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Nathalie Flex

Westhill Consulting Insurance - Connecticut learns less is more with state health insur... - 1 views

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    I have really bad eyes. I like to get them checked often, but since I don't have health insurance, no doctor's going to really want to take a look at me," he said. He found out that he may qualify for Medicaid, which was long-drawn-out under Obamacare. So far, 9,123 have enrolled over Connecticut's ultimate goal is to sign up 275,000 people. Kevin Counihan, chief executive officer of Connecticut's health exchange, says he's not discouraged by the number of people signing up for private health insurance. "Buying health insurance is expensive and it's expensive and it's confusing and it's complicated. So no, I am not disappointed by it. However, we clearly have a strong goal to meet by March," he said. Counihan look forward to have 100,000 people enrolled by the end of March. He credits the state's computer system with the smooth even out. "Number one is, less is more. Do fewer things well than try to do more things inconsistently. Two is test the heck out of the system and make sure that before you go live, you are pretty darn confident that you know what is going to happen. And three is hire the best people that you can," he said. Counihan was implicated with Massachusetts' health insurance rollout in 2006. He says that taught him people don't buy insurance like they do a book or car. They usually consider the options an average of 18n times before making up their minds. He foresees a sprint of people signing up between Thanksgiving and Dec. 15, which in case is the deadline for coverage beginning on Jan. 1.
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    "Tuesday, November 12, statistics put out by Connecticut demonstrate that its website is the only one to sign up more folks for private insurance than for Medicaid. Angel Medina, 21, went to talk to an Affordable Health Care act navigator in Hartford. Medina was dropped from his mother's health insurance two years ago. "I have really bad eyes. I like to get them checked often, but since I don't have health insurance, no doctor's going to really want to take a look at me," he said. He found out that he may qualify for Medicaid, which was long-drawn-out under Obamacare. So far, 9,123 have enrolled over Connecticut's ultimate goal is to sign up 275,000 people. Kevin Counihan, chief executive officer of Connecticut's health exchange, says he's not discouraged by the number of people signing up for private health insurance. "Buying health insurance is expensive and it's expensive and it's confusing and it's complicated. So no, I am not disappointed by it. However, we clearly have a strong goal to meet by March," he said. Counihan look forward to have 100,000 people enrolled by the end of March. He credits the state's computer system with the smooth even out. "Number one is, less is more. Do fewer things well than try to do more things inconsistently. Two is test the heck out of the system and make sure that before you go live, you are pretty darn confident that you know what is going to happen. And three is hire the best people that you can," he said. Counihan was implicated with Massachusetts' health insurance rollout in 2006. He says that taught him people don't buy insurance like they do a book or car. They usually consider the options an average of 18n times before making up their minds. He foresees a sprint of people signing up between Thanksgiving and Dec. 15, which in case is the deadline for coverage beginning on Jan. 1."
Rose McGowan

Finding Private Health Insurance - 1 views

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    Many of us have to rely on the company's health care insurance provider. Lucky for those people who can stay in one job for years. How about those people who jumps from one venture to the other? Westhill Insurance Consulting has faced queries on the best alternative whenever unemployment comes near. Private health insurance is the main source of health coverage for the majority of people in the United States alone. For elderly citizens and eligible children and families from low-income households, public programs are the primary source of health cover. If you are not covered by a publicly funded program, or if your coverage is only partial, you will need to have some kind of private health insurance. In developing cities like Tokyo, Japan, Seoul, South Korea, Jakarta, Indonesia and Singapore, millions of people have found themselves with no health cover at all. Reviews show that uninsured people reaches up to 46 million. Tens of millions more have inadequate insurance.
Rose McGowan

NICB Says Stop SCAMS Act Will Help Fight Insurance Fraud - 1 views

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    National Insurance Crime Bureau (NICB) says a bill introduced in the Senate yesterday provides much needed support for fighting healthcare fraud. The Stop Schemes and Crimes Against Medicare and Seniors (Stop SCAMS) Act, was introduced by Sen. Bill Nelson (D-FL), and is co-sponsored by Sens. Susan Collins (R-ME), Tom Carper (D-DE) and Chuck Grassley (R-IA).] The bill contains important provisions to strengthen the Healthcare Fraud Prevention Partnership (HFPP). The Partnership was established last year to focus on joint efforts to fight fraud by both the public and private sectors. "NICB is particularly focused on the bill's carefully crafted provisions relating to the sharing of fraud-related information and investigative activities among the HFPP's partners," said NICB President and CEO Joe Wehrle. This language is consistent with the HFPP's anti-fraud program and with laws already in effect in many states governing anti-fraud insurance investigations. "The same fraudsters who prey on government healthcare programs and private health insurance also target the medical component of auto and workers' compensation insurance," said Wehrle. "The HFPP is the most comprehensive effort ever undertaken to bring the nation's public and private resources together to protect the integrity of medical care and insurance. The Stop SCAMS Act's support for the HFPP will strengthen it and the anti-fraud program overall." About the National Insurance Crime Bureau: headquartered in Des Plaines, Ill., the NICB is the nation's leading not-for-profit organization exclusively dedicated to preventing, detecting and defeating insurance fraud and vehicle theft through data analytics, investigations, training, legislative advocacy and public awareness. The NICB is supported by more than 1,100 property and casualty insurance companies and self-insured organizations. NICB member companies wrote $371 billion in insurance premiums in 2013, or more than 78 percent of the nation's property/cas
Rose McGowan

Westhill Consulting Insurance - Connecticut learns less is more with state health insur... - 1 views

Connecticut learns less is more with state health insurance website Tuesday, November 12, statistics put out by Connecticut demonstrate that its website is the only one to sign up more folks for p...

westhill consulting healthcare Individuals families and the self employed Health Insurance

started by Rose McGowan on 14 Nov 13 no follow-up yet
Rose McGowan

READER'S VIEWS: Enabling or blocking health insurance fraud - Westhill Consulting Insur... - 1 views

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    When the subject of health insurance is discussed someone raises the argument that because Medicare or Medicaid are government programs, they are subject to fraud. This is usually an objection from politicians who support Free Enterprise and fear Big Government. Let's be honest with ourselves, any human event that involves something of value attracts fraudsters. A bank robber, a hacker, a big company submitting false claims; all fall into the category of fraud. Any googling of Medicare fraud brings up some infuriating examples. For example, health care industry giant HCA (which the New York Times notes was bought by Bain Capital in 2006) eventually settled a Medicare fraud scandal (overcharging) for more than $1.7 billion. Or, last May the feds arrested 107 health care providers, including doctors and nurses, in several cities and charged them with cheating Medicare out of $452 million. In 2010, 94 people were charged with submitting $251 million in phony claims. Fraud isn't the product of scheming low-income beneficiaries - Mitt Romney's 47 percent - it is most often committed by big companies and rich doctors, not a patient seeking a second colonoscopy. We should admit that fraud is endemic to the insurance business, whether public or private. The Coalition Against Insurance Fraud estimates that in 2006 a total of about $80 billion was lost in the United States due to insurance fraud. According to estimates by the Insurance Information Institute, insurance fraud accounts for about 10 percent of the property/casualty insurance industry's incurred losses and loss adjustment expenses. So, how to tackle any fraud. Putting more police on the streets is an acceptable way of reducing crime. Private industry is free to hire as many investigators and accountants as it takes to catch fraudsters.
Rose McGowan

Health Insurance for Young Adults - 1 views

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    As we grow older, our responsibilities add up. Having a health insurance should be one of the priorities that we should think of. By the time you are old enough to fend for yourself, you are then required to get an insurance. However, many young adults are still confused on its importance. 1. It may be Illegal When you are living in the United States, Affordable Care Act (ACA) compels you to purchase insurance. Going without insurance for three months would force you to pay a penalty of $325 or 2% of your monthly income, whichever is higher. In developing countries, uninsured individuals have the option to purchase from private companies but laws are already drafted for completion. In cities like Jakarta, Indonesia and Bangkok, Thailand, more than half of their unemployed population goes uninsured. 2. If you are a full-time employee, your employer should provide you with insurance Most companies require employees work for set period before benefits can be provided. It usually takes 3-6 months in a probationary period before regularization, by which insurance is given. It is in any law in any states and government to mandate to every employer to provide employee benefits. 3. Your parents may still be able to cover you Individuals under the age of 26 can still be listed under their parents' coverage. They can still cover even a modest premium cost. 4. You can do it alone If you are not insured under your parents' plan or purchasing insurance under your employer is not an option, you have the choice to purchase your own insurance from trusted private companies. If you are buying online, just make sure you
Rose McGowan

'Fraud' and 'cover-up' exposed in failing semi-privatised Irish healthcare - Westhill C... - 1 views

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      Image: Pharmaceuticals. Flickr/Waleed Alzuhair. Some rights reserved.   Commerce has corrupted healthcare in the Irish semi-privatized insurance-based system.   Late last year Senator John Crown revealed under parliamentary privilege in Ireland's Senead that his own hospital, St. Vincent's University Hospital in Dublin, had in 2002 billed the country's largest private health insurer €1 million for the drug trastuzumab (Herceptin). But the drug had in fact been supplied to the hospital free by pharmaceutical giant Roche, as part of clinical trials for women with breast cancer.   This was not an inadvertent error as the hospital claimed, said Senator Crown, but deliberate financial fraud, which the hospital board had spent perhaps tens of thousands trying to cover up, employing 'substantial intimidation' to bury the matter.   Senator Crown is also Professor Crown, arguably Ireland's most distinguished oncologist. He had been told of the fraud in 2002 and at once notified all relevant health authorities.   An investigation started, and then stopped in its tracks. The hospital argued it had not known about this major research program me taking place on its premises.   The debacle had ended with the suspension of the drugs trial for a year, jeopardising the lives of women with breast cancer who might otherwise have participated in this important trial
Rose McGowan

Westhill Consulting - Healthcare | Home - 3 views

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    Westhill Consulting: Healthcare & Insurance - Individuals, families and the self employed Health Insurance It is hard to find a health insurance in the current situation of our marketplace. It seems impossible to get one of those as per this individual health insurance can offer you a confusing array of options more especially if you're one of the millions of Americans who buys their own health coverage. This health coverage are sometimes good but not always and worse few are expensive. Agents though are everywhere, and they are easy to find and readily available. They offer you cheap health insurance but you got to remember this: health coverage isn't cheap if it doesn't adequately cover your expenses when you need it most. Health reform legislation is recently passed and thanks to this the landscape is changing for consumers. Soon, millions of uninsured will have an access for a quality but low-cost insurance. The chief challenge could be determining options to choose the right coverage. There is nothing to worry about! Because Westhill Healthcare Consulting has everything that one has to know, all the information you needed. Learn. Compare. Save. We have library of articles and we are sure every article is fruitful. Learn how to cut your health care costs, get coverage if you're self-employed. Go trough most frequently asked questions about health coverage and be familiar with health insurance terms. Discover how health reform will affect your benefits and your budget. Otherwise find out how it stands to help populations that historically have faced barriers to affordable health coverage. It would be useful and practical if you use free, no-obligation health insurance quotes to compare private health insurance in your area, plan benefits and coverage costs. Every plan id different in every state so the first thing to do is to go trough our state guide in order to evaluate coverage options, including whether yo
Rose McGowan

A Health Insurer Calls, With Questions - 1 views

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    Not long after she signed up for health insurance under the Affordable Care Act, Judy Shoemaker received a phone call that puzzled her. The caller said she was welcoming new members to the insurance network and then asked Ms. Shoemaker to take a survey about health care issues, so information could be provided to her physician. Ms. Shoemaker declined, saying she didn't understand why her insurer would be seeking medical information to give to her doctor. "I thought it was strange," said Ms. Shoemaker, a consultant to nonprofits in Indiana. "I can talk to my doctor myself." James Tuck, who runs a dog care business in Chicago, got a similar call after signing up for insurance through the Affordable Care Act in March. The caller said he was contacting Mr. Tuck on behalf of his new insurer, Blue Cross Blue Shield of Illinois, to go over his benefits and ask him some questions. Mr. Tuck hadn't yet received his insurance card and was hesitant to answer questions, especially after he consulted a private health advocate, who had helped him evaluate insurance options. She advised him not to answer the queries. "She said their goal is to find a reason to get you booted off your insurance." Insurers say they are doing nothing of the sort. Lauren Perlstein, a spokeswoman for the Health Care Service Corporation, parent of Blue Cross Blue Shield of Illinois and plans in four other states, said in an email that the company contacted new policy holders to help "new members get the proper coverage and medical assistance they need, by helping guide them through the health care system." The company's "experts" contact new members to explain benefits and answer any questions, she said, as well as to "identify members who can benefit from our personalized medical management program so they can best manage their health."
Rose McGowan

Hep C Cure Costs Pose Challenge for Medicare - 1 views

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    Hep C Cure Costs Pose Challenge for Medicare By Richard Knox NPR   Walter Bianco has had hepatitis C for 40 years, and his time is running out. "The liver is at the stage next to becoming cirrhotic," the 65-year-old Arizona contractor says. Cirrhosis is severe scarring, whether from alcoholism or a chronic viral infection. It's a fateful step closer to liver failure or liver cancer. If he develops one of these complications, the only possible solution would be a hard-to-get liver transplant. "The alternative," Bianco says, "is death." Previous drug treatments didn't clear the virus from Bianco's system. But it's almost certain that potent new drugs for hep C could cure him. However, the private insurer that handles his medication coverage for the federal Medicare program has twice refused to pay for the drugs his doctor has prescribed. Doctors are seeing more and more patients approaching the end-stage of hep C infection. "There isn't day that goes by when I don't have a story very similar to Mr. Bianco's," says Dr. Hugo Vargas of Mayo Clinic in Scottsdale, Ariz., his liver specialist. Researchers estimate that 3 to 5 million Americans carry the insidious hep C virus. The biggest concentration is among those born between 1945 and 1965.
Rose McGowan

The Medicaid Black Hole That Costs Taxpayers Billions - 1 views

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    Here's some cheerful news: States and the federal government are doing little to stop a costly form of Medicaid fraud, according to a government report released last week. Medicaid, the federal-state health insurance program for poor Americans, now covers more than half its members through what's known as Medicaid managed care. States pay private companies a fixed rate to insure Medicaid patients. It has become more popular in recent years than the traditional "fee for service" arrangement, in which Medicaid programs reimburse doctors and hospitals directly for each service they provide. Despite the growth of managed care in recent decades, officials responsible for policing Medicaid "did not closely examine Medicaid managed-care payments, but instead primarily focused their program integrity efforts on [fee-for-service] claims," according to the Government Accountability Office, the investigative arm of Congress. The managed-care programs made up about 27 percent of federal spending on Medicaid, according to the GAO. The nonpartisan investigators interviewed authorities in California, Florida, Maryland, New Jersey, New York, Ohio, and Texas over the past 12 months. STORY: No Background Checks Needed for Home Health Workers in 10 States Funded jointly by the federal government and the states, Medicaid provided health insurance to about 72 million low-income Americans at a cost of $431 billion last year, according to the report. By the Medicaid agency's own reckoning, $14.4 billion of federal spending on Medicaid constituted "improper payments," which include both overpayments and underpayments. That's 5.8 percent of what the federal government spends on the program. The $14 billion figure doesn't tally what states lose to bad payments. The fraud risk for managed care is twofold. Doctors or other health-care providers could be bilking the managed-care companies, which pass on those fraudulent costs to the government.
Rose McGowan

The Challenge of Health Care Fraud - 1 views

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    Consumer Alert: The Impact of Health Care Fraud on You! In 2011, $2.27 trillion was spent on health care and more than four billion health insurance claims were processed in the United States. It is an undisputed reality that some of these health insurance claims are fraudulent. Although they constitute only a small fraction, those fraudulent claims carry a very high price tag. The National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud are in the tens of billions of dollars each year. Whether you have employer-sponsored health insurance or you purchase your own insurance policy, health care fraud inevitably translates into higher premiums and out-of-pocket expenses for consumers, as well as reduced benefits or coverage. For employers-private and government alike-health care fraud increases the cost of providing insurance benefits to employees and, in turn, increases the overall cost of doing business. For many Americans, the increased expense resulting from fraud could mean the difference between making health insurance a reality or not. However, financial losses caused by health care fraud are only part of the story. Health care fraud has a human face too. Individual victims of health care fraud are sadly easy to find. These are people who are exploited and subjected to unnecessary or unsafe medical procedures. Or whose medical records are compromised or whose legitimate insurance information is used to submit falsified claims. Don't be fooled into thinking that health care fraud is a victimless crime. There is no doubt that health care fraud can have devastating effects. What Does Health Care Fraud Look Like? The majority of health care fraud is committed by a very small minority of dishonest health care providers. Sadly, the actions of these deceitful few ultimately serve to sully the reputation of perhaps the most trusted and respected members of our society-
Claire Barton

Everyday Low Benefits Wal-Mart dumps 30,000 part-timers onto the ObamaCare - 1 views

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    Wal-Mart endorsed ObamaCare in 2009 and helped drag the bill through U.S. Congress, and so far it hasn't recanted. By holding back economic growth and incomes, perhaps the law is expanding the retailer's customer base. Another plus-at least for management-is that Wal-Mart can jettison its employees into the ObamaCare insurance exchanges. The Associated Press reported Tuesday that the largest U.S. private employer is dropping health benefits for some 30,000 workers, or about 5% of its part-time workforce. Earlier health-plan eligibility triage in 2011 had removed tens of thousands of Wal-Mart workers from the balance sheet, so this latest purge was probably inevitable. Wal-Mart cites its inability to manage higher-than-anticipated health expenses. Perhaps- wasn't ObamaCare supposed to bring those costs down? Obviously the company is also responding rationally to ObamaCare's incentives. With a subsidized government alternative now open for business, and since corporations aren't liable for a penalty for not covering people who work fewer than 30 hours a week on average, cost-control logic says to send such coverage ballast over the side. Other retail and grocery chains including Target, Home Depot and Trader Joe's have already done the same. ObamaCare's critics predicted that such insurance dumping was inevitable, and the only question now is how many and how fast other companies partake of the new all-you-caneat entitlement buffet. Get whatever you like, the bill's on taxpayers. The disruptions will be concentrated in industries with large numbers of low-skilled and low-income workers, like restaurants, hospitality and, yes, retail. The irony is that even as Wal-Mart drops insurance because it is too costly, President Barack Obama is claiming credit for lowering health costs. He boasted the other day that the law gave every U.S. family "a $1,800 tax cut" by supposedly reducing the rate of employer-premium growth. Obama
Rose McGowan

Steer clear of health insurance scams - 1 views

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    How to spot and stop health insurance scams Medical and health insurance scams are rampant. Both government and private initiatives have renewed their focus on preventing health insurance fraud and abuse. Michael Williams, director of communications and membership of the National Health Care Anti-Fraud Association, says new and better technology, improved awareness, and more widely available information combine to combat fraud. Williams adds that while the majority of physicians run honest practices, consumers must also step up to the plate to prevent fraud. "Pay attention, do your research, read your EOBs (explanations of benefits) and beware of free offers," he says. Read on to discover some of the most common health insurance scams making the rounds and ways experts like Williams say you can guard against becoming another victim. Fake insurance policies Like counterfeit money, bogus health insurance is not only circulating, but it's becoming increasingly common. James Quiggle, communications director of the Coalition Against Insurance Fraud, says fake policies are particularly virulent. "These crooks come out of the woodwork and promise affordable premiums, no medical exams and guaranteed acceptance," Quiggle says, adding that the criminals who offer worthless policies often operate through sophisticated networks with strong marketing arms and money-laundering components. Many times they can be tied to organized crime. Often, these con artists target small businesses, unions and associations. It's only when a policyholder needs the insurance that the game's up.
juliarsantos

How to Spot and Prevent Medical Identity Theft - 1 views

Foxbusiness.com | westhill consulting insurance - While credit card breaches at retailers are grabbing headlines, identity thieves are quietly homing in on an even more lucrative area: health insur...

westhill consulting insurance how to spot and prevent medical identity theft

started by juliarsantos on 28 Aug 14 no follow-up yet
Rose McGowan

PROTECT YOURSELF FROM HEALTH INSURANCE SCAMS - 1 views

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    The U.S. health care system has changed significantly since the passage of the Affordable Care Act. The federal law introduced many changes to the insurance space and health care market and helped change the way that people shop for health insurance coverage. With the launch of insurance exchanges, new marketplaces were opened up to consumers, but these exchanges also represented a promising opportunity for scammers that are looking to exploit a person's private information. The U.S. Federal Trade Commission recently issued a warning about the growing prevalence of insurance scams, and there are some things that people can do to protect themselves and their information when shopping for insurance coverage. Be Careful About What You Share Online Many insurance scams seek to collect personal information through fraudulent websites. These sites can be designed to look official, but are merely fronts for criminal activity. Many fraudulent sites attempt to show that they represent an insurance or government agency, offering policies at discounted rates, but the policies that these sites offer are not real and exist only to collect information, such as medical records. Beware of Unsolicited Calls Sometimes, scammers prefer to take a more direct approach and will disguise themselves as insurance agents representing a reputable company or exchange. These people often attempt to call consumers and offer inexpensive insurance policies based on the information that they provide. Insurance exchanges do not randomly contact consumers and organizations promoting coverage through exchanges will never ask for personal information to be shared over the phone. Document Everything Keeping records of all salespeople you may come in contact with, as well as the names of their representative companies, could be valuable if your information is ever compromised. Information can be used for or against you, and collecting information from the agents or organizations trying to sell you
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