Trends in Health Insurance Premiums and Out-Of-Pocket Costs
The four seasons cycle every year in a predictable way; spring precedes summer which precedes fall; winter follows and then…
Startling Discoveries About Individual Health Insurance in Hall County,GA
My personal tutorial in healthcare economics lets me make a few eye-opening observations about health insurance for individuals residing in…
A Kitchen Table Tutorial in Healthcare Economics
Open enrollment for health insurance policies occurs every year. During this time period and only during this time period a…
Life’s Spectrum: From Commercial Insurance to Medicare–Part”D”
Self-administered medications are not a covered Medicare part “B” benefit. In 2003 Congress passed the Medicare Prescription Drug and Modernization…
Life’s Spectrum: From Commercial Insurance to Medicare–Part C
Medicare Part C is known widely by its moniker Medicare Advantage plan. These plans are purchased from commercial insurance companies…
Life’s Spectrum: From Commercial Insurance To Medicare–Part “B”
Medicare Part “B” is different from bothPart “A” and from commercial insurance. Unlike Part “A” Medicare individuals pay a monthly…
Life’s Spectrum: From Commercial Insurance to Medicare
There are two kinds of Medicare. The 1965 type is called “Original” and the newer version is named Medicare part…
Why We Cannot Blame Obamacare for All Our Problems
When I talk to people about my experiences with healthcare fraud and warn them to remain vigilant, inevitably I direct…
What Would True Healthcare Reform Look Like?
The US citizen, healthy or sick, needs to adjust his view of his position in the healthcare industry. If the…
Avoid Becoming a Victim of Healthcare Fraud
So what if your provider files false claims on you? Your insurance company will make it right…..right? In healthcare, the…
What is Healthcare Fraud?
The majority of healthcare fraud is committed by a small minority of dishonest healthcare providers with the only “red flag”…
Reviewing Your Medical Record for Accuracy
Educated healthcare consumers acquire the knowledge necessary to be effective advocates for themselves. Below are a few quick tips and…
Translating Insurance Language into Mainstream English
Since “healthcare speak” is often as foreign sounding as a second language, you practically need a phrase book when trying…
Take Action Today: Here’s What to Say to Your Legislators
Keep it simple. Ask for reform that: Requires patient consent forms be written at a 6th to 8th grade reading…
Elimination Of “Why Do They Do It? Because They Can!”
When a consent is slid across the receptionist’s desk with the words “sign this; it let’s us take care of…
Parsing Pages Of The Medical Bluebook
Everyone has made an outline for a project; the completed product may have been a porch or a term paper…
Third Party Payers In The US Healthcare Market: Patient Agent
An insurance company touts its ability to negotiate discounts from the posted price of a medical product. The charge master…
Obamacare: Is It Affordable?
In August 2014 I shared my thoughts about healthcare reform as seen through the Patient Protection and Affordable Care Act,…
Why Is Healthcare So Expensive?
Healthcare use and expenses are not controlled by the usual pesky supply and demand curves. If supply rises, price goes…
The Role Of Third Party Payers In The US Healthcare Market: A Payday Loan
Commercial insurance companies make a profit for their shareholders. State insurance commissioners set an allowable rate of return, that is…
Boots On The Ground In The War Against Healthcare Fraud
Third party insurers paid each of these practitioners or facilities. They do not have enough personnel to look at time-of-day…
Stories From Smaller Venues
Recently when I registered at a hospital for an outpatient study, the clerk pushed a single page through her window…
People Who Lie Once Might Do It Again
When the surgeon dictated at 4:21 p.m. his document titled “history and physical,” he decided he wanted an imaging study.…
Another Hospital, Another Story
In 2007, several years prior to the events at AMC described here and here, I experienced another incident, different in…
AMC Part Two: What My Chart Says
These events occurred at a prominent tertiary care, university teaching hospital (AMC). For the purpose of this story, it will…
Stories from an Academic Medical Center, January 2015: Part One
These events occurred at a prominent tertiary care, university teaching hospital (AMC). For the purpose of this story, it will…
Shoplifting or Plagiarism
As a student my mentors emphasized the importance of medical records I would create during my career. “That document refreshes…
Third Party Payers In The US Healthcare: What Do They Purchase?
During high school, college and medical school I took many exams. The tests were of two general formats, quantitative or…