AEI Pay It Now(sm) patient education.
•
0 likes•84 views
This document discusses making the case for medical cannabis reimbursement through health insurance. It notes that medical cannabis has been safely and effectively used by millions to treat certain conditions, and can be considered "reasonable and necessary" under insurance standards. The Pay It Now program helps coordinate advocacy efforts to achieve insurance coverage for medical cannabis at various stages of the claims process. Collective action is advocated to impact both private insurance policies and public policy regarding coverage of medical cannabis treatments.
Report
Share
Report
Share
Download to read offline
Recommended
HIRProject PP Revised
The H.I.R. Project is a nonprofit organization that pays the monthly health insurance premiums for patients who have stopped paying their premiums under the Affordable Care Act. When patients fail to pay premiums for 31-90 days, their health insurance is terminated and any medical claims are denied. The H.I.R. Project steps in during this 90 day grace period to pay outstanding premiums, reinstating patients' health insurance. This allows medical providers to resubmit previously denied claims for payment. The H.I.R. Project aims to help practices recover more revenue than traditional collections agencies in as little as one week.
What is a Medicaid Bond?
For healthcare providers that bill to Medicaid, this surety bond ensures that providers keep accurate records, bill correctly, and handle funds properly.
MediExcel Health Plan - SDAHU BUS EXPO 2017 AD_V008
MediExcel Health Plan offers ACA compliant health benefits with physicians located in Mexico to provide quality care at a lower cost, solving the healthcare cost problem. Interested parties should contact MediExcel at sales@mediexcel.com or (619) 421-1659 for more information or visit www.mediexcel.com.
What Does Health Reform Mean For You Presentation
The new health care legislation will impact every American. The NCPA has created a presentation, "What Does Health Reform Mean for You?," which explains the new legislation’s major points in a succinct and unbiased way.
Medicare Supplement vs Medicare Advantage
Medicare Supplement (Medigap) plans provide additional coverage to supplement Original Medicare, covering copays, coinsurance, and deductibles. Medicare Advantage plans are an alternative to Original Medicare that are sold by private insurers and must provide at least the same coverage as Original Medicare while also offering additional benefits. The main differences are that Medicare Supplement plans only supplement Original Medicare while Medicare Advantage plans are standalone, and Medicare Supplement plans have standardized coverage across insurers while Medicare Advantage plan coverage can vary. Someone cannot have both a Medicare Supplement and Medicare Advantage plan.
A Guide To Medicare Eligibility And Open Enrollment
Find out if you are eligible to receive Medicare, and how to apply for Medicare. Learn about the different types of Medicare and what you may be eligible to receive.
Medicaid Presentation
This document discusses Medicaid planning to manage the high cost of nursing home care, which averages $6,000-7,000 per month in Michigan. It provides two examples of Medicaid planning strategies. The first involves converting a joint living trust to a single survivor's trust to protect assets for the surviving spouse. The second uses a Medicaid trust to protect $250,000 in investments so a wife qualifies for Medicaid coverage of her nursing home costs immediately without spending down assets. Both strategies aim to qualify a spouse for Medicaid as soon as possible to cover nursing home costs.
Cigna ttk
Cigna is a global health services company with 95 million customers worldwide. It has over 40,000 employees and has been in business for over 200 years. Cigna offers a variety of health insurance and services, including medical, dental, life and accident insurance, as well as Medicare/Medicaid products. It operates in numerous countries around the world. In India, Cigna has a joint venture with TTK Group called CignaTTK Health Insurance, which offers individual and group health insurance plans across 15 cities in India.
Recommended
HIRProject PP Revised
The H.I.R. Project is a nonprofit organization that pays the monthly health insurance premiums for patients who have stopped paying their premiums under the Affordable Care Act. When patients fail to pay premiums for 31-90 days, their health insurance is terminated and any medical claims are denied. The H.I.R. Project steps in during this 90 day grace period to pay outstanding premiums, reinstating patients' health insurance. This allows medical providers to resubmit previously denied claims for payment. The H.I.R. Project aims to help practices recover more revenue than traditional collections agencies in as little as one week.
What is a Medicaid Bond?
For healthcare providers that bill to Medicaid, this surety bond ensures that providers keep accurate records, bill correctly, and handle funds properly.
MediExcel Health Plan - SDAHU BUS EXPO 2017 AD_V008
MediExcel Health Plan offers ACA compliant health benefits with physicians located in Mexico to provide quality care at a lower cost, solving the healthcare cost problem. Interested parties should contact MediExcel at sales@mediexcel.com or (619) 421-1659 for more information or visit www.mediexcel.com.
What Does Health Reform Mean For You Presentation
The new health care legislation will impact every American. The NCPA has created a presentation, "What Does Health Reform Mean for You?," which explains the new legislation’s major points in a succinct and unbiased way.
Medicare Supplement vs Medicare Advantage
Medicare Supplement (Medigap) plans provide additional coverage to supplement Original Medicare, covering copays, coinsurance, and deductibles. Medicare Advantage plans are an alternative to Original Medicare that are sold by private insurers and must provide at least the same coverage as Original Medicare while also offering additional benefits. The main differences are that Medicare Supplement plans only supplement Original Medicare while Medicare Advantage plans are standalone, and Medicare Supplement plans have standardized coverage across insurers while Medicare Advantage plan coverage can vary. Someone cannot have both a Medicare Supplement and Medicare Advantage plan.
A Guide To Medicare Eligibility And Open Enrollment
Find out if you are eligible to receive Medicare, and how to apply for Medicare. Learn about the different types of Medicare and what you may be eligible to receive.
Medicaid Presentation
This document discusses Medicaid planning to manage the high cost of nursing home care, which averages $6,000-7,000 per month in Michigan. It provides two examples of Medicaid planning strategies. The first involves converting a joint living trust to a single survivor's trust to protect assets for the surviving spouse. The second uses a Medicaid trust to protect $250,000 in investments so a wife qualifies for Medicaid coverage of her nursing home costs immediately without spending down assets. Both strategies aim to qualify a spouse for Medicaid as soon as possible to cover nursing home costs.
Cigna ttk
Cigna is a global health services company with 95 million customers worldwide. It has over 40,000 employees and has been in business for over 200 years. Cigna offers a variety of health insurance and services, including medical, dental, life and accident insurance, as well as Medicare/Medicaid products. It operates in numerous countries around the world. In India, Cigna has a joint venture with TTK Group called CignaTTK Health Insurance, which offers individual and group health insurance plans across 15 cities in India.
What Is the Five Year Medicaid Look-Back
Though the majority of senior citizens will qualify for Medicare coverage, Medicare is not set up to cover custodial care costs. Learn more about New York medicaid look-back in this presentation.
Medicare supplement insurance, aug 2011
Medicare supplement insurance, also known as Medigap insurance, is private insurance that helps cover costs that original Medicare does not. The website MedicareSupplement-Insurance.com helps users find affordable Medigap plans through a network of local agents. They assist users in selecting plans that cover costs like copays, coinsurance, and deductibles to provide comprehensive coverage at the lowest possible price. The website provides information about Medicare eligibility, enrollment, the different parts of Medicare coverage, and how to contact them for assistance.
Hsa Resource Center Consumer Presentation
This document provides an overview of Health Savings Accounts (HSAs) and the CelticSaver HSA Health Plan. It discusses that HSAs help address the growing number of uninsured, rising healthcare costs, and increasing popularity of consumer-driven health plans. It then describes the two components of an HSA program - a qualified high deductible health plan and a health savings account. The rest of the document focuses on detailing the specifics of the CelticSaver HSA Health Plan, including deductible and coinsurance options, as well as an overview of Celtic Insurance Company's other product offerings.
Cigna TTK pro health insurance prospectus
Get OPD benefits, tax savings up to Rs. 25000, worldwide emergency cover and other lucrative benefits with https://www.cignattkinsurance.in.
Soraya Ghebleh - Basic Medicare Explained
This is a presentation by Soraya Ghebleh that explains the major components of Medicare and the associated terms an individual would need to know to navigate the vast amount of information available on Medicare.
Health insurance
Health insurance covers medical and surgical expenses for insured individuals. It can reimburse costs out-of-pocket or make direct payments to providers. It is important for individuals and families who cannot get insurance through employers due to rising healthcare costs. Government plans like Medicare provide health insurance for those over 65, while private long-term care insurance covers nursing home and home healthcare costs for those needing assistance with daily tasks. Additional types of insurance include dental, vision, and disability coverage.
NPKUA July Presentaion Slides (revised2)
The document provides information about obtaining insurance coverage for medical foods. It discusses understanding insurance policies and coverage, following state mandates, communicating with insurance carriers using proper terminology, and removing exclusions for medical food coverage. The goal is to ensure medical foods are a covered benefit, deemed medically necessary, and processed correctly for approval of insurance coverage.
Medicare 101 - February 2017 Update
Read the latest benefits information from Independent Medicare broker Erin Hart from American HealthCare Group. Learn about Medicare income limits, care plans, and topics to consider when planning for health benefits in retirement.
IDIC_Health_And_Wellness_Overview
The document describes a participatory wellness program offered to employees. It includes:
1) A self-funded ERISA qualified group health plan integrated with employer-provided insurance that provides wellness services and benefits to offset medical expenses.
2) An example paycheck that shows how employee contributions to the wellness plan are deducted pre-tax, resulting in savings for both the employer and employee. Benefits paid out include claim payments given as flex credits to the employee.
3) Additional wellness program benefits for employees like health screenings, coaching, activities and supplemental benefits like life insurance and accident coverage.
Health insurance- insurance products-individual and family floater
Health Insurance products in India. the benefit of health insurance for individual , family and children
www.probusinsurance.in
Axiom National MSA Workers Compensation and Liability
This powerpoint presentation explains the history of Medicare Set-asides and all that surround them.
LPL Financial Guide to Long Term Care Insurance
The document provides information about long-term care, the costs associated with it, and ways to plan and pay for long-term care services. It explains that long-term care includes medical and non-medical services for those with chronic illnesses or disabilities, and that most claims are for people under age 64. It also outlines options for funding long-term care, including traditional long-term care insurance, life insurance with long-term care riders, and single premium life insurance with long-term care benefits. The document stresses the importance of planning ahead for long-term care needs.
r.i_individual_product_guide-actual-22-07-2014
Resolution Insurance entered the Kenyan market in 2002 as the first medical insurance provider. It has since grown to provide various insurance products including medical, personal accident, liability, and travel insurance. The company has over 60,000 members and a network of over 750 healthcare providers across East Africa. Resolution Insurance offers comprehensive medical insurance plans for individuals, families, and corporates with benefits like maternity coverage, chronic condition coverage including HIV/AIDS, and a 24-hour medical assistance hotline.
Medicaid Planning
Medicaid Planning and the Caregiver Crisis
https://www.thehalelawfirm.com/practice-areas/elder-law/medicaid-planning/
If you or someone you love is at risk of spending down their life savings to pay for the ever-growing cost of long-term care, then we invite you to call today for your free initial consultation. We look forward to exploring the opportunities our long-term care and asset protection planning can provide. The risk of needing long-term care and its related expenses is too great to ignore.
Call today to speak with a Dallas Medicaid planning attorney at the Hale Law Firm, P.C.
The Hale Law Firm, P.C.
417 W Main St
Waxahachie, TX 75165
(214) 446-5080
https://www.thehalelawfirm.com/
Medicare for all for more here's how medicare works
Medicare is the US government health insurance program for those aged 65 and older. It covers hospital stays, doctors visits, prescription drugs, and other services, but has gaps in coverage and costs that many Democrats want to address in their healthcare proposals. While Medicare benefits are comprehensive, it does not cover services like dental, vision, and long-term nursing home care. It also has premiums, deductibles, and co-payments that can be costly for beneficiaries with high medical expenses. Democrats debate expanding coverage and reducing costs through various proposals like a public option or allowing people to buy into Medicare at earlier ages.
Med supppresentation
UnitedHealthcare Insurance Company has partnered with AARP to offer AARP Medicare Supplement Insurance Plans to individuals enrolled in Medicare Parts A and B. The plans are designed to help cover costs that Original Medicare does not cover, such as copays, coinsurance, and deductibles. They provide coverage for medically necessary care and offer member services. Customers consistently report high levels of satisfaction with the benefits and coverage provided by the AARP Medicare Supplement Insurance Plans.
Health Care #1
The document summarizes key provisions of the Affordable Care Act (ACA) that took effect between 2010-2014. It discusses how the ACA prohibited insurance companies from denying coverage or charging more due to pre-existing conditions, allowed children to stay on parents' plans until age 26, eliminated the Medicare prescription drug "donut hole," established health insurance exchanges, and required most individuals to have health insurance or pay a penalty. The overall intent was to increase access to affordable health care and reward quality of care over quantity of services provided.
What is the Difference Between Medicare and Medicaid?
Medicare and Medicaid have similar sounding names, and they are both health insurance programs that are run by the government.
Cms 855 a medicare application(medicare accreditation)
CMS 855A Medicare Application made easy. Let us complete your CMS 855A Medicare Application and CHAP Medicare Accreditation.
NPKUA July Presentaion Slides (revised2)
This document provides information and guidance on obtaining insurance coverage for medical foods. It discusses understanding insurance policies and coverage, following state mandates, communicating with insurance carriers using the proper terminology, and removing exclusions. Tips are provided on requesting case managers, prior authorizations, and gap exceptions. The differences between medical and pharmacy benefits are explained. Assistance resources through Compassion*Works Medical and the NPKUA Insurance Coaches Program are outlined to help navigate the insurance process.
Week 2 Affordable Care Act
The Affordable Care Act (ACA) is comprehensive healthcare reform legislation that was signed into law in 2010. It expanded access to health insurance coverage in three primary ways: by expanding Medicaid eligibility; creating health insurance exchanges; and preventing insurance companies from denying coverage due to pre-existing conditions. The ACA was intended to provide more affordable health insurance options for millions of uninsured Americans and supports innovative healthcare delivery methods. It established different metal-tiered health insurance plan options that vary in out-of-pocket costs and premiums.
COST OF MEDICARE
Medicare Part D may be a God-send for most seniors who may be on a hard and fast income and possess ...
More Related Content
What's hot
What Is the Five Year Medicaid Look-Back
Though the majority of senior citizens will qualify for Medicare coverage, Medicare is not set up to cover custodial care costs. Learn more about New York medicaid look-back in this presentation.
Medicare supplement insurance, aug 2011
Medicare supplement insurance, also known as Medigap insurance, is private insurance that helps cover costs that original Medicare does not. The website MedicareSupplement-Insurance.com helps users find affordable Medigap plans through a network of local agents. They assist users in selecting plans that cover costs like copays, coinsurance, and deductibles to provide comprehensive coverage at the lowest possible price. The website provides information about Medicare eligibility, enrollment, the different parts of Medicare coverage, and how to contact them for assistance.
Hsa Resource Center Consumer Presentation
This document provides an overview of Health Savings Accounts (HSAs) and the CelticSaver HSA Health Plan. It discusses that HSAs help address the growing number of uninsured, rising healthcare costs, and increasing popularity of consumer-driven health plans. It then describes the two components of an HSA program - a qualified high deductible health plan and a health savings account. The rest of the document focuses on detailing the specifics of the CelticSaver HSA Health Plan, including deductible and coinsurance options, as well as an overview of Celtic Insurance Company's other product offerings.
Cigna TTK pro health insurance prospectus
Get OPD benefits, tax savings up to Rs. 25000, worldwide emergency cover and other lucrative benefits with https://www.cignattkinsurance.in.
Soraya Ghebleh - Basic Medicare Explained
This is a presentation by Soraya Ghebleh that explains the major components of Medicare and the associated terms an individual would need to know to navigate the vast amount of information available on Medicare.
Health insurance
Health insurance covers medical and surgical expenses for insured individuals. It can reimburse costs out-of-pocket or make direct payments to providers. It is important for individuals and families who cannot get insurance through employers due to rising healthcare costs. Government plans like Medicare provide health insurance for those over 65, while private long-term care insurance covers nursing home and home healthcare costs for those needing assistance with daily tasks. Additional types of insurance include dental, vision, and disability coverage.
NPKUA July Presentaion Slides (revised2)
The document provides information about obtaining insurance coverage for medical foods. It discusses understanding insurance policies and coverage, following state mandates, communicating with insurance carriers using proper terminology, and removing exclusions for medical food coverage. The goal is to ensure medical foods are a covered benefit, deemed medically necessary, and processed correctly for approval of insurance coverage.
Medicare 101 - February 2017 Update
Read the latest benefits information from Independent Medicare broker Erin Hart from American HealthCare Group. Learn about Medicare income limits, care plans, and topics to consider when planning for health benefits in retirement.
IDIC_Health_And_Wellness_Overview
The document describes a participatory wellness program offered to employees. It includes:
1) A self-funded ERISA qualified group health plan integrated with employer-provided insurance that provides wellness services and benefits to offset medical expenses.
2) An example paycheck that shows how employee contributions to the wellness plan are deducted pre-tax, resulting in savings for both the employer and employee. Benefits paid out include claim payments given as flex credits to the employee.
3) Additional wellness program benefits for employees like health screenings, coaching, activities and supplemental benefits like life insurance and accident coverage.
Health insurance- insurance products-individual and family floater
Health Insurance products in India. the benefit of health insurance for individual , family and children
www.probusinsurance.in
Axiom National MSA Workers Compensation and Liability
This powerpoint presentation explains the history of Medicare Set-asides and all that surround them.
LPL Financial Guide to Long Term Care Insurance
The document provides information about long-term care, the costs associated with it, and ways to plan and pay for long-term care services. It explains that long-term care includes medical and non-medical services for those with chronic illnesses or disabilities, and that most claims are for people under age 64. It also outlines options for funding long-term care, including traditional long-term care insurance, life insurance with long-term care riders, and single premium life insurance with long-term care benefits. The document stresses the importance of planning ahead for long-term care needs.
r.i_individual_product_guide-actual-22-07-2014
Resolution Insurance entered the Kenyan market in 2002 as the first medical insurance provider. It has since grown to provide various insurance products including medical, personal accident, liability, and travel insurance. The company has over 60,000 members and a network of over 750 healthcare providers across East Africa. Resolution Insurance offers comprehensive medical insurance plans for individuals, families, and corporates with benefits like maternity coverage, chronic condition coverage including HIV/AIDS, and a 24-hour medical assistance hotline.
Medicaid Planning
Medicaid Planning and the Caregiver Crisis
https://www.thehalelawfirm.com/practice-areas/elder-law/medicaid-planning/
If you or someone you love is at risk of spending down their life savings to pay for the ever-growing cost of long-term care, then we invite you to call today for your free initial consultation. We look forward to exploring the opportunities our long-term care and asset protection planning can provide. The risk of needing long-term care and its related expenses is too great to ignore.
Call today to speak with a Dallas Medicaid planning attorney at the Hale Law Firm, P.C.
The Hale Law Firm, P.C.
417 W Main St
Waxahachie, TX 75165
(214) 446-5080
https://www.thehalelawfirm.com/
Medicare for all for more here's how medicare works
Medicare is the US government health insurance program for those aged 65 and older. It covers hospital stays, doctors visits, prescription drugs, and other services, but has gaps in coverage and costs that many Democrats want to address in their healthcare proposals. While Medicare benefits are comprehensive, it does not cover services like dental, vision, and long-term nursing home care. It also has premiums, deductibles, and co-payments that can be costly for beneficiaries with high medical expenses. Democrats debate expanding coverage and reducing costs through various proposals like a public option or allowing people to buy into Medicare at earlier ages.
Med supppresentation
UnitedHealthcare Insurance Company has partnered with AARP to offer AARP Medicare Supplement Insurance Plans to individuals enrolled in Medicare Parts A and B. The plans are designed to help cover costs that Original Medicare does not cover, such as copays, coinsurance, and deductibles. They provide coverage for medically necessary care and offer member services. Customers consistently report high levels of satisfaction with the benefits and coverage provided by the AARP Medicare Supplement Insurance Plans.
Health Care #1
The document summarizes key provisions of the Affordable Care Act (ACA) that took effect between 2010-2014. It discusses how the ACA prohibited insurance companies from denying coverage or charging more due to pre-existing conditions, allowed children to stay on parents' plans until age 26, eliminated the Medicare prescription drug "donut hole," established health insurance exchanges, and required most individuals to have health insurance or pay a penalty. The overall intent was to increase access to affordable health care and reward quality of care over quantity of services provided.
What is the Difference Between Medicare and Medicaid?
Medicare and Medicaid have similar sounding names, and they are both health insurance programs that are run by the government.
Cms 855 a medicare application(medicare accreditation)
CMS 855A Medicare Application made easy. Let us complete your CMS 855A Medicare Application and CHAP Medicare Accreditation.
What's hot (19)
Health insurance- insurance products-individual and family floater
Health insurance- insurance products-individual and family floater
Axiom National MSA Workers Compensation and Liability
Axiom National MSA Workers Compensation and Liability
Medicare for all for more here's how medicare works
Medicare for all for more here's how medicare works
What is the Difference Between Medicare and Medicaid?
What is the Difference Between Medicare and Medicaid?
Cms 855 a medicare application(medicare accreditation)
Cms 855 a medicare application(medicare accreditation)
Similar to AEI Pay It Now(sm) patient education.
NPKUA July Presentaion Slides (revised2)
This document provides information and guidance on obtaining insurance coverage for medical foods. It discusses understanding insurance policies and coverage, following state mandates, communicating with insurance carriers using the proper terminology, and removing exclusions. Tips are provided on requesting case managers, prior authorizations, and gap exceptions. The differences between medical and pharmacy benefits are explained. Assistance resources through Compassion*Works Medical and the NPKUA Insurance Coaches Program are outlined to help navigate the insurance process.
Week 2 Affordable Care Act
The Affordable Care Act (ACA) is comprehensive healthcare reform legislation that was signed into law in 2010. It expanded access to health insurance coverage in three primary ways: by expanding Medicaid eligibility; creating health insurance exchanges; and preventing insurance companies from denying coverage due to pre-existing conditions. The ACA was intended to provide more affordable health insurance options for millions of uninsured Americans and supports innovative healthcare delivery methods. It established different metal-tiered health insurance plan options that vary in out-of-pocket costs and premiums.
COST OF MEDICARE
Medicare Part D may be a God-send for most seniors who may be on a hard and fast income and possess ...
Can I Give Away Assets to Qualify for Medicaid in Indiana?
"The Medicaid program will pay for long-term care, but it is a need-based program. To stay within the asset limits, people typically give assets to their loved ones
before they apply for coverage. Learn more about medicaid in Indiana in this presentation.
"
Developing healthcare finance fraud (2)
This document discusses healthcare fraud, waste, and abuse compliance. It begins with a case study of United States v. Halper, where a medical laboratory manager submitted 65 false claims to Medicare, mischaracterizing services to receive higher reimbursements. It then defines fraud, waste, and abuse in healthcare. Fraud involves knowingly making false statements for an unauthorized benefit. Waste means unnecessary costs from overuse or misuse of services. Abuse refers to practices inconsistent with sound business that cause unnecessary costs. The document emphasizes the importance of compliance programs and policies to protect taxpayer dollars from fraud and divert funds to those who need care.
Medicare, Medicaid, and the Health Insurance Portability and Accou.docx
Medicare, Medicaid, and HIPAA have impacted the healthcare industry both positively and negatively. Some key benefits include Medicare providing affordable coverage to seniors and people with disabilities, Medicaid expanding coverage to low-income groups, and HIPAA strengthening privacy protections for patient information. However, challenges also exist such as high administrative costs for the programs, low reimbursement rates discouraging some providers from accepting Medicaid, and HIPAA compliance adding expenses for healthcare organizations. On balance, the policies aim to expand access to care while balancing costs and privacy considerations across the complex U.S. healthcare system.
Medical Billing Simple Manual
- Medical billing companies handle the process of submitting claims to insurance companies and getting paid for physicians' services, as the process is lengthy, complicated, and involves many rules and regulations.
- There are three main parties in medical billing - the physician, the insurance company, and the patient. Medical billing companies work to maximize collections for physicians while complying with insurance company rules and not penalizing patients.
- The main functions of medical billing companies are to process patient information and file claims with private insurance companies and government programs like Medicare and Medicaid in order to get healthcare providers paid on time.
Chapter 2Fraud and Abuse StarkPhysician Self-Referral and
Chapter 2
Fraud and Abuse: Stark/Physician Self-Referral and Anti-Kickback
Learning Objectives
Physician Self-Referral (Stark) Law and Anti-Kickback Statute (AKS)
Services, individuals, organizations, and transactions affected by these laws.
Specific behaviors prohibited.
Exceptions and “safe harbors” for avoiding liability.
Anticipating and preventing violations.
Physician Self-Referral Law (Stark)
Initial law (Stark I) sponsored by Congressman Pete Stark enacted in 1989 and applied only to clinical laboratory services.
Omnibus Budget Reconciliation Act of 1993 (Stark II) expanded law to additional 10 types of clinical services.
Patient Protection and Affordable Care Act of 2010 added restrictions on physician-owned hospitals and required the issuance of a self-referral disclosure protocol.
Stark Prohibition
“... If a physician (or an immediate family member of such physician) has a financial relationship with an entity ..., then the physician may not make a referral to the entity for the furnishing of designated health services for which payment otherwise may be made” under Medicare (also applicable to Medicaid). (underlining added).
“Physician”
The person making the referral may be a(n)
MD
Osteopath
Dentist
Podiatrist
Optometrist, or
Chiropractor
“Immediate family member”
Besides the referring physician herself, this person may be a
spouse;
parent, child, or sibling (by birth or adoption);
stepparent, stepchild, step-brother, or step-sister;
father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law;
grandparent or grandchild; or
spouse of a grandparent or grandchild.
“Entity”
The entity with which there is a financial relationship must be one that bills CMS for designated health services (DHS) or that furnishes all or most of the components of the DHS.
This includes the person or entity that actually performs the DHS, or presents a claim for DHS services to the Medicare program.
7
“Financial relationship”
Direct or indirect ownership of an entity:
Equity stock, interest in a limited liability company, holding debt in an entity.
Direct or indirect compensation from an entity:
Physician’s compensation from an entity, lease between physicians and health care facilities, medical director agreements, and independent contract with physicians.
“Designated health services” (I)
Clinical laboratory services.
Physical therapy services.
Occupational therapy services.
Outpatient speech-language pathology services.
Radiology and certain other imaging services.
Radiation therapy services and supplies.
“Designated health services” (II)
Durable medical equipment and supplies.
Parenteral and enteral nutrients, equipment, and supplies.
Prosthetics, orthotics, and prosthetic devices and supplies.
Home health services.
Outpatient prescription drugs.
Inpatient and outpatient hospital services.
Penalties for Stark Violations
Payment for services in response to prohibited referral must ...
7 Biggest Medical Malpractice Insurance Mistakes
“7 Biggest Mistakes MD’s Make in their Medical Malpractice Insurance Coverage” contains many tips on what to avoid, information on choosing Risk Retention Groups, how to deal with insurance brokers, and industry insurance terms that doctors should know.
A health insurance roadmap
A health insurance roadmap takes a look at some simple solutions to the complex issues facing health insurance, medicare, medicaid, long term care insurance, and the high cost of health expenses in retirement.
This will work because so much of this is already in place and a lot of the rest would be quick and easy to implement. As in all areas, knowledge is power. Consumers can take control of your insurance portfolio by becoming educated about insurance. Better education and understanding will lead to positive results for consumers and for the insurance industry.
Medicare 1IV
This document summarizes Medicare Supplement (Medigap) insurance. It explains that Medigap insurance is sold by private insurers to help pay for costs that traditional Medicare does not cover, such as copays and deductibles. There are 10 standard Medigap plans that cover different benefits. The most popular plans are Plans F, G, and N. Medigap provides valuable protection against high medical costs for its nearly 12 million policyholders. Premiums vary based on factors like age, gender, location, and smoking status.
Affordable Care Act Evaluative Paper
The document discusses three provisions of the Affordable Care Act (ACA) that address market failures in the health insurance market:
1) Health insurance exchanges allow the uninsured to purchase qualified coverage, addressing missing markets. This increases insurance uptake and lowers overall healthcare expenditures.
2) Guaranteed issue prohibits denying coverage or charging more based on health status, addressing adverse selection. Risk adjustment offsets this by transferring payments between insurers.
3) Consumer protections like online tools provide information to allow informed plan choices, addressing high search costs in a complex market with little transparency.
The Art of Practice Management Dental Pearls - October 2016
An insightful and informative newsletter from the Art of Practice Management. A dental practice management consulting company that focuses on revenue and collection systems, front desk systems and forms, dental insurance processing, medical/dental cross-coding systems and employment-law compliance.
Medicare Medical Health Insurance - A B C D
If you have been paying into social security during your working life, and possess met the minimum w...
Top Medical Financing Company
Denefits offers medical financing options for patients who have been denied by other lenders like CareCredit, approving over 50% of applicants. As healthcare costs rise, affordable financing options are becoming necessary. Denefits provides instant approval, flexible payment plans, and helps patients rebuild their credit through on-time payments that are reported to credit agencies. Denefits also offers unique features like Social Healthcare Payments that allow patients to fundraise through social media.
Centers for Medicare and Medicaid Services.docx
The Centers for Medicare and Medicaid Services (CMS) suspended billions of dollars in risk adjustment payments meant to incentivize insurers to cover individuals with pre-existing conditions. Several medical organizations protested this decision, arguing it jeopardizes access to affordable healthcare and could cause insurers to raise premiums. The CMS suspended payments pending the resolution of a lawsuit challenging the risk adjustment program established under the Affordable Care Act. Critics worry insurers may increase premiums during this time, pricing many beneficiaries out of coverage and undermining the ACA's goals of expanding access.
Final Educational Pp Pet Insurance & Your Veterinary Practice
Veterinary costs continue to rise, Allows pet owners to budget for veterinary
care, Provides higher limits than most clients can afford, Can be used for their regular veterinarian, emergency clinics, referral centers or when traveling. Practices that incorporate a simple protocol to discuss pet health insurance with clients tend to enjoy a better level of support to provide the optimal care. This presentation provide a good overview for the entire veterinary staff. It is not a marketing effort for one company vs, another!
Complaint against Magellan Health, Inc. for $1 Million Unpaid Bonus Compensation
Complaint and Demand for Jury Trial against Magellan Health, Inc. alleging that Magellan failed to pay an employee more than $1 million+ in earned bonus compensation. United States District Court, Middle District of Florida, 2018. Pollard PLLC.
Broker Article
Jeff Marks discusses strategies for medical brokers to consider as health care reform is implemented. He believes brokers will need to expand their offerings beyond traditional insurance to include ancillary products that provide added value. Specifically, he recommends telemedicine services that allow clients 24/7 access to doctors by phone for diagnosis and treatment. Telemedicine could reduce costs for employers and employees while increasing productivity. Marks also suggests other non-insurance products like discount programs and lifestyle benefits that pay brokers commissions. To prepare, brokers should develop new business models incorporating these innovative ancillary options to differentiate themselves and generate additional revenue streams.
The ins and outs of the affordable care act
The Affordable Care Act aims to provide more Americans with access to affordable health care through various reforms. It establishes health insurance exchanges to allow individuals and small businesses to compare plans, regulates the insurance marketplace, prohibits denying coverage due to pre-existing conditions, and expands Medicaid eligibility. The Act also aims to reduce health care costs and ensure Americans receive high-quality care.
Similar to AEI Pay It Now(sm) patient education. (20)
Can I Give Away Assets to Qualify for Medicaid in Indiana?
Can I Give Away Assets to Qualify for Medicaid in Indiana?
Medicare, Medicaid, and the Health Insurance Portability and Accou.docx
Medicare, Medicaid, and the Health Insurance Portability and Accou.docx
Chapter 2Fraud and Abuse StarkPhysician Self-Referral and
Chapter 2Fraud and Abuse StarkPhysician Self-Referral and
The Art of Practice Management Dental Pearls - October 2016
The Art of Practice Management Dental Pearls - October 2016
Final Educational Pp Pet Insurance & Your Veterinary Practice
Final Educational Pp Pet Insurance & Your Veterinary Practice
Complaint against Magellan Health, Inc. for $1 Million Unpaid Bonus Compensation
Complaint against Magellan Health, Inc. for $1 Million Unpaid Bonus Compensation
Recently uploaded
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Top Travel Vaccinations in Manchester
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS). Parc Taulí. Sabadell
Acute Gout Care & Urate Lowering Therapy .pdf
In this document , the management of acute gout attacks and a description of urate lowering therapy is mentioned.
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Cervical Disc Arthroplasty ORSI 2024.pptx
Indication and installation of a mobile cervical disc prosthesis. Benefits of the PRODISC C VIVO mobile disc prosthesis (Centinel Spine)
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...Kosmoderma Academy Of Aesthetic Medicine
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
CLEAR ALIGNER THERAPY IN ORTHODONTICS .pptx
Dr. ZANAB FARHEEN FAYAZ ,MDS(ORTHODONTICS & DENTOFACIAL ORTHOPEDICS ).
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
MERCURY GROUP.BHMS.MATERIA MEDICA.HOMOEOPATHY
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
Pharmacology of 5-hydroxytryptamine and Antagonist
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Do you have abnormal smell after periods? It may be vaginitis. Do not worry, herbal medicine Fuyan Pill can help you get a cure.
share - Lions, tigers, AI and health misinformation, oh my!.pptx
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Recently uploaded (20)
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdf
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Pharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and Antagonist
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
AEI Pay It Now(sm) patient education.
- 1. MEDICAL CANNABIS REIMBURSEMENT Make your case with Pay It Now(SM) Arya Earth Inc. 2020 Copyright 1
- 2. Accelerating medical cannabis reimbursement. Arya Earth Inc. Copyright 2020 2
- 3. IT CAN BE COVERED Wondering if health insurance covers it? It can pay if a creditable claim is made. It must be Reasonable and Necessary (R&N). The Case “MedicalCannabis” is safely and effectively established in a $Billion growing market for millions, displacing harmful alternatives. It is reimbursed because it meets patient needs in a beneficial setting. It meets currently allowed legal standards for acceptance. A patient could spend ~$50,000 over 10 years, or they could be protected & covered. Reasonably legally determined ….. it is not DEA Schedule 1 marijuana. See: https://www.cms.gov/Medicare/Coverage/DeterminationProcess R&N Supports Assists Medical Goals Beneficial and Effective Value for Money Arya Earth Inc. 2020 Copyright 3
- 4. HOWWE HELP Your Certified Advocate Assures your interest’s protection. Applies best practices with app support. Assists with customizing your claim. Coordinates doctors and insures. The Pay It Now(SM) Program Coordinates cases with resources. Evidence collection and justification. Health EconomicsAnalysis. Advises clinical studies. Arya Earth Inc. Copyright 2020 4
- 5. COVERAGE JOURNEY Claim Stages: 1. Initial 2. Reconsideration 3. Medical Review 4. External Review Collective action results. Achieve coverage collectively. Cannabis is safer and economically better. Coverage may occur at any stage. It’s the right thing to protect life. Arya Earth Inc. Copyright 2020 5
- 6. GET STARTED A. Activate Pay It Now(SM) to receive a Certified Advocate. B. Contribute your medical history in www.PatinetsLikeMe.com to qualify with standard reports and have a community. C. Invite your friends and family. This is a private policy challenge that will impact public policy. Arya Earth Inc. Copyright 2020 6