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…

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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…

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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…

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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…

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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…

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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…

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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…

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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…

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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…

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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…

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What is Healthcare Fraud?

The majority of healthcare fraud is committed by a small minority of dishonest healthcare providers with the only “red flag”…

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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…

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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…

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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…

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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…

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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…

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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…

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Obamacare: Is It Affordable?

In August 2014 I shared my thoughts about healthcare reform as seen through the Patient Protection and Affordable Care Act,…

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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…

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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…

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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…

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Stories From Smaller Venues

Recently when I registered at a hospital for an outpatient study, the clerk pushed a single page through her window…

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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.…

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Another Hospital, Another Story

In 2007, several years prior to the events at AMC described here and here, I experienced another incident, different in…

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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…

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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…

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Shoplifting or Plagiarism

As a student my mentors emphasized the importance of medical records I would create during my career. “That document refreshes…

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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…

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