From the Desk of TRG Principal

 

13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference

Mary Corkins will be participating in Becker’s 13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference–on June 1113, 2015, at the Westin Michigan Avenue Hotel in Chicago.  For those conference attendees who would like to schedule time to talk with Ms. Corkins during their visit to the Chicagoland area, please send her an email @ maryc@trgltd.com with your preferred availability.

Start Ups!

There are lots of deadlines and cut-off dates that come in to play this time of year….from the AMA, CMS, and other “reimbursement” entities.  You may not have someone to reach out to for dedicated assistance.  If your organization is under the gun, and you need a second opinion….or have a “quick question”, or you really need access to an expert in this area today, please do not hesitate to reach out to me directly (maryc@trgltd.com).

We can get a mutual NDA in place immediately, and if I can help, I will.

Afterwards, if you are putting a project out to bid, we would be grateful for the opportunity to be of further service to your organization.

Thank you!

Mary


Framework on the Patient Protection and Affordable Care Act (a.k.a. Obamacare)

What it IS:

  1. It’s a law.
  2. It mandates that Insurance Companies (“accountable care organizations” or ACOs) provide certain minimum benefits and coverage (e.g. dental for all children under 19 years of age, annual mammograms beginning at age 40,  pediatric vision screening) must be included in ALL plans throughout the US.
  3. It provides a mechanism to identify patients who may qualify for subsidized premiums (low income) and referral to state run programs such as Medicaid or MediCal.
  4. It eliminates the small, individually purchased plans (“high risk pool”) and created a national pool that requires the ACOs to provide benefits.

What it’s NOT:

  1. It’s NOT an insurance plan.
  2. It does not make decisions regarding medical necessity or individual treatment options.
  3. It is NOT a funded program (e.g. Medicare), and does not process claims or payments or premiums.

The various state exchanges were established to act as clearinghouse for the projected millions of patients with the hundreds of ACOs for selection of plan type (HMO, PPO, etc.), and carrier (Aetna, United, BCBS, etc.), and premium levels (copays, deductibles, co-insurance).

~MMC

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