May 23, 2024 | Uncategorized
Are you worried about surprise medical bills? The recently passed No Surprises Act aims to protect consumers, but many people are still unsure about its implications. Fortunately, several organizations have added resources to help you understand the new legislation. Read on to learn more.
Advisories, information sheets, and FAQs are now available to assist hospitals, health systems, physicians, and consumers in navigating the new rules against surprise billing. Despite ongoing legal challenges, key elements of the No Surprises Act took effect on January 1, and various stakeholder organizations are offering guidance to their members.
Latest Updates:
American Hospital Association (AHA):
- On Friday, the AHA published a legislative advisory summarizing the No Surprises Act and its key takeaways. The advisory includes a 15-page detailed summary of the rules. “The hospital and health system field strongly supports protecting patients from surprise medical bills,” the AHA stated. They believe this legislation is a significant step forward in patient protection. The AHA’s advisory webpage also links to additional resources, including an FAQ on good faith estimates for uninsured/self-pay patients, details about the AHA/AMA lawsuit challenging billing dispute resolutions, and information on CMS guidance
American Medical Association (AMA):
- Also on Friday, the AMA published an advocacy update for physicians. It includes a new toolkit focusing on three key issues: notice-and-consent requirements for out-of-network care at in-network facilities, rules about emergency and post-stabilization care, and good faith estimates for self-pay and uninsured patients. An AMA Advocacy Insights webinar on January 20 will explore these topics further.
Centers for Medicare & Medicaid Services (CMS):
- CMS added new online resources for consumers explaining their new billing protections effective January 1. These include protections for emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. The CMS website states, “Through new rules aimed at protecting consumers, excessive out-of-pocket costs are restricted, and emergency services must continue to be covered without prior authorization, regardless of network status.” The page also provides links to resources that explain what surprise bills are and the new consumer protections.
Additional resources for hospitals and health systems are available from the Healthcare Financial Management Association and the Medical Group Management Association.
For more details, visit the original article on healthleadersmedia.com.
May 9, 2024 | Uncategorized
Arvada, CO April 2024 — RT Welter and Associates, Inc. DBA Welter Healthcare Partners (WHP), a leading provider of comprehensive healthcare business management solutions, proudly announces its achievement of National Committee for Quality Assurance (NCQA) Credentials Verification Organization (CVO) Certification. This recognition underscores WHP’s commitment to delivering unparalleled quality, security and excellence in credentials verification for over 30 years.
Achieving this honor places Welter Healthcare Partners in an elite group of six companies that have achieved the coveted URAC Accreditation and NCQA Certification for Credentials Verification Organization (CVO).
NCQA is a private, nonprofit organization dedicated to improving healthcare quality. NCQA accredits and certifies a wide range of healthcare organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. In recognition for its leadership in diversity, equity and inclusion, NCQA has won the Excellence in Diversity Award from the Chesapeake Human Resources Association. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more-informed healthcare choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, and on LinkedIn at linkedin.com/company/ncqa.
CVO Certification includes rigorous on-site evaluations conducted by a team of healthcare professionals and certified credentialing specialists. A national oversight committee of physicians analyzes the team’s findings and determines certification based on the CVO’s compliance with NCQA standards.
“Our team at Welter Healthcare Partners is immensely proud to achieve NCQA CVO Certification,” said Todd Welter, Chairman and CEO at WHP. “This recognition reflects our ongoing commitment to delivering exceptional CVO value and expertise to our clients. We are grateful for the validation of our dedication to quality, compliance, security, and accurate credentials verification and look forward to continuing to serve our clients with excellence.”
The NCQA CVO Certification reinforces WHP’s ability to provide managed healthcare services with excellence, benefiting both the organization and its members and clients. WHP’s expertise and dedication are translated into tangible benefits for its clients, enabling them to navigate the complexities of network management and expansion successfully. With NCQA CVO Certification, and URAC CVO Accreditation, WHP reaffirms its position as a trusted partner in the healthcare industry.
For more information about Welter Healthcare Partners and its comprehensive healthcare management solutions, visit welterhp.com or contact Jennifer Heuer at jh@welterhp.com or 303-534-0388.
About Welter Healthcare Partners:
Welter Healthcare Partners (WHP) is a leading provider of comprehensive healthcare business management solutions, and credentials verification; empowering physician practices, healthcare providers, payers, hospitals, and organizations of all types to thrive in the dynamic healthcare landscape so they can focus on providing the highest quality healthcare to their patients. With over 30 years of experience, WHP delivers unparalleled expertise and support to its clients, ensuring their success, sustainability, compliance and profitability.
Media Contact:
Jennifer Heuer
Welter Healthcare Partners
Email: jh@welterhp.com
Phone: 303-534-0388
Apr 11, 2024 | Uncategorized
The American Medical Association (AMA) has rolled out a comprehensive plan, named the “AMA Recovery Plan for America’s Physicians,” aiming to address the challenges confronting physicians, particularly exacerbated by the COVID-19 pandemic. This initiative comes in response to the critical issue of provider burnout, which has reached crisis levels. The plan’s key elements include:
- Supporting Telehealth Services: Recognizing the importance of telehealth, especially highlighted during the pandemic, the plan advocates for continued support and insurance coverage for telehealth services. This expansion acknowledges its benefits in terms of accessibility, convenience, and time-saving for both providers and patients.
- Reforming Medicare Payment for Physician Services: The plan underscores the longstanding issue of inadequate Medicare reimbursement for provider services. It calls for reforms to ensure stable and adequate payment, eliminating the annual uncertainties that impede physician practices’ financial stability.
- Addressing “Scope Creep”: The plan aims to curtail the expansion of non-physicians’ scope of practice. For example, nurse practitioners, and maintaining the integrity and quality of healthcare delivery.
- Streamlining Prior Authorization Processes: Recognizing the administrative burden placed on provider practices by prior authorization requirements, the plan advocates for reforms to reduce this burden and avoid delays in patient care.
- Tackling Physician Burnout and Mental Health Stigma: The plan acknowledges the pressing need to address physician burnout and reduce the stigma surrounding mental health issues in the medical profession. It emphasizes the importance of supporting provider’s well-being to ensure the sustainability of the healthcare workforce.
Overall, the AMA Recovery Plan aims to mitigate the challenges faced by physicians. It also safeguards the future of healthcare delivery in the United States. Through these strategic interventions, the AMA seeks to alleviate physician burnout, ensure fair reimbursement, and promote a supportive environment for healthcare professionals.
Apr 4, 2024 | Uncategorized
The American Academy of Dermatology has crafted a comprehensive guide to selecting and applying sunscreen effectively. With the onset of summer marked by Memorial Day and the resurgence of outdoor activities post-COVID-19 restrictions, it’s crucial to prioritize sunscreen application. Don’t forget to slather on that sunscreen as you indulge in your favorite outdoor pursuits—it’s summertime at last! Sunscreen plays a vital role in shielding your skin from skin cancer and premature aging, but its efficacy hinges on correct application. Here are some expert tips from dermatologists:
- Opt for sunscreen with an SPF of 30 or higher, water resistance, and broad-spectrum coverage to shield against both UVA and UVB rays.
- Apply before stepping outdoors to allow around 15 minutes for absorption and protection. Applying it after sun exposure leaves your skin vulnerable to burns.
- Ensure you use enough sunscreen, approximately 1 ounce to cover your entire body adequately—massage it thoroughly into your skin.
- Cover all exposed skin areas, including your neck, face, ears, tops of feet, and legs. For challenging-to-reach spots like your back, enlist assistance or opt for spray sunscreen. Protect your lips with an SPF-containing lip balm.
- Reapply sunscreen every two hours or immediately after swimming or sweating to maintain protection. Sunburn often occurs due to insufficient usage, failure to reapply, or using expired products.
Remember, UV rays penetrate your skin even on overcast days and during winter, so make sunscreen a year-round habit. Whether you’re vacationing or enjoying a stroll in your neighborhood, prioritize sun protection. For more tips on preventing skin cancer, consult a board-certified dermatologist.
Mar 27, 2024 | Uncategorized
Recent research from Oliver Wyman reveals a significant milestone in American healthcare:
Nearly 10 percent of patients in the U.S. are now receiving care through Accountable Care Organizations (ACOs). This finding underscores the rapid emergence of ACOs, once obscure just a couple of years ago, as substantial players in the healthcare landscape, with the potential to challenge traditional fee-for-service models.
According to Niyum Gandhi, co-author of the study, the perception of ACOs as minor players in healthcare is outdated.
The study, which encompassed various healthcare delivery entities that align with the core principles of ACOs, demonstrates their growing influence. ACOs, characterized by taking responsibility for the overall health needs of a specific population and receiving incentives based on cost savings and quality, are reshaping healthcare delivery.
The proliferation of ACOs is not limited to Medicare programs; commercial ACOs are also on the rise. With Medicare currently hosting 150 ACOs, expected to double in number with the announcement of the next round of participants in the Shared Savings Program, the impact is set to expand further. Notably, many organizations participating in Medicare ACOs eventually extend this model to their non-Medicare patient populations.
Currently, between 25 to 31 million Americans receive care through ACOs, spanning various programs and initiatives. This includes Medicare ACO programs, non-Medicare patients in Medicare-oriented ACOs, and those in non-Medicare ACOs.
The study’s analysis reveals a striking statistic:
45 percent of Americans reside in areas served by at least one ACO, with 19 states boasting a majority of their population covered by ACOs. However, critics contend that many current ACOs fall short of realizing the full potential of the model. Rick Weil, another co-author of the study, acknowledges this disparity but highlights the exceptional performance of leading ACOs. These top-tier ACOs are demonstrating remarkable outcomes, such as achieving zero percent premium increases, challenging longstanding beliefs within the healthcare industry.
As ACOs continue to refine their models and improve performance, they have the capacity to revolutionize the dynamics of American healthcare for the better. This shift promises increased efficiency, better outcomes, and ultimately, improved healthcare experiences for patients nationwide.
Source: www.thestreet.com
