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Tuesday, June 26, 2012

Dentists in the US - Email Data

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Health Insurance Blog - 2 new articles

 

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"Health Insurance Blog" - 2 new articles

  1. Health Care Reform: “The Decision”
  2. Health Insurer Grades: Higher Scores From AMA
  3. More Recent Articles
  4. Search Health Insurance Blog
  5. Prior Mailing Archive

Health Care Reform: “The Decision”

June 25, 2012 – Americans continue to anxiously await the long over-due decision on President Obama’s health law.  There is hope that the big announcement will be made by the end of the week.  Check out this article on the BostonHerald website that talks about the debate that will surely follow “The Decision” – Supreme Court Health Law Ruling Will Only Begin More Debate

This article follows the variety of scenarios that may come about from the final decision and talks about the guessing game that is being played among experts – Health Law Guessing Game Grips the Capitol

We will keep you posted daily as more information is released on this epic health law announcement and the details that arise from “The Decision”.

 




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Health Insurer Grades: Higher Scores From AMA

The American Medical Association (AMA) recently released their fifth annual National Health Insurer Report Card which is based on a random sampling of about 1.1 million electronic claims for 1.9 million medical services submitted in the month of February 2012.  The companies included were Aetna, Anthem Blue Cross Blue Shield, Cigna, Health Care Service Corporation, Humana, Regence, UnitedHealthcare and Medicare.

The AMA found that these commercial health insurers incorrectly processed about one in 10 claims in the early part of 2012 which is an improvement over error rates from the previous year.  According to the report card, the error rate was only 9.5% compared to 19% last year.  This reduction in errors adds up to approximately $8 billion in health systems savings by eliminating costs from extra administrative work.  Another $7 billion could be saved if there were no errors made on claims.

The AMA has worked closely with individual health insurance companies over the past year to troubleshoot the claims payments systems and reduce overall errors.  Their efforts to transform the health insurance billing and payment system is a major factor in cutting error rates in half.  They will continue to work with insurers to drop this error rate even further going forward.

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Saturday, June 23, 2012

Health Insurance Blog - Health Insurance Exchanges Changed by Agents and Brokers

 

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"Health Insurance Blog" - 1 new article

  1. Health Insurance Exchanges Changed by Agents and Brokers
  2. More Recent Articles
  3. Search Health Insurance Blog
  4. Prior Mailing Archive

Health Insurance Exchanges Changed by Agents and Brokers

Cindy Gillespie from HealthAffairs.org wrote a very interesting article, “Little-Noted Provision On Agents and Brokers Could Mean Big Changes For Exchanges”, which talks about an important decision made by the Department of Health and Human Services (HHS) in regards to the role brokers and agents will play in health insurance exchanges.

Basically, HHS has opened the door for states to allow an agent or broker to enroll individuals, employers and employees in Qualified Health Plans (QHPs) through their own website.  If the individual is eligible for a refundable tax credit for a QHP purchased on the exchange’s website, they are then eligible to access the credit for purchases through the broker or agent’s private web portal.

This regulation sets out multiple requirements brokers or agents must meet in order for their clients to access credits for purchases through their web pages.  Brokers and agents must be registered with the exchange in advance and all QHPs must be sold and the agents and brokers assisting the consumer must be trained on all of the options.  A single-carrier exchange will not be able to qualify as an example.

The article goes into more detail on the various requirements for brokers and agents, but the bottom line implies that consumers never have to go near the state or federally-facilitated exchange website to buy the product they are looking for and access the tax credit in many cases.  All information transfers between the private broker site and the ACA exchange as well as the insurance carriers are visible to the consumer which is crucial in smart shopping.

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