Blog

Having worked for years on both sides of the Provider/Payer spectrum, it has always surprised me how little each side knows about the other when it comes to the medical billing and payment, especially with hospital bills. Usually when I speak with colleagues in the Insurance industry they have lots of opinions about hospitals and […]

  Throughout my career as a managed care professional in the workers’ compensation industry, I have had the privilege of working with insurance carriers, third party administrators, bill review companies and medical providers alike. I have seen many innovative and successful payment mechanisms bring speed and efficiency to an administratively bloated and vastly outdated work […]

Along with ringing in the New Year, many people resolve to make lifestyle changes (or resolutions) to accomplish certain goals and make it great. There is no reason why Revenue Cycle executives shouldn’t use this time to re-examine their business line strategies. Workers’ Comp (WC) claims are notoriously difficult to manage for several key reasons. […]

Most hospitals that I encounter have at least a few Preferred Provider Organization (PPO) Network contracts that include workers’ compensation. Some have dozens. These contracts range from super simple 1-page Letters of Agreement, to massively complex multi-line managed care agreements. Hospitals typically devote staff to developing and managing these contracts, but just as is true […]