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"Balance Billing" ruling

Healthcare By anandgad on 4/4/2008 8:15 AM
This is in reference to the recent ruling by the Department of Managed Health Care in California. To understand what the ruling is, let’s see what “Balance Billing” is all about.

Whenever a doctor provides a service, he/she can set the fee for that service. It does not mean that they are going to get paid the fee that they charge. There are many doctors who practice at different hospitals. They may not be hospital employees. The hospital may have a different contract with the HMO and a different contract with the doctors. In most cases, the HMO payment is less than what the doctor bills and sometimes less than the UCR (Usual, Customary and Reasonable charges). If the doctor does not have a contracted amount for the provision of that service, he/she can bill the patient for that portion not covered by insurance.

The ruling would prohibit hospitals and hospital-based physicians from billing patients for the cost of emergency department services that should be cover ...
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Aetna and Cigna to pay for online visits

Healthcare By anandgad on 4/1/2008 3:32 PM
This is a follow up on one of my earlier posts. I had written about paying doctors for emails they send to patients. But now, apart from paying physicians $25 - $35 for online visits, Aetna and Cigna are going to charge copays to patients. Personally I would not want to pay for an online service. What do you think?

How Green is your Business?

How Green is your Business? By Mahadevan Seetharaman on 3/28/2008 4:21 AM
I have been a big proponent of green living. And, I want every one of us to ask the question – how green is my company? I am not talking about celebrating St. Patrick’s Day. I am talking about being environmentally friendly as a company.
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U.S. Supreme Court declines challenge to retiree benefits rule

Healthcare By anandgad on 3/26/2008 5:32 AM

Retirement benefits has been a hot topic in recent times. This news adds to the fire. The Age Discrimination in Employment Act of 1967 (ADEA) protects individuals who are 40 years of age or older from employment discrimination based on age. The ADEA's protections apply to both employees and job applicants. Under the ADEA, it is unlawful to discriminate against a person because of his/her age with respect to any term, condition, or privilege of employment, including hiring, firing, promotion, layoff, compensation, benefits, job assignments, and training.

We all know that older people use many healthcare benefits than younger people. Employers have only a limited budget allocated for employee benefits. They are working with a fixed amount. The Equal Employment Opportunity Commission (EEOC) ruled that employers can create two classes of retirees - those younger than age 65 and those older than 65 -- and offer different benefits to each group. In addition, the ruling allows emp ...

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Critical: What We Can Do About the Health-Care Crisis

Healthcare By anandgad on 3/25/2008 5:32 AM

Currently reading "Critical". Very gripping and thought provoking indeed!!!

 Here is a preview of the book by Publishers Weekly
The U.S. is the only industrialized nation that does not guarantee necessary health care to all of its citizens, and as former senator Daschle observes, Skeptics say we can't afford to cover everyone; the truth is that we can't afford not to because U.S. economic competitiveness is being impeded by the large uninsured population and fast-rising health costs. Daschle's book delineates the weaknesses of previous attempts at national health coverage, outlines the complex economic factors and medical issues affecting coverage and sets forth plans for change. ...

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How healthy lifestyle imitates chess!!

Healthcare By anandgad on 3/14/2008 7:54 AM

How healthy lifestyle imitates chess!!

I just finished this book and all I can say is "WOW!". One might think that this book is all about chess but it is not. You don’t need to know how to play chess to read this book though some background historical knowledge would really make this book gripping.

Rather than talk about how life imitates chess, I’m going to talk about how a healthy lifestyle relates to chess.

The game of chess has three stages – opening, middle game and end game. How you play the opening and the middle game decides how you end up with the end game. The objective of the game, of course, is to win. What is ‘winning’ ...

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Should doctors be paid to send emails to patients?

Healthcare By anandgad on 3/6/2008 2:55 PM

This is an issue that many doctors have been complaining about for the past 2-3 years. The complaint is that they need to be paid extra for sending emails to patients. What is the reason behind this?

Well, many healthcare organizations have started implementing Electronic Medical Records (EMR). Some of these offer the functionality by which patients can email their doctors and vice-versa. Doctors feel that they should be doing what they do best and what is good for their patients, which is taking care of patients and not sending emails.
Now let’s think about this for a moment.

Consider a mechanical design engineer. His/Her responsibility is to design good products and not send emails to their customers. Who are their customers? They could be internal or external to their organization. They don’t necessarily get paid extra for that. There is nothing mentioned in their employment contract that explicitly states tha ...

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Personal Health Records: My personal problem.

Healthcare By anandgad on 3/3/2008 9:13 PM

I’ve never really realized the benefits of a Personal Health Record until I switched jobs earlier this year. In my previous employment, I had great coverage and all my information was stored in an Electronic Medical Record (EMR). I had access to my information such as lab reports and discharge summary. I could send emails to my doctor about non urgent questions and track my health profile including profiling how my weight was progressing over the course of years and how my vitals like BMI and blood pressure was changing as I progressed in age and wisdom. The only feature that was not available was the ability to see my radiology images. But for that, I had no other complaints.

Now that I’ve switched jobs, the coverage is great. I now have a PPO plan compared to an HMO plan before. I now have the freedom to choose any doctor, within the network of course. I can choose a doctor close to work or close to home. I have a lot more choices to choose from. But I am not ...

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Marketing with Social Media/Networking Sites

Marketing By Pratheeba Panneer Selvam on 1/23/2008
Social networking sites like Facebook, Orkut and Social media sites like YouTube, MySpace are booming day by day and mostly young users are eager to engage with their favorite brands. How will you use this neworking/media websites for marketing?
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RATER Model to Improve the Customer Service

Marketing By Pratheeba Panneer Selvam on 7/17/2007

RATER model is invented by Leonard Berry. He identified this five quality customer service dimensions. Reliability, Assurance, Tangibles, Empathy, and Responsiveness. Nowadays, B2C businesses are taking care of this model. But, this will work out for all businesses such as B2B, B2C etc.

The quality customer service is the foundation for long run businesses. RATER model will regulate the business process, solutions and services.

Reliability – Which means that the service providers ability to identify and provide business solutions to their customers to achieve their goals and objectives.

Assurance – Providing trust and confidence to the buyers with good quality solutions.

Tangibility – Making customers happy with business environment, internal processes, corporate structure, meeting schedule and everything

Empathy – Understanding the customer’s business, goals, objectives and providing solutions with ...

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