As healthcare payers, tech platforms, and pricing vendors increasingly collaborate through sophisticated analytics, this case is a clear reminder: if you’re coordinating decisions that competitors used to make…
Tag: provider
Aetna Health v. Radiology Partners and the Danger of Pass-Through Billing
There are, depending upon the particular arrangement, potential end runs around contractual pass-through billing prohibitions, but they are highly fact specific and technical.
Making the Bet Without Knowing the Odds – The Risk of “Large” – Podcast
In your search to understand risk, don’t fall for the simple heuristic that bigger is better.
Making the Bet Without Knowing the Odds – The Risk of “Large”
In your search to understand risk, don’t fall for the simple heuristic that bigger is better.
Payor Agreements and Hidden False Claims Act and Criminal Traps – Podcast
Criminal and, at least, serious civil, liability lurks in many neat neighborhoods. Create your own neighborhood watch to make sure that it’s not lurking behind your medical group’s otherwise metaphorical neat lawn.
Musical Administrator Chairs and Off-The-Record Side Deals – Success in Motion
Ride along with Mark as he discusses the necessity of getting the entire deal in writing.
Is Your Medical Group Built on the Quicksand of Deemed False Claims?
All of your claims might have been deemed “false claims” subject to recoupment times a factor of 3…
Relax, They Just Want to Steal Your Identity – Success in Motion
Ride along with Mark as he discusses a new tactic in management schemes.
Provider Agreements Plus Inflation Equals Trouble Unless… – Success in Motion
Take a seat while Mark discusses the cure to the “tax” of inflation, cost of living (COLA) adjustments.
Special Announcement on AB 72 for California Physicians or Anyone Afraid This Crazy Idea Will Spread
Would any payor pay a physician or medical group more than Medicare plus 25% if they didn’t have to? Would any payor with the ability to control what its “average” contract rate is, reduce its “average” if that’s all it has to pay to an out-of-network physician or medical group? California’s law known as “AB…