Tag: Insurance

Coordinating surgical care means precise staff handoffs

In every OR, the complicated dance of surgical care coordination—the series of handoffs between stakeholders throughout the surgery lifecycle—is performed mainly in the background. Those stakeholders include physician offices, schedulers, preadmission testing, insurance verification, vendors, sterile processing, supply chain, anesthesia, and surgical staff. But what does it look like when…

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By: Carisa Brewster and Jonathan Reimer
January 23, 2024
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Doctors with multiple malpractice suits become insurance company medical directors

Editor’s Note An investigation by the nonprofit organization ProPublica and the Capital Forum revealed many doctors with a history of malpractice cases now serve as insurance company medical directors—a role with major influence on decisions that impact patient outcomes. According to a December 15 article in ProPublica, the organizations used…

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By: Brita Belli
December 15, 2023
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A closer look at variations in regional health insurance prices

Editor's Note This new study in JAMA Health Forum is one of the first to review publicly available insurer price data and compare regional rate differences. The research was published by JAMA Network on October 27. Following are some highlights: Over half of the US population receives health insurance from…

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By: Brita Belli
October 30, 2023
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Problems with prior authorization, utilizing health insurance coverage are prevalent, survey finds

Editor's Note This KFF survey from June 2023 found that some six in 10 adults with health insurance have experienced problems when trying to use their insurance, KFF Health News September 29 reports. The problems included denied claims, network adequacy issues, and preauthorization delays and denials.  According to the survey,…

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By: Brita Belli
October 4, 2023
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US uninsured rate reaches all-time low

Editor's Note  The number of Americans without health insurance coverage has hit a record low of 8% this year, exceeding the previous low of 9% in 2016, the Department of Health and Human Services July 3 reports. Since 2020, 5.2 million people have gained coverage, including 4 million adults and…

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By: Lauren McCaffrey
August 4, 2022
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Lawsuit filed against UnitedHealth for underpayment of telehealth services

Editor's Note A female patient in Chicago, Illinois, filed a lawsuit on July 7 against the multinational UnitedHealth Group for alleged underpayment of telehealth services, Becker’s Payer Issues July 8 reports. The lawsuit claims that the woman’s insurance plan covers telehealth services, including pay benefits for-out-network services. After receiving out-of-network…

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By: Lauren McCaffrey
July 12, 2022
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HHS says more funding is needed to combat COVID-19

Editor's Note According to the February 16 Becker’s Hospital Review, Health and Human Services (HHS) Secretary Xiaver Becerra said the Biden administration is estimating it will need some $30 billion to continue to fight against COVID-19. Another HHS representative told Politico the funding is needed "for additional resources to support…

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By: Tarsilla Moura
February 17, 2022
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ASCs sue over lack of spine surgery reimbursement

Editor's Note According to the February 2 Becker’s ASC Review, two ambulatory surgery centers (ASCs) recently filed lawsuits against insurance payers over reimbursement, or lack thereof, for spinal procedures. Surgery Center of Viera, based in Melbourne, Florida, filed its lawsuit January 20 against Cigna and consulting services Strategic Enterprise Solutions…

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By: Tarsilla Moura
February 3, 2022
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Association of COVID-19 with hospital readmissions

Editor's Note This study by researchers from New York University School of Medicine finds several factors associated with increased odds of readmission of patients hospitalized with COVID-19. In this retrospective cohort analysis of 6,191 adult patients hospitalized with COVID-19 in a New York safety-net hospital system between March 1 and…

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By: Judy Mathias
January 26, 2022
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Socioeconomic differences in telemedicine use for ambulatory surgical care during COVID-19

Editor's Note This study from Brigham and Women’s Hospital and Harvard Medical School, Boston, finds that Black patients used telemedicine platforms more often than White patients for ambulatory surgical care during Phase 2 of COVID-19. During Phase 1 (March 24 through June 23), there were 347 in-person and 638 virtual…

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By: Judy Mathias
January 24, 2022
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