A Body of Knowledge

    Looking for insights on how to succeed as a Medicare Advantage Prime? Everything you need to know is right here.   How about succeeding as an organization with your Medicare Advantage contract? This is where you need to go.   Are you patient looking for unbiased Medicare Advantage information? Here’s everything you need to know.   Looking for deeper insights in real-time? Subscribe to Value-Based Transformations and get them sent to you in-box....

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Buying Studies in Bulk

  If you’re a single speciality primary care group or even a multi-speciality group without your own imaging center, consider buying your imaging studies in bulk from an outside vendor and then using them on the patients in your panel as the need arises.       Check your Medicare Advantage contract, but many will allow you to service your patient outside your contract without charge.       If yours does not, ask your...

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Sunday Links

    Come and get it!     Most of the MA links across the web this week are consumer advocacy pieces written in local publications. They would all do better to simply refer patients here. –yet one more example of how Medicare Advantage has gone mainstream. The ACA was supposed to be funded by dramatic cuts to the program. If you made a bet in 2009 (as I did) that it would be the...

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Saturday Q and A

  Dr. Cathy wrote me to ask:   “Thank you for all your writings. My comp formula is being changed so that I can lose or gain up to 20% of my RBV revenue based on how much my money my Medicare Advantage patients cost.  What should I do?”       Cathy, You don’t say how many Medicare Advantage patients you have, but suddenly those folks have become very valuable too you.    ...

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Know Your Financials

    The financial reports you get from your employer and your insurance partners are the key to your happiness.       Understand them, and you’ll understand where your can capture the greatest value for your labor.       Fail to do so, and you’ll simply push yourself to create more billable encounters as you seek to generate more revenue. That’s a recipe for burnout, depression, and worse.       I’m a...

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YourTelemedicineCommunity.com

    Point your browser to YourTelemedicineCommunity.com and follow all my regular postings dedicated to your success in telemedicine.     Industry insights. Actionable tactics. Business tips.     The ONLY place on the net where you’ll find all this purely from a clinician’s perspective and 100% directed towards your success.   YouTelemedicineCommunity.com   Be there!    

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An Open Enrollment Guide

    Open enrollment is here for Medicare Advantage—and here’s what you need to do to keep yourself safe:   Don’t purchase a plan from someone who contacts you—either by mail, phone, or message. Use the Medicare plan finder tool to compare plans but be careful. There are many look-alike web pages which are actually sales tools in disguise. The real Medicare plan finder too ends in .gov. Once you find a plan, purchase it...

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A Disturbing Trend in Non-Competes

  Check your contract to make sure your non-compete is centered at the primary office in which you practice, rather than any office site the health system owns.     The “primary office”language has long been standard, but as competition for clinician labor heats up (I recently saw a pop up ad recruiting general internists for Mayo), non-competes are becoming as restrictive as the law can make them.     The fact that health systems...

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Career Coaching

  I find it curious to that even as clinicians, we ourselves have training in the process of helping our clinicians make positive change—quitting smoking, losing weight—we don’t see the process of our own career transitions as similar.       They are.     Change involves addressing both the emotional and practical aspects and implications altering our habits.     And whether it’s smoking or changing career focus, unless you address both in a...

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Mind Your Risk-Coding Vendors

  If you contract with an outside service to help you recover diagnostic risk-codes and those codes are rendered invalid through a whistleblower suit, it’s your revenue that’s going to be clawed back.       I’m not just taking about the standard CMS audits (although if extrapolation becomes official policy, those audits will become more dangerous too). I’m talking about qui tam and whistleblower lawsuits.       Code-harvesting arrangements usually involve the health system...

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