, CPT Code Billing: HOW THE ABN PROTECTS THE PROVIDER

ABNs should only be provided to Medicare beneficiaries. The ABN allows the beneficiary to make an informed decision about whether to receive services that he may be financially responsible for paying. The ABN serves as proof the patient had knowledge prior to receiving the service that Medicare might not pay. If a provider does not deliver a proper ABN to the patient, the patient cannot be billed for the service.
Source: medicarepaymentandreimbursement.com

Four Tips for Understanding Fee Schedules

In order to track your accounts receivable (AR), you should keep your fee schedules as simple as possible. If all your codes are set at 175 percent of Medicare, it is easy to look at your AR and understand how much you have out. If some codes, however, are set at 130 and others at 175 percent of Medicare, this becomes much more difficult. The percentage in which your fee schedules are figured based on Medicare is totally up to your practice. When figuring these percentages take into consideration your payers that are going to pay according to your billed charges. Also review your contract and make sure there is a clause in your contract that protects your facility from a decrease of your reimbursement when ever Medicare makes their cuts.
Source: urgentcaremanagementmonthly.com

Doctors Face Deep Medicare Pay Reductions

CQ HealthBeat: Physician Payment Formula Cut Slightly Less Than Expected Medicare payments to doctors will be reduced by 27.4 percent in 2012 under a final rule released late Tuesday by the Centers for Medicare and Medicaid Services. That’s a slight decrease from the 29.5 percent reduction federal officials had predicted earlier this year. CMS projects that it will pay out $80 billion in 2012 under the Medicare physician fee schedule, which establishes payment levels for more than one million Medicare health care providers, including doctors, podiatrists, nurse practitioners and physical therapists (Reichard, 11/1).
Source: kaiserhealthnews.org

Interested in the 2012 Fee Schedule Statistics?

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Source: illinoispathology.org

Legislative Action Alert: Therapy Cap

Legislative Action Alert: Therapy Cap. Only 88 days remain for Congress to take action on the therapy cap and Medicare payment cuts. It is critical that Congress pass legislation before December 31, 2011 to extend the therapy cap exceptions process and to avoid the scheduled 29.5% cut in provider payments under the Medicare physician fee schedule. (APTA) (Click Link Above for more)
Source: wordpress.com

Understanding the Medicare Payment Schedule 

Since 2010 and until today, there are many issues embracing the subject of Medicare Payment Schedule. The United States Congress has considered limiting many of the payments in the schedule of up to 25 percent in order to manage the rising cost of healthcare. This has stirred up the medical community since doctors and suppliers complain of receiving less compensation for their services. Plus, associations are concerned that doctors and suppliers will leave their contracts with Medicare due to this, thus leaving fewer choices to beneficiaries. Since the debate about this issue is so intense, the US Congress has passed a legislation that extends the current schedule until the end of 2011 so that the matter will be scrutinized well.
Source: auction-endowmentpolicy.com

Medicare Payment Schedule: Just An FYI

Snopes confirms. The per person Medicare insurance premium will increase from the present monthly fee of $96.40, rising to $104.20 in 2012, $120.20 in 2013, and $247.00 in 2014. These are provisions incorporated in the Obamacare legislation, purposely delayed so as not to ‘confuse’ the 2012 re-election campaigns. Don’t talk about Social Security if you are running for office…..just stand around and do nothing…
Source: performanceboats.com