Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Insurance Carriers”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,135 records · Page 63Linked to original sources
PubMed2005

The disappearing doctor.

As medical malpractice premiums continue to rise, physicians are leaving practice in record numbers, and states are taking matters into their own hands. See what the AMA's "crisis states" and, in some cases hospitals, are doing to stem the exodus.

American Medical Association↗
PubMedDate not supplied

The impact of concentration in dental insurance markets on dental reimbursement in Minnesota.

The following article has been prepared by the American Dental Association (ADA) at the request of the Minnesota Dental Association (MDA). The article is the culmination of a rigorous national study by the ADA to measure the concentration of dental insurance in major dental marketplaces around the country. Five Metropolitan Statistical Areas (MSA's)from Minnesota were compared to other MSA's around the country. The results of this study are very significant for dentists and dental patients in Minnesota. Minnesota' practicing dental community may find the results of the study to be somewhat disturbing. Nevertheless, the MDA believes that it is important to share the results of this study with MDA members and others in the Minnesota dental community. It is important to consider both the study's short-term ramifications, as well as its long-term implications, as we attempt to better understand Minnesota's dental marketplace. It is also important for MDA members to know that the ADA brought the results of this study as they relate to the Minnesota Dental Marketplace to the appropriate federal agencies. The ADA believed that these agencies might choose to develop it into an anti-trust case. After reviewing the matter and working with the ADA over a long period of time, these agencies decided that they would not proceed with a Minnesota-based anti-trust case; additional information beyond what the ADA was legally able to provide was needed by the federal agencies in order for them to proceed. The MDA will continue to analyze and respond to these dental marketplace developments.

Cities↗
PubMed1992

The future of the end-stage renal disease program.

The rapidly changing health care environment in the United States will affect the future of nephrology in several areas. Reductions in Medicare spending will affect graduate medical education, physician payments, and, eventually, payments for medical supplies and therapeutic agents. The resource-based relative value system (RBRVS) developed by the Health Care Financing Administration (HCFA) will be implemented over the next 4 years, and it is likely that similar plans will be adopted by other insurance carriers. Under this system, payments for the procedure of dialysis will be substantially reduced--decreases in Medicare reimbursement will range from approximately 30% to 60% depending on geographic location and current charges. However, the current economic pressures may have a beneficial effect on the practice of nephrology by providing an incentive to develop standardized practice guidelines that will eliminate wide variations in practices and minimize unfounded litigation. In the near future, attention must also focus on the training of nephrology fellows; ideas for future directions are presented.

Forecasting↗
PubMed2005

When is it appropriate to bill physician services using modifier -59?

Accurate coding of medical services is a constant challenge for physicians and could jeopardize a practice if not taken seriously. Insurance carriers use sophisticated claims-processing software that easily identifies coding trends by physicians and flags outliers within specialties. The Office of Inspector General (OIG) and the Center for Medicare and Medicaid Services (CMS) hire auditors to identify areas for review which are commonly miscoded. One area that has been flagged for review is billing with modifier -59 because misuse of this modifier has increased inappropriate reimbursement. Be cautious when using this modifier, due to the legal and compliance ramifications when documentation does not adequately support the "distinct procedural service" to justify the use of modifier -59.

Current Procedural Terminology↗