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Health Insurance & Benefits
Plan types, HSAs/FSAs, open enrollment, and navigating coverage denials/appeals.
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Community Connection - When your doctor falls out of your Medicare Advantage plan network
6+ hour, 4+ min ago (374+ words) Mike Hitcho, CEO of Hitcho Insurance Agency, explains the costs and ramifications of losing access to your doctor in a Medicare Advantage plan. Mike Hitcho discusses the proactive approach Hitcho Insurance Agency takes when a medical provider gets dropped from…...
Belfast Health Trust building abandoned 20 years ago branded a ‘danger’ as kids use TikTok to arrange hangouts inside
1+ day, 17+ hour ago (530+ words) A building that could potentially provide social housing or assisted living has been described as a “merry-go-round for antisocial behaviour” after lying vacant for more than two decades. Minnowburn House, off the Old Milltown Road in Belfast, served a number…...
29 Health Systems Dropping Medicare Advantage Plans
6+ day, 6+ hour ago (872+ words) The number of terminated contracts this year is down from 40 in 2025 and 32 in 2024, Becker’s Hospital Review reported on Sept. 4. Naples Comprehensive Health, one of the top 50 U.S. hospitals, will go out of network with Centene’s Wellcare and Health Care Service…...
How Medical Denial Management Actually Works (And Why Most Practices Get It Wrong)
2+ day, 2+ hour ago (31+ words) Claim denials cost healthcare practices more than most providers realize — not just in lost revenue, but in staff …...
Guest Commentary | ‘Prior authorization’ remains a pain point for physicians, patients
3+ day, 21+ hour ago (382+ words) Physicians devote the early part of their careers to education and training. They spend years honing and refining their clinical skills through medical school, internships, residencies and fellowships. Finally, they are ready and eager to step out on their own…...
157 Lab Providers Lost Medicare Billing Privileges—Here’s Why Checking Your Medicare Statement Matters
4+ day, 5+ hour ago (192+ words) According to CMS, those systems look for abnormal combinations involving testing, results, billing, documentation, and relationships that could indicate fraud, waste, or abuse. The technology can help flag high-risk claims for additional review and potentially allow claims to be held,…...
Medicaid Risk Contracts in New ACO LEAD Model
4+ day, 5+ hour ago (223+ words) Integrated care programs for dual-eligible beneficiaries, including ACO LEAD, aim to incentivize efficient care delivery while preventing unintended cost shifting between Medicare and Medicaid. How LEAD calculates shared savings and losses will be central to achieving both goals. First, a…...
Advantage Plans Said No 4.1 Million Times in 2024. Four in Five Appeals Won. Nine in 10 Denials Were Never Appealed.
4+ day, 6+ hour ago (629+ words) Medicare Advantage plans denied millions of prior authorization requests last year, and most patients accepted that answer without a fight. What happened to the ones who pushed back reveals something uncomfortable about how those first decisions get made. The Full…...
RCGP opposes NHS England's proposals for neighbourhood contracts 'in their current form"
4+ day, 10+ hour ago (757+ words) Does it make sense for GPs to take on local enhanced services? The RCGP does not support the proposed contracting models for neighbourhoods ‘in their current form’, the college has told NHS England. In its response to the NHSE consultation…...
Peel Land and partners move ahead with £520m commercial and housing development
5+ day, 1+ hour ago (577+ words) How the Health Innovation Bolton project could look(Image: Health Innovation Bolton (HIB)) An agreement has been signed by partners hoping to bring forward a massive development which would 'create a new neighbourhood' and transform much of the south of…...