Mandated Appeals and External Review
Effective first of the plan year or after September 23, 2010 , health plans will have in effect internal claims appeal procedures. Each plan must allow the insured to review his or her plan to present evidence and testimony as part of the appeal process. So what this means is if carrier declines a claim […]
Increasing Non-Medical Benefits For Indiana Small Group
As we move forward with health insurance reform small group plans with under 50 employees may be dropping health plans all together in 2014. There is still going to be a need and desire for employee benefits. These future employee benefit packages are going to come in the form on non-medical benefits. This would Long […]
Physician-Rating Measures
The major health carriers have developed a kind of efficiency rating for doctors and hospitals. These rating systems are directly communicating with the consumer. The rating systems show price of a procedure and quality of care. So if an insured wants to look up how many times a doctor has performed a certain procedure they […]
Preventive Care Services Required By Law For Indiana
With the health care reform we are now going to see plans required to cover preventive care. It should be very interesting to see what kind of impact these coverages have on premium. There is no doubt that these additional coverage will increase premium. The problem right now is no one knows what kind of […]
Explanation of Health Care Tax Credit for Indiana
This is the clearest explanation that I could find on the health care tax credit. This information was put together by 15 attorneys that specialize in interpreting these types of laws. This is very complicated. What was spun as a simple tax credit is very difficult to qualify and understand. A small business might end up spending […]
Update on the NAIC’s Role in PPACA Implementation
The medical loss ratio (MLR) is the most important aspect of healthcare reform. This interpretation of this law is going to determine if the private industry stays in business. The one positive thing is the NAIC is in charge of interpreting the MLR. The National Association of Insurance Commissioners was charged by Congress with considerable […]
Indiana Hospital Compare
The Government website www.healthcare.gov has just released a free service for comparing hospitals services. This tool provides a listing of Indianapolis hospitals, and 44 quality measures. This kind of information is cutting edge when it comes to healthcare. Recently companies like Anthem and Unitedhealthcare have released these kinds of tool to their clients. Now everyone can access this type […]
Indiana HealthCare Reform
As we move through and have a better understanding of this very complicated health care reform it becomes clearer the disconnect from the white house and real life. This is so complicated and the effects are only going to raise costs. For Small group health plans there is very little chance they can be grandfathered […]
The Changing Cost of Healthcare in Indiana.
Last week there was an article in the Indianapolis Star called Do your home work or pay the price. http://www.indystar.com/article/20100629/BUSINESS/6270392/1003/BUSINESS It was a very interesting article because it address what has been going on in the health care industry locally and the rest of the country. What we are are seeing is hospital groups buying up smaller medical practices. […]
New HHS Website
http://healthfinder.gov/ Was recently launched to help people understand what options they have from a health insurance standpoint. The site also incorporates disease management. So now every0ne has a tool that they can use to look at health insurance options. In the past a % of the population has gone uninsured because they did not know […]