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Billing News and Insurance Trends


Welcome to our Mental Health News Bulletin!

We will be regularly publishing articles and new related to mental health, billing, health insurance, and more directly on our blog! As we monitor trends in the industry we want you to be kept up to speed on the latest news, so we will be publishing regular news updates.

Stay tuned for more, but for now here is our news bulletin:

Amendments to health insurance plan will return costs for mental health treatment to a lower price

Aetna, Northwestern’s health insurance provider, has agreed to amend the Student Health Insurance plan after students expressed concern over an increase in the cost of mental health treatment, Julie Payne-Kirchmeier, interim vice president for student affairs, announced in an email Saturday.

The University and Aetna renegotiated the terms of the plan to reinstate a $20 cap on in-network mental health care that had been previously removed for the 2019-2020 academic year, as well as increase the coverage on out-of-network care from 60 percent to 80 percent, Payne-Kirchmeier wrote. She emphasized the impact of student feedback that came through “a few channels” including administrators from The Graduate School and in Student Affairs.

Read more here.

Insurance Products May Change For 2020

Question: I got a letter from WellCare, saying welcome to their plan, but I didn’t change my drug coverage. Why did I get this letter? Did my plan change?

Answer: I have heard this type of concern from a number of individuals. I also have talked with the person who trains me on Medicare related issues. This relates to the bigger issue for everyone as we head into the Annual Open Enrollment. This is the time of year when we hear from our current insurance company about how they will change their insurance product for the New Year, 2020.

To get back to your particular situation, over the past year the WellCare company has purchased the three Aetna Stand Alone Prescription Drug Plans (PDPs). This means that the three, of the 23 PDP’s, we have in New York State will be changing from Aetna-owned plans to WellCare-owned plans. This ownership change will probably include a name change. It may also include other changes as well like where your bill is mailed when you pay it. If you have an electronic funds transfer set up to pay the premium, that EFT will need to be changed also.

Read more here.

The crisis of healthcare is in its costs

The current conflict between insurance provider Blue Cross Blue Shield and the Southcoast network is the most recent act in the absurd circus of unaffordable healthcare.

Southcoast president Keith Hovan is demanding higher reimbursements from BCBS to pay for their “world-class care.” But for the typical patient, myself included, the crisis of healthcare has nothing to do with quality and everything to do with cost. Let’s look at the facts. Medical debt remains the leading cause of bankruptcy in the US. With 18% of GDP spent on healthcare domestically, compared to an average of 12% in other developed nations, we are spending billions more for comparable care.

Read more here.

10 steps for appealing a medical claim or bill

So you got a huge bill, and you're sure there's been a mistake, either in the bill or the insurer's processing of a claim. You want to appeal, because it's a lot of money. Here's a step-by-step course of action. We cannot guarantee that you will win, but at least you will have tried. Read first, and then dive in! And if you want us to help, let us know. Sometimes we can, though arguing bills is not our core business — we love to tell people how to avoid bad bills on the front end if they can.

O.K., steel yourself. This is not likely to be fun, and you're probably going to spend a fair amount of time on hold, in phone voice prompt systems, being asked to find a fax machine and so on. You will most likely feel that you are being tortured.

Read more here.

Five embarrassingly easy ways to fix America’s health care mess

Earlier this month, presidential candidates presented big ideas for health care. So far, their ideas have been about different ways to finance our broken system, not how to fix it.

In a new Johns Hopkins study, my colleagues and I found that 48 percent of all federal spending goes to health care in all its hidden forms — enough to give everyone in America gold-plated care. Remember that statistic next time you pay your taxes.

We just need to cut the waste and ignore the echo chambers of cable news telling us we’re a divided nation. The path out of our health care mess is embarrassingly simple and has broad American support:

Read more here.

Doctor involved in health care fraud sentenced to 3 years

A doctor is headed to prison for his role in what authorities say was a complex scam by an addiction treatment firm to make millions of dollars by fraudulently billing insurance companies.

Domenick Braccia was sentenced Friday to just over three years in federal prison. The 58-year-old Hatfield man had pleaded guilty in May to conspiracy to commit health care fraud in May.

Besides his 37-month sentence, Braccia must also serve 150 hours of community service and pay restitution of just under $2.5 million.

Read more here.

Who helps the caregiver? Penn counselor's suicide highlights how experts aren't immune from struggles

When University of Pennsylvania counseling center director Dr. Gregory Eells died by suicide earlier this month, many expressed shock that the tragedy involved an expert in the field of mental health.

But college counseling directors nationwide say they can face a struggle to seek help and support amid mounting pressures in their jobs.

Their message? No one is immune to the public health issue of suicide.

Read more here.

As Little Rock mental-health clinic shuts, clients face search for services

In a low-ceilinged room at Pinnacle House, about a dozen clients of the day treatment center sat in rows, eating a lunch of tacos, corn and pieces of pineapple that had been sliced by one of their social workers.

Within days, the program for people who have mental-health disorders would be disbanded as operator Little Rock Community Mental Health Center prepared to close its doors.

Read more here.

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