…. I did a bit of research on infusion center accreditation. Ask who their accreditation agency is as it may not be JCAHO.
Here’s another agency that does accreditation. If you scroll down the page you will see the “standards” that must be met.
https:…[Read more]

Ask them if the facility/facilities are accredited by JCAHO, The Joint Commission on Accreditation of Healthcare Organizations. I’d bet that they are, and the fact that they indicate that there are “no records” is not only “below the standard of care,” but also in violation of JCAHO standards, and they are at risk of losing their accredita…[Read more]

No questions, just congratulations to all! And thank you Trisha for bringing your vision to life and providing so much knowledge, training and support to all of us.
I do hope there will be a virtual send off for you. It would be a pleasure to toast to you as you move towards retirement, although I may be wrong, but something tells me you’re g…[Read more]

Usually in cases where the charge amount isn’t at least the amount that was negotiated, the insurance company will pay the full charge amount that was billed, and it’s the hospital/practice/healthcare entity’s lose for not setting their prices high enough . In my past, this is how we were able to identify charges that needed to be reviewed to…[Read more]

California Advocates for Nursing Home Reform (http://www.canhr.org, a non-profit staffed by lawyers and other professionals, offers general advice on spending down assets to qualify for Medi-Cal (California’s version of Medi-cAid). Their services are free. A company that owns multiple nursing homes refers people to a related “consultant” for advice on…[Read more]

Linda,
I’m still intrigued by this dilemma. Has there been any resolution or explanation?

Hi Sherry. We often refer to an elder attorney firm that has a non-attorney on staff whose full-time job is helping folks with the Medicaid spend down process. He can often lawfully help protect assets, but this must be done under the supervision of an attorney. This has been a great community partner for us! I get the sense that this type of…[Read more]

Thank you, Jen! My partner, Deb, and I are so excited about the future. I hope you can join one of the upcoming zoom calls. It would be so nice to see you again! Thank you so much for the shout-out!

In my opinion having worked in one of the largest HMO’s and a large Blue Cross plan, anything is an appropriate ask. These insurance plans are making so much money that you can ask what ever you think is reasonable.

I understand, Gayle. We both know these kind of issues are best negotiated prior to treatment. I guess it’s up to her to decide if she wants to ask for an exception or review considering the unique circumstances. If it were me, I’d definitely ask, all they can say is, ‘No.’

The truth of the matter, the higher up the ladder the employee is, and…[Read more]

If this helps: APHA offers two podcasts of calls focused on advocacy and working with employers. There is another one about working with unions – same idea, just a different audience.

Find them by doing a search at the top or bottom of any page for “employers”.

They are mostly focused on marketing to employers, but with discussions about the…[Read more]

We did go through HR/benefits to get the current exception. I’m not sure how much she wants to use her “clout” but I had told her she should!