RT Welter
Medical News

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It Is All About "The Spend"

Your providers see waste in the system every day. Services that are done (by other providers and facilities), but not needed for a particular patient’s care—Make note of these! Use them when you sit down to re-negotiate your next rate increase with the payers. You don’t need the specific patients (this is protected information), you…

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Self–Funded Plans

In most markets half, or more, of the payer lives are in self-funded plans This means the “insurance company” is not really providing an Insured Product—they simply administer the plan. The actual payer, at the end of the day, is the employer themselves. All of these employers have a Human Resources Department (or something similar)…

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Know Your Payer Representatives

Do you know the payer representatives? Find out who they are and develop a relationship! Usually there is someone assigned to you. Invite them to drop in for lunch. They are not the enemy and very often a good relationship can pay big dividends when you need help with a problem claim, or when it…

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The Doc Fix

The US Senate has recessed without taking up the Doc Fix We were so close to finally doing away with the SGR (Sustainable Growth Rate) calculation which has held good medical care hostage year after year. The House of Representatives sent through a bi-partisan bill to the Senate, the President was ready to sign, and the…

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