Out of Network Claims Cost Containment Strategy : Don’t Damage MLR

Since most of the cost containment and settlement solutions vendors do charge the plan, this actually works against the health plan's ability to manage their expenses and comply with regulations. Health plans should look to solutions that support the MLR calculation and regulations, and maximize the speed and the amount of reimbursement to the provider.

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Why did the AMA vote to try to skip ICD-10 and move to ICD-11?

Delaying ICD-10, AMA believes will help preserve its relevance, and its control over physician compensation. Sadly it seems that AMA hasn't served its own members well, or the healthcare industry. ICD-11 won't "arrive" in a year or two. Our health system needs to digest it and then determine when and how to move to it. While ICD-11 has some intriguing benefits, it is a long way off. The base version from WHO is expected in May 2015. After that, the United States will probably need another two years for development of the US version. The earliest it would be available for study would be 2017, and we would need another 4 years to implement it – so that brings us out to 2021, way too far in the future.

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HIPAA 5010 and ICD-10 Implementation Timeline Widgets

HIPAA 5010 and ICD-10 implementation timelines were published as widgets for payers, large providers, small providers and vendors by Health and Human Services Centers for Mediare and Medicaid (CMS). There are helpful items such as actions to take immediately, for HIPAA 5010 and more regarding ICD-10.

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Medical Loss Ratio Provision of the Affordable Care Act – Less For ICD-10 and Other Reform Issues

on November 22, 2010 the Obama Administration's regulation implementing new standards for the “medical loss ratio” provision of the Affordable Care Act will make the insurance industry more transparent and is intended to enable consumers to purchase health insurance that provide more value for every dollar paid for premiums.

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ICD-10 and HIPAA 5010 and Health Care Reform

No World Borders believes that the clock is ticking on important implementation deadlines for electronic health care and claims compliance dates, and these changes only delay that process. Many health care companies are still asking “What is HIPAA 5010” when they should be asking “how fast can we implement HIPAA 5010.” The new EDI standard enables improved data and provides the foundation for the ICD-10 medical coding standard. These two initiatives have important implementation milestones. See www.noworldborders.com for more information on our home page.

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HIPAA 5010 Webinar Speakers Panel

On Monday, November 30th at 1pm ET Mike Arrigo, CEO of No World Borders, Inc. will be participating in a health care industry panel on health care, HIPAA 5010, electronic…

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