How Can You Protect Your Medicare Advantage Patients?

On June 22, 2020, CMS released data detailing the top five conditions that were seen in hospitalized patients with Covid-19. It is important for providers to understand that our Medicare Advantage patients are at a higher risk. Patients with hypertension, hyperlipidemia, chronic kidney disease, anemia, and diabetes have a higher prevalence of hospitalization. With what
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UnitedHealth Group To Sell Medicare Advantage In 100 More U.S. Counties

BLOOMBERG NEWS UnitedHealth Group said it will expand its Medicare Advantage health plan offerings to seniors in 100 new counties next year in what has become the most competitive business for health insurance giants. UnitedHealth said its UnitedHealthcare insurance business will “offer more than 100 new plans as it expands its offerings to reach an
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Knowing the Differences Between Medicare Plans Matter

Knowing the Differences Between Medicare Plans Matter

I recently had a conversation with my nurse practitioner and she asked me what was the difference between United Medicare, Medicare and Medicare HMOs (Capitation)?  My initial reaction was shock, then disbelief, and finally disappointment. Disappointed not in my nurse practitioner but in myself.  Here I am caring for a large Medicare population of patients
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4 Practical Solutions For Decreasing Hospital ER Visits

4 Practical Solutions For Decreasing Hospital ER Visits

For many primary care physicians emergency room visits can be attributed to access and communications issues. Medical reimbursement and profits are now being tied to patient related expenses. It is becoming increasingly important to understand how to keep ER visits from impacting your bottom line. Over the past 19 years, I have used tools, protocols,
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3 Mistakes Doctors Make When Joining Health Plans

3 Mistakes Doctors Make When Joining Health Plans

Why is it that most residency programs place very little emphasis on teaching physicians the ins and outs about contracting with health insurance companies? With so much riding on paying down medical school debt, teaching institutions should help graduates understand health insurance plans better. Professors are certainly at a disadvantage since most of the residency
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5 Facts About Medicare Advantage Plans You Must Know

Did you know that 31% of all patients enrolled in Medicare are in a Medicare Advantage Plan!!! Enrollment to Medicare Advantage (aka Medicare HMO) has been growing steadily over the past decade. With such a large growing population of insured patients, you would expect physicians and other providers to understand these plans well. Unfortunately, medical schools, residency
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Job Search Resources

Over the past couple of years, I have discovered several websites that have helped organize my life and save me time and money.  Some of the sites require additional software like Microsoft Word, Excel or Adobe Reader but some are free. Resume Writing Resume writing is a common weakness among physicians and other healthcare providers. 
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Become a Top Notch Provider in Managed Care

Become a Top Notch Provider in Managed Care

Whether you are a new residency graduate or healthcare provider in practice for a couple of years, you are aware that the business of healthcare in the United States is changing rapidly. Accountable care organizations (ACOs), health management organizations (HMOs), mega insurance companies, large physician practices, and hospitals are all looking for top physicians in
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Doctoritis

Doctoritis

Doctoritis is a preventable condition characterized by the superfluous spending by physicians or other healthcare practitioners that have gone through rigorous and time-consuming training.  It is unclear how many providers are affected by the condition but we do know that those affected have numerous ailments ranging from the increase in stress, poor decision-making capabilities, destructive
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