All posts by Denise Doyle

More and More Companies are Moving to Self Funded Insurance – Here’s Why

If only a crystal ball or portal to another time could help us predict the future of American health care. Heck, even a Magic 8 ball with a high rate of accuracy could be useful. Alas, no such magic device exists (we think), so the confusion and uncertainty that surround health care and insurance aren’t ending anytime soon. Many people agree that our current system is broken, but no simple solution exists to bring down costs and give all Americans access to the care they need. Considering the political discord around this issue, it seems unlikely that a major change – like a move to a single-payer system – is just around the corner. So what does that have to do with self funded insurance? Continue Reading >

For Healthcare Data Security, 2018 Was a Bad Year

Did your organization’s healthcare data security protections hold during 2018? Most employees have no idea how to answer that question. Unless they work in IT or handle financial transactions, data security might not be a top priority – or at least, it might not seem like a top priority. One breach is all it takes to realize how wrong that thinking is. Any company that handles healthcare information is obligated to safeguard it, even if the company’s only healthcare records are related to employee insurance. Hospitals and other health-care providers aren’t the only entities that are affected by accidental and malicious breaches.  Continue Reading >

Does Reference Based Pricing Make Sense for Your Organization?

The lack of transparency around medical pricing puts self-insured employers and their employees at a disadvantage. Without the bargaining power that major insurers have, self-insured employers can’t be certain that they’re getting the best possible prices for the services that their plan members need. Enter reference based pricing. It’s a pricing strategy that more and more self-funded employers are using to control costs. Traditionally, hospitals and health care providers set inflated prices for services and insurers negotiate lower rates for their members. A procedure that a hospital charges $10,000 for may only be billed at $5,000, depending on the patient’s insurance plan. Continue Reading >

Where’s Our Check? Getting Stop Loss Claims Paid Quickly

With stop loss coverage, claims costs depend on the services you need, as well as the actual costs of those services. This can be tricky to navigate, and reimbursement for claims can also be a pain to receive in a timely manner. But, what you may not know is that there's actually a lot on the back-end that goes into claim reimbursement. Continue Reading >

A New Bill Could Raise the Stakes for Self-Funded Insurers

Self-funded insurers may be negatively affected in a newly drafted bill titled “Protecting Patients from Surprise Medical Bills Act” back in September. Though its goal is to minimize unexpected medical bills and prevent medical bankruptcies, self-funded insurers and covered employees, might not garner any savings from this proposed legislation. Continue Reading >

Improving Transparency About Health Care Costs

The human's natural instincts for curiosity are not always about being nosy: other considerations, such as financial transparency, help to distinguish what is right and fair within the healthcare industry. Going into an operation with some sort of estimated rate for services and goods keeps patients from being exploited and overcharged. In this case, being nosy can benefit Americans greatly with their health costs. Continue Reading >

Keeping Millennials on Your Self-Insured Health Plan

If some news outlets are to be believed, Millennials only care about avocado toast and Netflix. But while this generation isn’t well respected by some older Americans, Millennials take health insurance seriously. Considering that they have lived through a period when health insurance has been a hotly contested issue, it shouldn’t be a surprise that Millennials are invested in their coverage. Continue Reading >