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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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Collecting Claim Overpayments 

Tuesday, November 29, 2011 12:22:00 PM Categories: Prior Presentations
Finding claim overpayments is easy. Collecting them is not. Claim audits routinely find 5% to 10% in overpayments. But collection efforts typically yield 1% to 3%. Why does this happen? What can be done to improve overpayment collection ... read more
 

Overpayment Collection 

Sunday, November 27, 2011 12:02:00 PM Categories: Prior Presentations
Finding claim overpayments is easy. Collecting them is not. Claim audits routinely find 5% to 10% in overpayments. But collection efforts typically yield 1% to 3%. Why does this happen? What can be done to improve overpayment collection ... read more
 

Finding Provider Fraud 

Thursday, October 27, 2011 2:14:00 PM Categories: Prior Presentations
Fraud prevention starts with fraud detection. This webinar features two innovators in fraud detection. Rich Lanza is a nationally recognized Certified Fraud Examiner who has developed principles and procedures related to fraud... read more
 

Finding Provider Fraud 

Thursday, October 27, 2011 12:56:00 PM Categories: Prior Presentations
Fraud prevention starts with fraud detection. This webinar features two innovators in fraud detection. Rich Lanza is a nationally recognized Certified Fraud Examiner who has developed principles and procedures related to fraud... read more
 

Enrollment Validation  

Tuesday, September 20, 2011 2:25:00 PM Categories: Prior Presentations
Accurate plan administration requires accurate enrollment information. While dependent audits have become popular, they are only one part of Complete Enrollment Validation. This webinar will present all facets of Complete Enrollment... read more
 

New HIPAA Accounting Requirements: An Opportunity, Not an Obstacle 

Thursday, August 25, 2011 4:20:00 PM Categories: Prior Presentations
The new HIPAA accounting regulations are being met with the usual chorus of “too much big government intervention” and “too costly to comply.” Self-funded plan managers that can look beyond this political rhetoric will see a... read more
 

Do's and Don'ts of Competitive Bidding 

Thursday, July 28, 2011 12:42:00 PM Categories: Prior Presentations
Why hasn't automation reduced health plan administrative costs? Health claim billing and payment processing is almost all automated. Yet health plan administrative fees have not been reduced - they have skyrocketed! Why is this? What... read more
 

You've Done a Dependent Audit. Now What?  

Tuesday, June 28, 2011 4:16:00 PM Categories: Prior Presentations
Dependent eligibility verification (DEV) has risen from obscurity to common practice in the last decade. With these audits now commonplace for group health plans, the question arises – Now what? To help answer this question we have surveyed ... read more
 

24 reasons Why Claim Payment Error Occurs 

Tuesday, May 31, 2011 2:20:00 PM Categories: Prior Presentations
Why can’t claim payment errors be prevented or stopped? Every group health payer has the goal of paying every claim correctly the first time. No payer meets that goal. Despite years of effort and automation, even the most... read more
 

How Does Your Plan Compare?  

Friday, April 29, 2011 4:14:00 PM Categories: Prior Presentations
Self-funded plans are not all the same. They vary widely across a number of dimensions. Is your plan “typical” or “unusual”? In this webinar we will review over a dozen dimensions of self-funded plan performance. Using actual experience... read more
 
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