Jim Organ on LinkedIn: Deadline Reminder: RxDC Reports Are Due by June 1, 2024 (2024)

🩺 New RxDC reporting instructions are HERE! And guess what...reports are due by June 1st. ⏰ No worries - we have the details on the most essential changes to note. #RxDC #reporting #employeebenefits

Dean Waldeman MD MBA has been writing books on government price fixing in healthcare for decades. He routinely eviscerates public option and single payer policies. But now he is also against free market principles?I am routinely surprised by the volume, both quantitative and auditory, of those who believe that consumers are incapable of making health economic choices. We have people who manage to make complex, value-based decisions for housing, vehicles, financing, appliances, secondary-education, job offers, mattresses, furniture, and insurance products of all kinds. And while we can debate the quality of those decisions from a user experience and behavioral economics standpoint, the truth is that hundreds of millions of people make billions of value judgement decisions each year. It’s what allows a capitalistic, price-based economy to run. At BILLY we believe that regular people, with the right tools, can make cost and quality decisions in healthcare, fully acknowledging the clinical, financial, personality, and health literacy hurdles standing in their way. Articles like this are dangerous. The infantilize, victimize, and paralyze the populace into overpaying for procedures through no fault other than where they chose to work. To argue against both single-payer and market-based forms of healthcare is to SUPPORT the oligopolistic captive-network model we have today. It’s another argument for the status quo, hiding behind the spurious claim of “risking lives.” Would love to know who sponsors this kind of “expert testimony.” When 41% of Americans delayed recommended care or halved their dosage to make meds last longer due to cost, the evidence runs contrary to the argument that higher costs lead to greater patient care and safety. Apologies if I sound a bit agitated about a market full of incumbents whose business models rest squarely on holding people in intellectual ignorance and financial codependence. #disrupthealthcare

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🩺 New RxDC reporting instructions are HERE! And guess what...reports are due by June 1st. ⏰ No worries - we have the details on the most essential changes to note. #RxDC #reporting #employeebenefits

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The list ofBCBS alpha prefix CAA-CZZthere are total of 795 alpha prefix in BCBS CAA-CZZ list and 41 are Not Assigned prefixes out of 795. We have listed below all theBCBS Alpha Prefixesalong with BCBS home plan with State name for BCBS member IDs from CAA to CZZ.#bcbsprefixes #bcbsprefixlist https://lnkd.in/gSbm6FgY

https://lnkd.in/ghvCvYiYHow the carriers 'comply' with MLR (Medical Loss Ratio) while lining their pockets and extract massive amounts of wealth from the American public.

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WHAT KINDS OF CLIENTS DOES MLS SERVE?We offer Peer Review services in Workers’ Compensation, Group Health and Disability for TPAs, insurance carriers, utilization review organizations, hospitals, state and federal agencies, and more.Learn more about our service offerings here- https://lnkd.in/efjrX6q#IRO #Workerscompclaims #grouphealthinsurance #TPAs #federalagencies #medicalclaims #claimreview

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WHAT KINDS OF CLIENTS DOES MLS SERVE?We offer Peer Review services in Workers’ Compensation, Group Health and Disability for TPAs, insurance carriers, utilization review organizations, hospitals, state and federal agencies, and more.Learn more about our service offerings here- https://lnkd.in/efjrX6q#IRO #Workerscompclaims #grouphealthinsurance #TPAs #federalagencies #medicalclaims #claimreview

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Learn what the Transparency in Coverage rule means to insurers:https://hubs.ly/Q01_klTr0

Making Healthcare Consumerism Work for PatientsHealth insurance companies are masters of human behavior and systems design.Case in point... deductibles and 'in network' health plan rules.Patients across the U.S. can easily find less expensive health services when spending their own money (i.e. the spending below their insurance deductible). BUT, if they do and the service is purchased using a cash price vs. the typically much higher insurance negotiated price, then the spending WILL NOT count toward their deductible.This leaves patients with a difficult decision... spend LESS to save themselves money (with ZERO deductible 'credit') OR spend MORE using higher insurance rates in order to get deductible credit (which is important if a patient later spends enough to have insurance start contributing).Many patients choose to pay more, which health insurance companies love.Higher healthcare spending drives their profits.TN & TX are standing up for their residents. See article below.If we want transparency and consumerism to grow across the U.S., this is an important battleground.If you want to learn more about this initiative for your state, please reach out to Josh Archambault.

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Short Term Medical Policies (STM) are a helpful and viable solution for many indiviudals and situations-- there's a need for this type of coverage. STM's are not intended to be major medical coverage and the policies are very clear about that. Limiting to 4 months is going to leave many individuals without coverage when their current STM expires. Wrong move here, in my humble opinion.https://lnkd.in/eFmhpga3

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