Si's Library Navigation

This room contains pieces drawn from my experiences at Health Decisions. It offers practical advice for anyone involved in managing group health plan expenses.
From the present, this room contains articles and reports by others that I wanted to share. Reasons for sharing will vary, so expect a potpourri.
This room provides reference points and norms I have observed or documented that can be used by persons trying to get their bearings in the often confusing world of group health.
This room contains my views on the future of the US health care system. My intent is not to convince anyone, but to broaden the discussion beyond the political debate that passes for health reform in America.
This room contains recordings and trasncripts of conversations I've had with interesting people I have had the privilege of meeting. Some are friends, some professional acquantances; all have interesting perspectives worth sharing.
From the past, this room contains some of the talks and articles I have done that I thought were worth sharing.

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Si Nahra (1950-2020) 

Saturday, August 22, 2020 10:10:00 AM Categories: News and Views
Born on May 8, 1950 in Bangor, Maine to John J. Nahra and M. Hilda (Fowler) Nahra, Si Nahra attended St. John’s Grammar School. He spent his high school years at Sacred Heart Juniorate, Ipswich, MA, anticipating a future as a seminarian for the... read more
 
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Press Release: Health Decisions Sells Eligibility Verification Business 

Thursday, June 27, 2019 11:35:00 AM Categories: News and Views
PLYMOUTH, MI – June 12, 2019 – Health Decisions, Inc., a company with more than 30 years helping employers and trusts discover, recover, and remove waste, abuse, and fraud in their health plans, announced the sale of select assets to Part D... read more
 
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Exciting news about our DEA service! 

Wednesday, May 8, 2019 9:34:00 AM Categories: News and Views
We have exciting news to share with you. For more than 33 years, Health Decisions, Inc. has successfully helped employers, trusts, plan fiduciaries, and health payers reduce wasteful expenditures with our cost-containment services. We... read more
 
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Prudence says: Look out for fraud in provider billing! 

Tuesday, December 11, 2018 10:23:00 AM Categories: Tools of the Trade
In our latest "Prudence Says" video, Prudence addresses provider billing and fraud. Check it out! Click here to view previous “Prudence Says” videos. Enjoy! Questions? Comments? Give Prudence a call at 1-855-PRU-SAYS.... read more
 
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Dependent Audits DONE RIGHT: How? 

Tuesday, November 27, 2018 11:16:00 AM Categories: Tools of the Trade
A dependent eligibility audit, when DONE RIGHT, is not a burden on your workforce, and still generates a positive return on investment. In order to do a DEA the RIGHT way, the focus needs to be on the response rate. Earlier this year, a... read more
 
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Dependent Audits DONE RIGHT: When? 

Wednesday, November 14, 2018 11:08:00 AM Categories: Tools of the Trade
For many of you, it's Open Enrollment season. Whether it is or isn't, it's definitely a good time to consider a Dependent Eligibility Audit (DEA). Many groups use Open Enrollment ... read more
 
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Dependent Audits DONE RIGHT: Why? 

Wednesday, November 7, 2018 10:55:00 AM Categories: Tools of the Trade
A Dependent Eligibility Audit (DEA), when DONE RIGHT, is an extremely effective tool for managing a plan's rising health care costs. At this point, every organization is in one of three... read more
 
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Reference-based pricing is gaining momentum — here’s why - Employee Benefit Adviser article 

Thursday, July 26, 2018 11:54:00 AM Categories: News and Views
This article makes a good case for billing and payment reform. Reference-based pricing using Medicare is a vast improvement over meaningless PPO “discounts” that currently dominate the self-funded market. Providers have completely co-opted PPO... read more
 
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Why Your Health Insurer Doesn’t Care About Your Big Bills - ProPublica Article 

Monday, June 25, 2018 10:08:00 AM Categories: News and Views
Check out Michael Frank’s personal experience with health care billing. The fact that he is very familiar with how the health care system works makes his comments even more powerful. This is not an unusual event. What is unusual is that someone... read more
 
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Prudence says: Don’t forget your ongoing fiduciary tasks! 

Tuesday, May 22, 2018 10:22:00 AM Categories: Tools of the Trade
In this video, Prudence discusses the ongoing fiduciary responsibilities that need to be accounted for. The resources Prudence refers to are: https://www.irs.gov/pub/irs-pdf/p969.pdf;... read more
 
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