Posts

More “Whoops”

Recently, I shared an example of insurance company shenanigans reported to me by a customer.  Since then, I’ve seen at least two or three other examples on places like the “Financial Management Society” MGMA mailing list, etc. So, here’s another subtle one – and it’s subtle, only because it happens so often that people don’t …

Fight Club (UHC and the Land of Make Believe)

The first rule about Fight Club is not to talk about Fight Club. SOAPM-list members know all about this, but a copy of the most ridiculous and obnoxious confidentiality agreement I have ever, ever seen is making the rounds. It’s so…ludicrous, my heart stops. Sadly, I know there are folks out there who have signed …

Vaccine Showdowns (Go EBP!)

My apologies to the readers of the SOAPM mailing list, as this is a repeat, but there are too many folks who would otherwise miss this piece from the San Francisco Chronicle: Doctor-insurer disputes force parents to pay up front for shots It’s the children who feel the sting of vaccinations, but it’s their parents …

Financial Analysis for the Managing Pediatric Provider

First, the facts: October 11 7-9 p.m. $75/person Doubletree Hotel Boston Downtown Boston, MA What are we covering? PCC’s Pediatric Solutions team will share current pediatric trends that drive bottom line change and show you where to look to evaluate the impact these trends have on your practice. Then, we’ll teach you how to apply …

A Recipe For Success

Excerpts from a fun letter one of our clients put together recently. Note the results at the end. …Vaccine reimbursement is always an issue with your company. In our practice, [MCO] has the lowest vaccine reimbursement of all insurance companies. The American Academy of Pediatrics has published recommendations for vaccine reimbursement. You can find the …

Not Making the Grade

I picked up this tidbit from a message forwarded to PedTalk (thanks, Dr. Gewanter). Family Practice Magazine and the associated AAFP (from whom the AAP is finally starting to learn!) “…decided last year to conduct a Consumer Reports-style survey of physicians’ experiences with third-party payers.” The results are hardly surprising. OK, I was surprised that …

Merging Practices

Here’s a great press release to start your day! Some important excerpts for those who don’t make the jump: The [payment] disparity is forcing pediatricians out of business and may be prompting the next generation of physicians to choose other specialties. “I love caring for children; it’s the best job in the world. I don’t …

Back To The Mothership

Whew, I am finally back from a whirlwind tour and Vermont hasn’t looked this good in a long time. During my travels, I have had over a dozen new insurance updates/stories/foibles forwarded to me, 90% of them originating with United Health Care. I’ll toss some up, of course. I can’t wait for United to find …

PedTalk

I suspect that most of the readers of this blog are already well aware of PedTalk, the original and longest-running public pediatric discussion group. If you’re not familiar with the mailing list, here’s the summary: started in 1996, archived publically since 1997, usually somewhere between 350 and 600 active readers with thousands of visits to …

Aetna Settlements (Awake!)

Hot off the presses, plus I wanted to stop picking so much on UHC/Oxf. From the Medical Society of New Jersey: AETNA PENALIZED $9.5 MILLION AND ORDERED TO PAY REPARATIONS TO OUT-OF-NETWORK PROVIDERS This week the New Jersey Department of Banking & Insurance (DOBI) fined Aetna almost $9.5 million for its attempt to pay certain …