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Rose McGowan

Westhill Consulting - Healthcare | About Us - 4 views

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    Westhill Healthcare Consulting has a complete editorial freedom over the content on its pages since it was published. Some information we provide such as view expressed are our editors' and this are not to be shared by other sites we link to or partner with. About Westhill Healthcare Consulting Westhill Healthcare Consulting is one of the internet's oldest sites that offer consumer information on reasonably priced health and medical coverage since it was published during early 90's. It is the most-trusted independent site, respect and loyalty was earned through the years of hard work. All the information on this site is projected to the general consumer audience. Westhill Healthcare Consulting is not selling insurance and is not an insurance agency Your concern is our business, as service to our visitors, we provide health insurance quotes from carefully chosen partners who are in the business of selling health insurance, and who meet Westhill Healthcare Consulting strict standards. It is the referrals that pay us and in turn this is what we use to pay the cost of publishing this site. Editorial policy Westhill Healthcare Consulting has a complete editorial freedom over the content on its pages since it was published. Some information we provide such as view expressed are our editors' and this are not to be shared by other sites we link to or partner with. On behalf universal health insurance access, advocacy efforts are issue-specific. Also, they are not supposed to be considered an endorsement of any particular elected official, political party or ideology. Personal advice We are qualified to give advice on individual situations or legal issues. Aside from our individual state pages that offers links to all state departments of insurance, Westhill Healthcare Consulting, also offers personal consulting. If you have questions about your
Rose McGowan

Westhill Consulting - Retire Overseas : 8 Top Spots For Quality Health Care - 0 views

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    http://www.westhillinsuranceconsulting.com/blog/westhill-consulting-retire-overseas-8-top-spots-for-quality-health-care/

    Retiring overseas may seem like a fabulous idea, but the quality of health care often has post 50s thinking twice before making a move abroad. But they needn't worry.Live and Invest Overseas, an online publication devoted to helping those interested in living abroad, has a list of the eight best places to retire for quality health care. (They also published a list of the 21 best places to retire in 2013 earlier this year.)

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-
Rose McGowan

WellPoint Offers Seniors Tips for Bouncing Back from Hospitalization - 3 views

INDIANAPOLIS, Feb 10, 2014 (BUSINESS WIRE) -- Imagine you've been in the hospital. You've eagerly waited for the day you could go home. When that day finally arrives, you're thrilled. It's a safe b...

WellPoint Offers Seniors Tips for Bouncing Back from Hospitalization westhill consulting insurance

started by Rose McGowan on 12 Feb 14 no follow-up yet
Rose McGowan

Westhill Consulting - Tips for navigating Obamacare - 1 views

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    Tips for navigating Obamacare http://www.westhillinsuranceconsulting.com/blog/westhill-consulting-tips-for-navigating-obamacare/ Think hard before your drop insurance entirely Tambe said that might not make good business sense despite some companies might be tempted to abolish insurance benefits completely and let employees go to marketplaces to get coverage. The problem is insurance purchased on the marketplace will be more expensive for individuals. Then the company will risk talent leaving the company for a competitor who offers them the less expensive option if the company isn't willing to compensate by raising their salary. "It may work to keep costs down but you'll have a hard time keeping talented folks," he said. Other federal programs could help you For households making under 400 percent of the Federal Poverty Level, the ACA grants subsidies available on the public marketplace under certain circumstances. Additionally there are current efforts for Ohio to spread out the Medicaid program to households making less than 138 percent of the poverty level. This in turn if acted out would make more people eligible for those programs. Not all individuals will qualify for subsidy even though most Americans will be eligible to obtain coverage through the exchange. Employer-sponsored coverage may affect an employee's ability to meet the criteria for the subsidy. If there are many employees qualify for federal assistance, it will be reasonable to let them use those plans, particularly since employees being offered insurance by an employer aren't allowed onto the marketplace if their employer is offering insurance deemed affordable, or 9.5 percent of their wage rate based on 130 hours per month for single coverage. "A lot of folks qualify for these things, and there's no penalty to employers," Tambe said. Know the paperwor
Rose McGowan

One Reason Health Insurance Premiums Vary So Much - 1 views

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    A 27-year-old in Jackson pays $336 a month for the second-cheapest silver health plan on Mississippi's s federally run insurance marketplace. That is more than twice as much as the $154 a 27-year-old in Nashville would pay for the same type of policy, and the $138 for a similar person in Tucson. Across all 34 insurance marketplaces run by the federal government, the average is $287, about 25 percent cheaper. The reason for the higher prices in some markets? Paltry competition, say Leemore Dafny and Christopher Ody from Northwestern University, and Jonathan Gruber of the Massachusetts Institute of Technology. Jackson has only two insurers on the marketplace: Humana and Centene. By contrast, four insurance companies slug it out on Nashville's exchange. In Tucson, there are eight. Jackson's over-the-top premiums underscore one of the least-heralded shortcomings of the rollout of the Affordable Care Act: the scarcity of insurers on health plan exchanges, which is driving up the price of policies across the country. The research by Ms. Dafny, Mr. Gruber and Mr. Ody, to be published by the National Bureau of Economic Research next week, concludes that premiums on the exchanges are 11 percent higher than they would be if all the health insurance companies that sell policies in each state had participated in the new markets for health plans. More competition not only would lower premiums, but would also save the federal government money. It would spend $1.7 billion less in subsidies to low- and middle-income Americans buying policies on the health care insurance exchanges. "Half of the population in the states with health exchanges facilitated by the federal government is served by three insurers or fewer," Ms. Dafny said. "To have competition on the exchanges you need competitors." The findings are somewhat perplexing, though. By law, 80 to 85 percent of premiums must be devoted to medical spending. Insurers don't have particularly large profit margin
Rose McGowan

Medicare card and identity theft; help to get cell phones - 1 views

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    Dear Savvy Senior, I just turned 65 and received my Medicare card. I see that the ID number on my card is the same as my Social Security number, and on the back of the card it tells me I need to carry it with me at all times. What can I do to protect myself from identify theft if my purse and Medicare card get stolen? Answer: Many people new to Medicare are surprised to learn that the ID number on their Medicare card is identical to their Social Security number (SSN). After all, we're constantly warned not to carry our SSN around with us, because if it gets lost or stolen, the result could be identity theft. But the Medicare ID is more than an identifier. It's proof of insurance. Beneficiaries need to show their Medicare card at the doctor's office and the hospital in order to have Medicare pay for treatment. Over the years, many consumer advocates, have called for a new form of Medicare identification. The Centers for Medicare & Medicaid Services, which administers Medicare, also acknowledges the problem, but so far nothing has been done. One of the main reasons is because it would cost an estimated $255 to $317 million to fix it. And that's just the direct cost to the federal government. It doesn't include the expense for physicians and other health care providers to adjust their systems, or the cost to the states. Other government health systems like the Department of Veterans Affairs and Department of Defense have already begun using ID numbers that are different from SSNs, but no one knows when Medicare will follow suit. In the meantime, here are some tips offered by various consumer advocate groups that can help keep your Medicare card safe and out of the hands of fraudsters. * For starters, AARP suggests that you simply don't carry your Medicare card at all, because it's not necessary. Most health care providers already have their patients in their electronic systems and know how to bill you.
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

Clinical Trials Supported by Insurance - 1 views

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    Trials involving human patients are crucial to the advancement of clinical science. But they're not without risk. Fortunately, insurers are willing to cover them. Westhill Insurance Consulting, one of the most trusted on-line insurance consultant that offer consumer information on reasonably priced health and medical coverage has these following things to review if you are planning to take part in a clinical test. Challenging trials One challenge for underwriters is the relatively small premium base measured against a trend for higher [insured] limits to be requested. Clinical trials policies normally have "claims made" wordings which means that insurance coverage does not automatically extend beyond the trial dates. The potential gap is where you arrange insurance, let the policy end and have no insurance for an event which may occur sometime in the future that can be attached to the clinical trial. Serious problems in clinical trials are rare, as Rossano points out. "But what I would say is that clinical trials are not without risk. The risk of a clinical trial is that the human body is very complex and in rare cases there can be unforeseen outcomes, as happened in cases like TeGenaro."
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

Evidence of HIPAA compliance tips for healthcare providers - 1 views

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    According to healthcare attorney Susan Miller, detailed evidence of HIPAA compliance and going beyond just the black letter HIPAA rules will be important factors when the Office for Civil Rights (OCR) makes its HIPAA audit rounds this fall. Miller said that OCR has been talking about evidence of compliance since 2009, when it first released the HIPAA Omnibus Rule Notice of Proposed Rule Making (NPRM). Evidence of compliance, in my view, goes beyond what the rule asks of an organization, such as where its policies and procedures are. This includes the Notice of Privacy Practices (NPPs), business associate agreements (BAAs), but they've also [made it clear] that organizations must have a breach plan. In no place in the regulation does it say that an organization has to have a breach plan or process. It does makes sense to have a breach plan to know what the organization will do when it has a breach event. I would suggest that organizations have a breach plan that they look at and update yearly. OCR will be looking for specific things in the plans, Miller said, including communication tactics within a breach plan. And Miller tells her clients that they need a detailed training plan, as well as the training materials and sign-in sheet or even some way to know when staff completes computer based training (CBT) modules, depending on how they do training. The important thing is knowing the training was completed. And organizations need something similar to a contingency plan, which is in the Security Rule but the larger organizations name as business continuity and disaster recovery plans. "Think of [the Boston Marathon bombings] - you need something that's going to help you continue to function during these events that are out of the control of the covered entity or business associate (BA)," Miller said.
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

Practical Saver : Tips for saving money on healthcare - Westhill Consulting Insurance - 1 views

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    Practical Saver: Tips for saving money on healthcare By KARA ROZENDAAL Courier Columnist Changes in the health insurance arena have many consumers scrambling for affordable options. Don't despair; there are still ways to save significant money on healthcare. Below are a few medical resources that Prescott has to offer, as well as tips on how to pay less at the doctor's office, and an alternative to health insurance. To save money on premiums, many families opt for higher-deductible health insurance policies. High deductibles generally equate to lower monthly insurance premiums. However, in exchange, the majority of the medical expenses are paid out of pocket. In the case where doctor's visits and medical treatment are paid out-of-pocket, you can save money by asking the medical office if there is a cash pay discount. When a patient pays cash and the business doesn't need to submit the claim to the insurance company, it saves the office time.
Rose McGowan

Fighting insurance fraud is an important department job - 1 views

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    The Anti-Fraud Division of the Kansas Insurance Department (KID) worked nearly 850 cases of suspected insurance fraud in Kansas during 2013. That's a pretty hefty number for our four-person division, but that figure is an average one for us, unfortunately. How to spot the scam: Use common sense, says Quiggle. Check with your state's department of insurance to see if the company is properly licensed. And remember, if it seems too good to be true, it most likely is. What to do: If your policy is through an organization, report fraud to someone within the organization. Also, report the fraud to the Federal Trade Commission at FTC.gov and your state's department of insurance. On a national level, if insurance fraud was a business, it would be a Fortune 500 company, according to national reports. It is, by all accounts, the second largest economic crime in America; only tax evasion exceeds it. This type of fraud is the intentional misrepresentation of facts and circumstances to an insurance company in order to obtain payment that would not otherwise be made. Insurance fraud costs upwards of $80-120 billion annually, but most importantly, it adds hundreds of dollars to your annual insurance premiums, as companies have to include that cost of doing business in the premiums you pay. The fraudulent activity comes in all shapes and sizes, from accident insurance and annuities through health insurance and homeowners claims to renters insurance and travel insurance. It also includes application or policy fraud, where the applicant-or an unscrupulous agent - provides false information or forged documents. The reasons for committing fraud are as numerous as the people who commit it-the need for money for some legitimate (in their minds) or illegitimate activity, or maybe just plain old greed.
Rose McGowan

There Is a Reason We Never Crack Down on Medicare Fraud - 1 views

Did you know there's a government program that gives more than $60 billion a year to felons and voracious, unscrupulous hospitals and doctors? There is: improper health-care payments. In FY 2012, M...

Westhill consulting healthcare insurance There Is a Reason We Never Crack Down on Medicare Fraud

started by Rose McGowan on 08 Dec 14 no follow-up yet
Rose McGowan liked it
Rose McGowan

Austin Company Leads Medicaid Fraud Crackdown - 1 views

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    Texas pays out $28 billion a year to some 4.8 million people, according to Kaiser. The state picks up one-fourth of the tab, and the feds pay the rest.  The FBI estimates that 10% of Medicaid claims are fraudulent, which comes out to $2.8 billion a year in Texas alone. On Monday, Austin company 21CT launches a new computer system called "Torch" to help the state bring scammers to justice. Torch will collate state data around the clock. The system will monitor frequency of claims, the size of claims and any funny patterns or anomalies. 21CT has grown to over 100 employees, most of them devoted to the crackdown. Company officials say what they are finding is eye opening. "You know it's there," said Kyle Flaherty, Vice President of Marketing for 21CT. "What's so surprising is how complex and entrepreneurial the fraudsters can be. This is a business for them and we need to disrupt the business they are creating." Torch will eyeball providers: businesses, medical supply companies, doctors, therapists, dentists, ambulance firms, hospitals and more. The system will make it easier to sort out.
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.
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