Comments on: National Work Comp Conference Summary http://healthcarethoughts.com/2007/11/09/national-work-comp-conference-summary/ observations on healthcare, technology and the American way by Brian Sharp Sat, 19 May 2012 17:58:43 +0000 http://wordpress.org/?v=2.2.2 By: Law iz Law http://healthcarethoughts.com/2007/11/09/national-work-comp-conference-summary/#comment-126 Law iz Law Mon, 08 Sep 2008 17:44:47 +0000 http://healthcarethoughts.com/2007/11/09/national-work-comp-conference-summary/#comment-126 i like the fair and reasonable stuff to but i dont like that libs try to not make it that way they are lame i like the fair and reasonable stuff to but i dont like that libs try to not make it that way they are lame

]]> By: KevinHatchett http://healthcarethoughts.com/2007/11/09/national-work-comp-conference-summary/#comment-29 KevinHatchett Thu, 06 Dec 2007 14:18:10 +0000 http://healthcarethoughts.com/2007/11/09/national-work-comp-conference-summary/#comment-29 Like the "fair and reasonable" model talk, proud to report that Medical Cost Remedy (MCR) is primed and prepared for the inevitable paradigm shift from the currently prevailing % of billed charges contracts to an accepted objective equitable payment recommendation methodology. MCR is the only Specialty Bill review company that offers a software and service solution specifically tailored and developed based on actual reimbursement data of providers. By benchmarking the results across local geographic areas, state and country - what better way to demonstrate real usual and customary recommendations. Combined with true web based automation, the end result is a consistent, accurate, and objective review each time - instantly! Keep us in mind! Like the “fair and reasonable” model talk, proud to report that Medical Cost Remedy (MCR) is primed and prepared for the inevitable paradigm shift from the currently prevailing % of billed charges contracts to an accepted objective equitable payment recommendation methodology. MCR is the only Specialty Bill review company that offers a software and service solution specifically tailored and developed based on actual reimbursement data of providers. By benchmarking the results across local geographic areas, state and country - what better way to demonstrate real usual and customary recommendations. Combined with true web based automation, the end result is a consistent, accurate, and objective review each time - instantly! Keep us in mind!

]]> By: Bryan http://healthcarethoughts.com/2007/11/09/national-work-comp-conference-summary/#comment-18 Bryan Wed, 14 Nov 2007 15:34:48 +0000 http://healthcarethoughts.com/2007/11/09/national-work-comp-conference-summary/#comment-18 Well, it was a good Show. I was surprised (well, was I really?) of the lack of presence of Coventry and Aetna. I guess they were thinking that the buzz was enough for them. Enough about them. I'd like to hear from some other PPO networks and what they're up to. I spoke to many payors that are tired of them anyway. The market wants to see change but I wonder if the market is really up to the challenge. I've said this before, I know there are other networks out there that are more valuable and are eager to offer solid savings (and I believe superior savings in various state markets) and service and I'm sure that we'll see them making a run on this window of opportunity that's been created by someone else's decisions. As far as the "fair and reasonable" model, I spoke with a small - but seemingly growing number of folks that are doing negotiations with this "fair and reasonable" model. This model takes nationwide provider charge data from all markets across the country and industry standard benchmarks to calculate "fair and reasonable" recommendations. Definitely worth looking into. Folks like Fair Pay, Qmedtrix and Moody Review and others are doing a pretty good job of this in various forms. I definitely agree that this will become a major form of cost containtment in the coming months. Well, it was a good Show. I was surprised (well, was I really?) of the lack of presence of Coventry and Aetna. I guess they were thinking that the buzz was enough for them.

Enough about them. I’d like to hear from some other PPO networks and what they’re up to. I spoke to many payors that are tired of them anyway. The market wants to see change but I wonder if the market is really up to the challenge.

I’ve said this before, I know there are other networks out there that are more valuable and are eager to offer solid savings (and I believe superior savings in various state markets) and service and I’m sure that we’ll see them making a run on this window of opportunity that’s been created by someone else’s decisions.

As far as the “fair and reasonable” model, I spoke with a small - but seemingly growing number of folks that are doing negotiations with this “fair and reasonable” model. This model takes nationwide provider charge data from all markets across the country and industry standard benchmarks to calculate “fair and reasonable” recommendations. Definitely worth looking into. Folks like Fair Pay, Qmedtrix and Moody Review and others are doing a pretty good job of this in various forms.

I definitely agree that this will become a major form of cost containtment in the coming months.

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