Tag Archives: centers for medicare

MEDICARE B COVERAGE

Medicare B or Medicare Part B facilitates coverage of medical essential services. Some of these services are physician services, outpatient care services, home healthcare services, as well as other health services. This part also has coverage for a number of preventive services. Part B medical insurance facilitates payment for a number of services and items not under Part A, commonly on outpatient services. Part B is actually discretionary and may be overdue if the husband or wife still works. There is a fine of ten percent per year. Thos is enforced due to non-enrolment to Part B unless the person still works. The coverage for Part B commences as soon as a

Latest Medicare Enroll News

UnitedHealthcare service sends out tips and reminders
According to Denise Puskaric, senior director of Quality Management and Performance for UnitedHealthcare, a study found that 79 percent of individuals enrolled in Medicaid send text messages compared to 43 percent of this enrolled in Medicare and 68 …
Read more on New Pittsburgh Courier

Quadrant 4 Announces U.S. Federal Government Agreement With the Centers
Quadrant 4 Health is the only pure technology company to achieve Web Broker Entity Agreement status with the Centers for Medicare & Medicaid Services (CMS) that offers benefits administration, private exchanges for groups, and private exchanges for …
Read more on GlobeNewswire (press release)

Health care coverage
Q. I am a federal employee, 66 years old, planning to retire Jan. 3. I now have full coverage under Blue Cross Blue Shield for me and my husband. I understand that when I retire, I must sign up for Medicare Part A, but I am not sure about part B. If I …
Read more on Federal Times (blog)

Medicare Assistance Program can save Branch County seniors money

Medicare Assistance Program can save Branch County seniors money
Enroll in Medicare Savings Programs. • Review your Medicare supplemental ("Medigap") insurance needs compare policies and pursue claims and refunds. • Identify and report Medicare/Medicaid fraud and abuse. MMAP counselors will not advise you on …
Read more on Coldwater Daily Reporter

Medicare to Review Drug Prescriptions Strictly!
The Centers for Medicare and Medicaid Services, last Monday have declared that all healthcare providers should enroll to Medicare for ordering medications for its patients, under its new drug program referred as Part D. This move would help bar …
Read more on YottaFire

Medicaid, Medicare coverage can merge
He said in an email that people who enroll in the plan “work with a care manager … who will get to know them individually and explore (their) needs and preferences for health care.” Markva said supplemental benefits “not available under traditional …
Read more on Staunton News Leader

RISARC CEO Richard Stephenson predicts rapid improvements in collaboration and healthcare as U.S. providers and payers adopt advanced IT systems under Obamacare.


Burbank, California (PRWEB) April 30, 2014

Richard Stephenson, Founder and CEO of RISARC, a leading national high-technology and revenue recovery consulting firm to the health care industry, predicts that the advanced IT improvements mandated by federal health care laws will dramatically improve collaboration between payers and providers.

Seamless connectivity

Said Stephenson: “The dream has always been for seamless connectivity between those who deliver healthcare services and those systems and plans that pay providers and payers alike.” Stephenson noted that federal legislative and regulatory incentives now make the adoption of electronic health records (EHR) accessible for virtually all healthcare stakeholders participating in federally-subsidized insurance plans – and that the fluid integration of these systems is “advancing at encouraging rates.”

Better rates, better access

Said Stephenson: “The promise of EHR is ultimately to reduce the cost of healthcare and give patients better rates while also giving them easier access to quality and value. Projects and field reports from those in the healthcare industry, which include some of the largest and most innovative providers and payers in the country, confirm that this goal is achievable. The enrollment success of Obamacare which included a healthy segment of 30 and under individuals, known as the ‘invincible Millennial’ generation will be helpful in that transition.”

Stephenson reports that the transformation of physician attitudes has been remarkable. Said Stephenson: “Doctors in America are moving to systems that seamlessly link them with providers and payers and offer more uniformity in electronically recording and reporting patient activity. The result is they are able to reduce costly administrative and staffing burdens.”

Meaningful analysis

According to Stephenson, uniform reporting also means that meaningful treatment analysis can be instantly made across hundreds, even thousands of cases, whether the results are kept in a HIPAA-protected external “cloud” or inside the centralized computers that record outcomes and costs.

Said Stephenson: “Reliable analytics that truly understand how the health of the community as a whole can be improved – and where the costs for protecting community health can be reduced are essential. Through improved payer/ provider engagement and optimized communications the goal for achieving better patient care and population management is within reach.”

About RISARC

RISARC is a leading national high-technology and revenue recovery consulting firm to the health care industry. RISARC, founded in 1990, has recovered over $ 1 billion for its clients. The company offers the RMSe-bubble™ for secure electronic document exchange and the signature RISARC 360° single-source solution that combines health care revenue cycle expertise with innovative cloud-based, cost-saving technology to help clients optimize existing resources, meet business objectives and reach financial goals. RISARC is a pioneer in health care technology solutions and is a certified Health Information Handler for the Centers for Medicare and Medicaid Services, esMD project. The RMSe-bubble provides the industry’s best secure, HIPAA-compliant environment for electronic record and document exchange and has been endorsed and accepted by providers, commercial insurance carriers and government agencies across the United States.

Please visit us at http://www.risarc.com for additional information.







Around the Tiers: Dis-enrolling from medicare

Around the Tiers: Dis-enrolling from medicare
The Medicare Advantage Plan (or Medicare Part C) Disenrollment Period will run from January 1, 2014 to February 14, 2014. During this time, Medicare beneficiaries can dis-enroll from a Medicare Advantage Plan and return to Original Medicare.
Read more on WBNG-TV

Working Past 65 and Medicare Part D
Some had kept their employer health insurance while others had enrolled in Medicare. They all had questions, and the answers depended on each person's particular situation. I had a call today from a woman who has a good job with good health insurance.
Read more on Tucson Citizen

Medicare Advantage enrollment grew
A health policy think tank says Medicare Advantage plan enrollment may be at least 5.5 percent higher this year than it was last year. Analysts at Avalere Health are reporting that finding in a look at new Centers for Medicare and Medicaid Services …
Read more on LifeHealthPro

Obamacare Enrollment – Huge Uptick Seen In December

obamacare enrollmentsAccording to a December 31, 2013 post by Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner, a surge of Obamacare enrollment in December brought the total number of people who have signed up for healthcare coverage through the state and federal insurance exchanges to over 2.1 million.

The federal health insurance website, HealthCare.gov, had its enrollments nearly double right before the deadline for a January 1 effective date passed when compared to numbers from the end of November. In fact, the number of people who enrolled in an Affordable Care Act plan was six times the number of people who enrolled in plans in October and November combined.

Obamacare Enrollments Expected to Continue to Climb

Even though these numbers are encouraging, they are still below the original predictions of over three million. This shortfall is mostly attributed to the technical problems with the federal insurance exchange website, but now that the site is up and running more smoothly, CMM officials expect the Obamacare enrollment numbers to steadily increase through March 31, 2014, when the open enrollment period ends.

The Obama administration also mentioned that 3.9 million Americans are newly eligible for Medicaid or the Children’s Health Insurance Program (CHIP) because of the program’s expansion. Although those numbers include both renewals and new enrollments, the White House is encouraged that more people than ever before will have insurance through either the Medicaid program or the health insurance exchanges.

Obamacare Gives Relief to Uninsured Individuals with Health Problems

For some people who have already participated in Obamacare enrollment through the health exchanges, it will mark the first time they have had health insurance because of pre-existing conditions. Many of them put off going to the doctor because they were afraid of what they might find. If a serious illness was detected, they wouldn’t have had the money to treat it.

Other people who have already been diagnosed with serious conditions like diabetes or high blood pressure are now able to get health insurance coverage without worrying about being denied by insurance companies. In addition, their cost of coverage will be significantly cheaper than anything they would have been approved for before the ACA went into effect.

The ACA also allows them to have more affordable prescriptions as well. Many people who were on medications without insurance had to pay hundreds of dollars out of pocket every month. Now, though, depending on the plan they choose, they may be able to pay lower copays to keep their costs more manageable. Learn more about obamacare and its benefits here.

ACA Encourages Entrepreneurs

Another positive side effect of Obamacare is the freedom to quit a job and start a small business without worrying about health insurance. Before Obamacare enrollment became a reality, people often felt stuck in their jobs because they were afraid of losing their health insurance coverage. Now, however, more people are gaining the freedom to pursue their own dreams because they know they can get health insurance coverage through the ACA.

People who have been paying for COBRA benefits will likely find financial relief as well because there are Obamacare plans that cost less than half of the price of paying for extended coverage of an employer-sponsored plan. One family was paying $ 1,600 per month for COBRA but will only be paying $ 700 per month with their new Obamacare plan.

Cancelled Policies Make Way for Better Coverage

Even people who saw their old health insurance plans cancelled because they didn’t meet the requirements of the ACA are choosing Obamacare enrollment options because they are getting more benefits, often at a lower price. For instance, one happy customer said she paid $ 550 per month for her hold plan that had an out-of-pocket maximum of $ 8,500.

Under her new plan, though, she will be paying $ 100 less per month and will only have to meet an out-of-pocket maximum of $ 3,750. This customer is no longer worried about having $ 10,000 set aside for medical bills because her plan will now cover more procedures than her old one did, at a lower cost.

 

The post Obamacare Enrollment – Huge Uptick Seen In December appeared first on ObamaCare Insurance.

ObamaCare Insurance

Live From The Field

WASHINGTON — Senior Obama administration officials, including several in the White House, were warned by an outside management consultant early this year that the effort to build the HealthCare.gov site was falling behind and at risk of failure unless immediate steps were taken to correct the problems, according to documents released by House investigators.

The report, by McKinsey & Company, which was prepared in late March at the request of the Department of Health and Human Services, said that management indecision and a “lack of transparency and alignment on critical issues” were threatening progress, despite the tight deadline.

The McKinsey report found that the effort was at risk because of issues including “significant dependency on external parties/contractors,” as well as “insufficient time and scope of end-to-end testing,” and “parallel stacking of all phases,” all predictions that have turned out to be accurate. Briefings on the report were held in the spring at the White House and at the headquarters of the Health and Human Services Department and for leaders at the Centers for Medicare and Medicaid, congressional investigators said.

“The administration was on track — on track for a disaster — and yet officials refused to be transparent with the Congress and the American people,” said Representative Fred Upton, Republican of Michigan and chairman of the House Energy and Commerce Committee, which released the report. The McKinsey warnings were first reported online by The Washington Post.

A White House spokesman said the report raised important points, but that the Obama administration moved immediately to address them, such as revising the decision-making process at the Health and Human Services agency to address so-called critical path issues. “As we have said many times now and as has been frequently reported, flags were definitely raised throughout the development of the website, as would be the case for any IT project this complex,” said Eric Schultz, the White House spokesman. “But nobody anticipated the size and scope of the problems we experienced once the site launched.”

The latest evidence detailing the Web site’s troubled startup came amid signs of progress in repairing it. As of mid-November, more than 50,000 people had selected an insurance plan — up from 27,000 in the entire month of October, people working on the project said.

That is still a fraction of the number the administration had hoped for. And specialists plowing through an initial list of more than 600 software and hardware defects remain worried about whether they can meet the administration’s goal of enabling four in five users to enroll through the online federal exchange, HealthCare.gov, by Nov. 30. One person said a more realistic goal was that four out of five people “have a positive experience,” which could include being redirected to customer service agents.

White House officials said on Monday that many of the remaining users would turn to call-in or counseling centers because their insurance situations were complicated. But specialists involved in the repair effort said technical issues may frustrate more users than administration officials suggest. And it is unclear how many fixes remain to be made, because the list keeps changing.

White House officials and some computer experts say much of the criticism is overblown, designed more to scare would-be enrollees away from the insurance exchanges. But the concern is bipartisan. At a closed-door meeting last week, two Democratic senators pressed administration officials on efforts by Chinese hackers to break into the site, according to a Democratic Senate official at the meeting.

“When consumers fill out their online marketplace applications, they can trust that the information that they are providing is protected by stringent security standards,” said Patti Unruh, a spokeswoman for the health department’s Centers for Medicare and Medicaid Services, which is responsible for the federal exchange. “Security testing happens on an ongoing basis using industry best practices to appropriately safeguard consumers’ personal information.”

This article has been revised to reflect the following correction:

Correction: November 19, 2013

An earlier version of this article incorrectly attributed information about how many people had selected a plan on HealthCare.gov. People working on the project, not Obama administration officials, said that as of mid-November, more than 50,000 people had selected an insurance plan, up from 27,000 in the entire month of October.

The running battle against the health care law has kept the White House and Democrats on their heels. As they work to respond to one set of problems, the law’s opponents move onward. Republicans began with attacks on the website’s functionality, shifted to millions of cancellation notices going to people whose insurance policies did not meet the law’s coverage standards, and are now pressing the computer security case. On Friday, the House Committee on Oversight and Government Reform will hold a field hearing in the politically sensitive state of North Carolina on yet another front: rate shocks that Republicans insist are coming.

The computer security question may be particularly delicate. The federal insurance website collects a broad range of personal information, including applicants’ Social Security numbers, addresses, emails, income and health information.

House Republicans have latched on to a final report by the Mitre Corporation, one of the main firms hired to assess the security of the site, which said on Oct. 11, 11 days after the site went live, that it was “unable to adequately test the confidentiality and integrity” of the health exchange. Mitre went on to say that a “complete end-to-end testing” of the site “never occurred.”

Jason Providakes, Mitre’s senior vice president and general manager, will put some distance between his company and that assessment in a hearing before the House Energy and Commerce Committee, one of the two hearings scheduled for Tuesday.

“We were not asked nor did we perform ‘end-to-end’ security testing,” he will say, according to written testimony posted in advance. “We have no view on the overall ‘safety’ or security status of HealthCare.gov.”

That is not likely to stop the law’s opponents from passing their own judgment.

“Unfortunately, in their haste to launch the website, it appears the Obama administration cut corners, leaving the site wide open to hackers and other online criminals,” said Representative Lamar Smith, Republican of Texas and the chairman of the House Science, Space and Technology Committee, which will hold the other hearing.

Documents show that as recently as September, senior Health and Human Services officials were worried about the vulnerability of the system to security threats.

When the health care exchanges first opened for business, an important vulnerability could have allowed hackers to try to hijack users’ accounts by resetting their passwords. But federal officials fixed that problem the same day they learned about it, after it was pointed out to them by Ben Simo, a software engineer and tester from Arizona.

Some vulnerabilities still existed through mid-November, Mr. Simo said. For example, the enrollment system sent consumers their username and account activation code in a single message, which could potentially be intercepted.

That combination has led to repeated warnings, and a continued focus at congressional hearings on the possibility that hackers might gain access to private, personal data.

As of last week, the Homeland Security Department had received reports of 16 attempted cyberattacks, all of which it was investigating.

This article has been revised to reflect the following correction:

Correction: November 19, 2013

An earlier version of this article incorrectly attributed information about how many people had selected a plan on HealthCare.gov. People working on the project, not Obama administration officials, said that as of mid-November, more than 50,000 people had selected an insurance plan, up from 27,000 in the entire month of October.