Other providers are having patients sign financial waivers and are "balance billing" the patient, even though in many instances this is prohibited in their signed contracts with third-party payers
In exchange, the third-party payer
has no influence over the recovery process other than the opportunity to make a claim (or object) at the end of the claims procedure.
Garrison Bliss on recreating the traditional doctor-patient relationship that third-party payers
A totally unproductive artificial situation has been purposefully created by third-party payers
as a scheme to delay, reduce, or avoid payment altogether.
are increasingly establishing policies that seek to contain the rising costs of health care.
The third-party payer
is dictating to physicians what they can and can't do, and who they can and can't treat.
A joint development effort of the ACR, the American College of Radiology Imaging Network (ACRIN) and the Academy of Molecular Imaging, the NOPR is a national, Internet-based, audited data repository designed to gather PET data from beneficiaries and providers, and report on that data to third-party payers
including the Centers for Medicare & Medicaid Services.
The court stated that third-party payers
could be held liable for "defects in the design or implementation of cost containment mechanisms" that result in the denial of medically necessary services.
Verispan's Vector One: Payer provides projected market share at the individual third-party payer
But "there have been instances in which third-party payers
receive funds from employers for payment of payroll taxes, but they have not remitted those taxes to the IRS.
The Anglo-Swedish pharma major will pay USD13m to two classes of plaintiffs -- third-party payers
who paid some or all of their Medicare co-insurance for its cancer drug Zoladex and/or its asthma treatment Pulmicort Respules in the northeastern US state of Massachusetts as well as consumers and third-party payers
who paid cash or a co-pay for these drugs outside of Medicare in Massachusetts.
The current inequitable limits applied to mental health benefits by third-party payers
affect most profoundly the patients with severe psychiatric disorders.
wages lost because of menstrual problems and opportunity costs of doctor visits), researchers found that if the pills were priced comparably, a year of the new regimen would cost a user $41 less than a year of the standard regimen; societal costs per user would also be reduced by $41 annually, but direct costs for third-party payers
would not differ by regimen.
The issues involve the possible consequences of subcertification: restricting the general otolaryngologist from performing ear surgery or allowing third-party payers
to avoid paying for ear surgery performed by the general otolaryngologist.
I suggest that legislators do the right thing and begin legislating changes such as mandating a pay scale according to experience, decreasing the required costly continuing education units and requiring third-party payers
to reimburse us when we employ interns who work with clients.