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Anthem BlueCross BlueShield and UnitedHealthcare: New Worries for Patients and Providers
Manage episode 204492175 series 2288292
Content provided by RACmonitor. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by RACmonitor or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
Patients and providers are reeling in Ohio, given the new Anthem BlueCross BlueShield emergency department (ED) policy, allowing the payer to decline claims for non-emergency ED visits. Advocates caution that Ohio patients might not visit the ED, fearful of not having their visits covered. Former ED physician-turned healthcare consultant Erica Remer, herself an Ohioan, reports on this developing story.
Another headline grabbing story is the reported lawsuit filed by Envision Healthcare against UnitedHealthcare (UHC). Envision is using the giant insurer alleging the UHC "unilaterally" lowered payments of Envision's contracted physicians, according to Axios. Healthcare attorney Mary Inman, a partner at Constantine Cannon, reports on this developing story, calling in from the firm's London office.
Yet another story about UHC is reported by Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS). UHC, DeConda reports, is cracking down on emergency ED service codes of Level 4 and 5.
The episode rundown also includes:
- Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment.
- Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO for Nancy Beckley and Associates, returns to report on all the latest hot topics and the Monitor Mondays Listener Survey.
- Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron reports on a developing story that some facilities are receiving CERT letters containing misleading information.
Monitor with us™
324 episodes
Share
Manage episode 204492175 series 2288292
Content provided by RACmonitor. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by RACmonitor or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
Patients and providers are reeling in Ohio, given the new Anthem BlueCross BlueShield emergency department (ED) policy, allowing the payer to decline claims for non-emergency ED visits. Advocates caution that Ohio patients might not visit the ED, fearful of not having their visits covered. Former ED physician-turned healthcare consultant Erica Remer, herself an Ohioan, reports on this developing story.
Another headline grabbing story is the reported lawsuit filed by Envision Healthcare against UnitedHealthcare (UHC). Envision is using the giant insurer alleging the UHC "unilaterally" lowered payments of Envision's contracted physicians, according to Axios. Healthcare attorney Mary Inman, a partner at Constantine Cannon, reports on this developing story, calling in from the firm's London office.
Yet another story about UHC is reported by Shannon DeConda, founder and president of the National Alliance of Medical Auditing Specialists (NAMAS). UHC, DeConda reports, is cracking down on emergency ED service codes of Level 4 and 5.
The episode rundown also includes:
- Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment.
- Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO for Nancy Beckley and Associates, returns to report on all the latest hot topics and the Monitor Mondays Listener Survey.
- Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron reports on a developing story that some facilities are receiving CERT letters containing misleading information.
Monitor with us™
324 episodes
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Similar to Monitor Mondays
America is more divided than ever—but it doesn’t have to be. Open to Debate offers an antidote to the chaos. We bring multiple perspectives together for real, nonpartisan debates. Debates that are structured, respectful, clever, provocative, and driven by the facts. Open to Debate is on a mission to restore balance to the public square through expert moderation, good-faith arguments, and reasoned analysis. We examine the issues of the day with the world’s most influential thinkers spanning s ...
…
continue reading
A top podcast for healthcare leaders, with over one million downloads, Radio Advisory is your weekly download on how to untangle the industry's most pressing challenges to help leaders like you make the best business decisions for your organization. From unpacking major trends in care delivery—like site-of-care shifts and the rise of high-cost drugs—to demystifying stakeholder dynamics, to shining a spotlight on priorities that may get overlooked, we're here to help. Our hosts and seasoned r ...
…
continue reading
The Art of Charm is where self-motivated people, just like you, come to learn from the company’s coaches about to how to master human dynamics, relationships, and becoming your best self with the help of Johnny and AJ, the company’s founders. Johnny and AJ bring their 11 years of coaching experience from their famous Bootcamps, where they host clients in Los Angeles from all over the world and they share their stories, best practices and themselves on this weekly podcast. Not only does The A ...
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continue reading
Tempers fly as the newsmakers of the week face-off in this award-winning show. Anchored by Sanket Upadhyay, this weekly program has politicians battlling wits with a live audience.
…
continue reading
PT Inquest is an online journal club. Hosted by Jason Tuori, Megan Graham, and Chris Juneau, the show looks at an article every week and discusses how it applies to current physical therapy practice.
…
continue reading
The day's biggest news dissected by the day's newsmakers. Diverse opinions from across the political spectrum. The show that makes you decide, are you the Left, Right or the Centre?
…
continue reading
We are often distracted in life and never really dive deep into the real foundation of self improvement, goal achieving, and wellbeing. - Join our team of experts every week as we discuss the real facets of manhood. Topics like: How to develop more self esteem, self love, deeper relationships. How to improve our wellbeing, mental toughness, resilience, and productivity. How to develop critical skills, become better leaders, expand our careers/business, create financial security and contribut ...
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continue reading
The American healthcare system is one of the most innovative in the world. But it’s also riddled with complex challenges, such as access to affordable medications, inefficiency and administrative burdens, and communication barriers between providers. There’s clearly a better way—and at Surescripts, we have a unique sightline into what that may be. In this series, host Melanie Marcus, Chief Marketing Officer of Surescripts, sits down with today’s most inspiring and innovative leaders in healt ...
…
continue reading
Although the world is becoming mostly sedentary, our bodies still require a wide variety of daily movements in order to work well. Many of us struggle to get regular exercise, but even that can fall short of nourishing the body from head to toe. How can we move more—a lot more—when we have sore, stiff parts and overly busy lifestyles? Join Katy Bowman M.S., biomechanist, author, and movement educator as she combines big-picture lessons on biomechanics, kinesiology, physiology, and natural hu ...
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