Looking For Insurance Savings, Consumers Could Possibly Get Unwittingly Wedged Into Narrow-Network Plans

 

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In search of savings, consumers can get unwittingly wedged into narrow-network plans

Video taken from the channel: David Dolan


In search of savings, consumers can get unwittingly wedged into narrow-network plans Some health plans have “narrow networks” of medical providers. In Search Of Insurance Savings, Consumers Can Get Unwittingly Wedged Into Narrow-Network Plans. As a breast cancer survivor, Donna Catanuchi said she knows she can’t.

In search of insurance savings, consumers can get unwittingly wedged into narrow-network plans. by Steven Findlay, Kaiser Health News, Posted: November 1, 2018. Polsky is completing an analysis of 2018 plans and expects the percent of narrow network plans to remain “relatively constant” for this year and into. In Search Of Insurance Savings, Consumers Can Get Unwittingly Wedged Into Narrow-Network Plans. By Kaiser Health News | November 01, 2018. In searching to save money on monthly insurance premiums, people may unwittingly sign up for plans that limit choice of hospitals, doctors and other sources for health care.

Steven Findla. Home Lifestyle In search of savings, consumers can get unwittingly wedged into narrow-network plans In search of savings, consumers can get unwittingly wedged into narrow-network plans. In Search Of Insurance Savings, Consumers Can Get Unwittingly Wedged Into Narrow-Network Plans November 1, 2018 Eileen Cook 0 Comment (By Steven Findlay for.

Home Lifestyle In search of savings, consumers can get unwittingly wedged into narrow-network plans In search of savings, consumers can get unwittingly wedged into narrow-network plans. November 2, 2018 Lifestyle Comments Off on In search of savings, consumers can get unwittingly wedged into narrow-network plans This story is from Kaiser Health News As a breast cancer survivor, Donna Catanuchi said she knows she can’t go without health insurance. In Search Of Insurance Savings, Consumers Can Get Unwittingly Wedged Into Narrow-Network Plans Polsky is completing an analysis of 2018 plans and expects the percent of narrow network plans to remain “relatively constant” for this year and into 2019.

Pennsylvania Insurance.

List of related literature:

(c) The better behaviour resulting from smart devices is just one threat to the insurance industry.

“48 SBI & IBPS Bank PO Solved Papers (2010-2019) 5th Edition” by Disha Experts
from 48 SBI & IBPS Bank PO Solved Papers (2010-2019) 5th Edition
by Disha Experts
Disha Publications, 2020

Faced with the pressure to reduce prices or risk being excluded from an insurer’s network, providers must also balance tradeoffs in negotiating with selective contracting plans.

“Changing the U.S. Health Care System, CafeScribe: Key Issues in Health Services Policy and Management” by Ronald M. Andersen, Thomas H. Rice, Gerald F. Kominski, Abdelmonem A. Afifi, Linda Rosenstock
from Changing the U.S. Health Care System, CafeScribe: Key Issues in Health Services Policy and Management
by Ronald M. Andersen, Thomas H. Rice, et. al.
Wiley, 2011

Instead, some consumers are prone to shop around and switch plans in search of lower premiums or enticing coverage options.

“Redefining Health Care: Creating Value-based Competition on Results” by Michael E. Porter, Elizabeth Olmsted Teisberg
from Redefining Health Care: Creating Value-based Competition on Results
by Michael E. Porter, Elizabeth Olmsted Teisberg
Harvard Business Review Press, 2006

Yet the radical transparency of such insurance makes it plausible that consumers might learn that smart contracts are trustworthy, and more than that, consumers might be able to determine which smart contracts are most appropriate for their particular circumstances.

“Regulating Blockchain: Techno-Social and Legal Challenges” by Ioannis Lianos, Philipp Hacker, Stefan Eich, Georgios Dimitropoulos
from Regulating Blockchain: Techno-Social and Legal Challenges
by Ioannis Lianos, Philipp Hacker, et. al.
Oxford University Press, 2019

And with a lack of transparent forward curves, this further implies that some disagreement about the pricing of multiyear coverage is likely to result.

“Structured Finance and Insurance: The ART of Managing Capital and Risk” by Christopher L. Culp
from Structured Finance and Insurance: The ART of Managing Capital and Risk
by Christopher L. Culp
Wiley, 2011

If providers are placed at substantial financial risk, the plan should provide or require those providers to obtain stop-loss coverage to limit their risk once they reach a specified risk threshold.

“The Managed Health Care Handbook” by Peter Reid Kongstvedt
from The Managed Health Care Handbook
by Peter Reid Kongstvedt
Aspen Publishers, 2001

(e) The data has enabled insurance companies to gauge the situation and plan accordingly.

“SBI & IBPS Bank PO Solved Papers 32 papers 2nd Edition” by Disha Experts
from SBI & IBPS Bank PO Solved Papers 32 papers 2nd Edition
by Disha Experts
Disha Publications, 2017

Even this is only a second-best optimum because in a first-best world—and in the absence of moral hazard—every risk-averse individual would want to buy full coverage at a fair premium.

“Handbook of Health Economics” by Mark V. Pauly, Thomas G. McGuire, Pedro Pita Barros
from Handbook of Health Economics
by Mark V. Pauly, Thomas G. McGuire, Pedro Pita Barros
Elsevier Science, 2011

This already results from the generally unequal distribution of (financial) resources between the insurer and the policyholder, which allows the insurer to unilaterally set the terms of the contract.

“Transparency in Insurance Contract Law” by Pierpaolo Marano, Kyriaki Noussia
from Transparency in Insurance Contract Law
by Pierpaolo Marano, Kyriaki Noussia
Springer International Publishing, 2020

Similarly, if salespeople cannot access decision makers at the accounts in segments 1 through 4 more frequently than the coverage plan calls for, then perhaps the plan for these segments should remain as is.

“Sales Force Design For Strategic Advantage” by A. Zoltners, P. Sinha, S. Lorimer
from Sales Force Design For Strategic Advantage
by A. Zoltners, P. Sinha, S. Lorimer
Palgrave Macmillan UK, 2004

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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15 comments

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  • Again, very informative. Direct to the numbers with the data and not pushing any particular agenda. I’m glad I found this channel.

  • I wanted to share this video because it relates so closely to the conversations about Jimmy Kimmel’s son going around my social networks, but the vocabulary felt too high level to make it relatable. I think it’s great that you trust your audience with the raw policy lingo, but it would be nice if you could decode the important bits a little more (and show the decoded messages as text blocks on the screen). Just my two cents. Thanks for all of the work you do, your channel is awesome!

  • The truth is that a good doctor makes a huge difference. I have to very healthy children, one a ballet dancer and the other a drum core DCI percussion musician. Both need to see a doctor for their overused feet, tendon etc. One of the best doctors in Michigan take care of what he calls “elite atheles,” and his experience and suggestions are what you are looking for.
    My daughter had a problem with pain in her legs when she was little and was in point. He looked at her and in five minutes of this child walking, and he gave a diagnosis. And also told us to find a physical therapy who trully understand “dancing.”
    Now, my daughter goes once every six months to the sports medicine at the University of Michigan for maintenance.
    And while both of them are doing fantastic, there are a lot of young dancers that I know that have lingering problems with their legs because the parents used the traditional doctor, and the HMO health provider physiotherapist.
    One of the things that nobody talks is that because the doctors and physiotherapist are in contract with the HMO, they can not say they…DO NOT KNOW, NOR THEY DO NOT HAVE THE EXPERTISE,” specially if that is a referral, like with physiotherapy, and continue with practices that are not the best for the patient.
    My son has flat feet. And I can tell you the enormous difference between a doctor in the HMO program doing my son’s insoles, and this best Dr. doing the insoles…day and night, and I paid around $200 dollars for each pair of insoles.
    So, cost is very important, but quality when you really need is the question. At least for my children made a huge difference.

  • Idiots! Idiots! Healthcare is not a business and business shouldn’t pervert healthcare. This doc is a tool that is only making the blow of a criminal insurance system seem softer. It’s all wrong, the system and ways of healthcare are so unimaginably flawed beyond just high premiums. When you have insurance companies involved within the healthcare system an unnecessary ‘market’ is created that will/has only deteriorate the care you receive while driving the premiums up. Ask yourself “will the premiums ever go down?” NO F&CKING WAY, they never have. “Will the care associated with the ever growing premiums ever improve?” Absolutely not! It hasn’t because it was never designed to improve healthcare. Your debates against this would be laughable if they weren’t so damn sad.

  • Our system is geared toward keeping adults who’ve already wrecked their health alive a little longer instead of ensuring kids, who don’t make financial or political decisions, reach adulthood. Who knew?

  • I have a two word answer to this problem: Single Payer. Seriously, it’s time we join the civilized world and STOP allowing huge corporations to exploit and murder our people for their filthy lucre. If a few insurance companies drop down a peg, so much the better and GOOD RIDDANCE!

  • Well I guess this aspect of the affordable care act won’t be problematic anymore… since the affordable care act is gone.

    Good luck Americans!

  • With regards to areas with no pediatric specialists in the network, the barrier is first that there is no in network specialist.  The second barrier is that the parent/guardian then needs to fight tooth and nail to get see out of network without penalty if they have a child that meets medical necessity criteria.  It is a nightmare that no parent wants to face but there are advocates in the medical and insurance fields that can and do help them navigate this mine-field of insurance barriers.  My work in coding and billing has exposed me to the ugliest sides of insurance and the appeals process can be so long in order to get people to just give up so the carrier keeps your premium and pays out almost nothing for your care (which is a win in their book).  Fight your carrier if you have special needs like these and Appeal, Appeal, and Appeal again, even if you have to involve your state board of insurance.

  • I can do these @ home w/o any problems. Since I stopped driving over 2 years ago, I seem to have to limit where I go. I do follow a good program that helps me a lot. Will continue to see how good programs can be of benefit in my life.

  • We all have Obama and the democratic party to thank for shoving this BS down America’s throats. Remember? Pelosi and the 2 goons walking beside her to take their bill to be signed, parading with their noses stuck up in the air at protesters who were demanding they do not do this? It was Obama actually BRIBING some democratic congressmen in a back room; it was on CNN LIVE, back when CNN was news-worthy. They went in, one by one, then came out shortly after, smiling from ear to ear, because THEY got the gold mine, America got the shaft!!!

  • Always ask a Medical Provider if the Practice accepts Humana payments or Not!!! Experience is NOT the best teacher which is what happens if you do NOT ask!

    ALWAYS AUDIT BILLS FROM YOUR PRIMARY PROVIDER. I HAVE FOUND TWO INSTANCES OF BILLING LATE BY A HOSPITAL THAT ITS BILLING DEPARTMENT FAILED TO SUBMIT OVER $19K ON TIME AND HUMANA DENIED IT. I CALLED BOTH HUMAN AND THE HOSPITAL AND EVENTUALLY GOT THEM TO COMMUNICATE AND WORK OUR FULL PAYMENT. BUT THE HOSPITAL KEPT BILLING ME FOR MONTHS,; AND THE HOSPITAL WAS NOT SUPPOSED TO.

  • Keep up the pressure on congress to address this issue… see Nov 2019 https://www.advisory.com/daily-briefing/2019/11/18/surprise-bills. ‘Surprise’ billing 101: Inside Congress’ epic fight over out-of-network billing. Not call ‘surprise” for nothing. Some states already have consumer protection statutes: If you live in New Jersey there is some reasonably good protection from the 2018 New Jersey’s Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act. see https://www.insidearm.com/news/00044301-new-jerseys-out-network-medical-billing-l/

  • You great during speaking from past and now the client has been suffering a lot of problems such as accessibility, low quality, increasing cost and low of trust in insurance organization. Are there problems creating. Is there alternative…? Are MHCOs there a need to be reformed? What are you experiencing for MHC concepts and practices?
    Are the clients have full satisfaction? If you upgrade articles pls provide me to learn more.
    Thank you

  • U dont realize how lucky we are to have insurance
    I have blue anthem cross ppo from the carpenters union best insurance out there
    Blessed

  • I worked for BC/BS for 33 years, and was promised free health insurance for life, but they lied. I am 77 now, and getting ripped off by landlord, utilities, Medicare, and now my old employer BC/BS. My retirement income is not keeping up with the high prices. I was going to just drop everything, but God told me to continue to pay these greedy and evil demons, for he is going to send ALL to hell in gasoline drawers.������������������

    https://youtu.be/VAuYL2vjD_4