by Advize Admin | Nov 11, 2022 | Healthcare
Doris Spatz takes a once-a-day pill, Kisqali, to keep her metastatic breast cancer in check. As a patient in the Defense Department health system, she can fill routine prescriptions at a military pharmacy without a copay but also has the option of using a regular...
by Advize Admin | Jul 1, 2022 | Healthcare
Consumers, employers, and just about everyone else interested in health care prices will soon get an unprecedented look at what insurers pay for care, perhaps helping answer a question that has long dogged those who buy insurance: Are we getting the best deal we can?...
by Advize Admin | Mar 25, 2022 | Compliance
Providers are most often paid in Fee-For-Service (FFS) models for visits AFTER they occur. The patient sees a provider, a service or procedure is performed, and a bill (claim) goes to the health insurance plan (payor/issuer) for reimbursement for those services that...
by Advize Admin | Mar 25, 2022 | Healthcare Facepalm, OIG Files
I recently needed to get a CT scan done as part of a full physical examination. The ordering doctor and the imaging center are associated with a very large group in the Central Florida area. Upon leaving the visit with the physician, I was handed a hard...
by Advize Admin | Feb 25, 2022 | Healthcare
The Comprehensive Error Rate Testing (CERT) program is a CMS initiative that seeks to identify national error rates in a variety of areas. Temporarily suspended due to COVID-19, the CERT program came back into action in August 2020. The program, in a...
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