Healthcare Services

Let the dogs out!

Surprise medical bill? – Surprise medical billing applies to fully-insured commercial insurance plans.   No federal laws exist to prevent surprise medical bills and of the states that do less than half provide comprehensive legislation.   Employees are confused when they receive a surprise medical bill and it generally reflects poorly on the company plan when it occurs.

Bill Dog was made for the moment a confusing medical bill arrives. Members can be confident before paying any medical bill. Bill Dog researches and explains every situation to our members.

  • What is the bill for?
  • What are the codes?
  • Are the charges too high?
  • I have insurance, why do I have this bill?
  • I am confused.

Bill Dog works directly with members, providers, and insurance companies to resolve issues, support appeals, and assist with price negotiations. Bill Dog provides an easy way to verify any medical bill so it can be negotiated and paid with confidence. It is easy to use. You can reach them by phone, chat, email or direct message. Codes and charges are verified. Billing errors are identified and corrected. Appeals and price negotiations are supported. It is results driven. Errors are identified and corrected — claims denials and out of network charges are verified.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

OSHA Recommends that Employers Encourage Workers to Wear Face Coverings at Work

As businesses open and employees return to work, large numbers of employees of workers will be required to wear faces masks in the workplace.

The Occupational Safety and Health Administration (OSHA) has published a series of answers to frequently asked questions (FAQs) regarding the use of masks in the workplace to help employers provide a safer work environment. The guidance outlines the differences between cloth face coverings, surgical masks and respirators.

Guidance includes:

  • Cloth face coverings are not considered personal protective equipment and employers are not required to provide them. (Employee Benefit Advisors believes this is an extremely important as it could provide the employer a layer of liability protection.)
  • OSHA generally recommends that employers encourage workers to wear face coverings at work.
  • Cloth face coverings are not a substitute for social distancing measures.
  • OSHA suggests following CDC recommendations, and always washing or discarding cloth face coverings that are visibly soiled; and
  • Employers must not use surgical masks or cloth face coverings when respirators are needed.

Click here for more information.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Florida’s COVID-19 Data and Surveillance Dashboard

The link below provides some very insightful data regarding the spread of COVID-19.

https://experience.arcgis.com/experience/96dd742462124fa0b38ddedb9b25e429

The chart in the lower left is particularly interesting. Obviously, one would expect an increase in cases as the number of tests increase. However, note the trend of the decrease in the number of new cases.

What does this mean? To me it says we may be getting ready, hopefully, to start the economy back up. It also suggests we should start thinking about how to restart our businesses. – Need help planning the restart? I know people, experts – people that can help. – Let me know what you need, I’ll help you find the right person.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

COVID-19 and Medicare

Employee Benefit Advisors recommends communicating the following to you employees. Odds are your company has either employees on Medicare, family members on Medicare, or both.

Copays for the Coronavirus test have been waived, but not the cost of the doctor visit needed to get the test or the treatment.

Telehealth – CMS announced that it will expand telehealth services for Medicare beneficiaries and cut back on HIPAA enforcement. Email and texts to docs will be possible! Read the CMS details here

Cost of testing – Medicare Part B (Medical Insurance) covers a test to see if you have coronavirus (officially called 2019-novel coronavirus or COVID-19). https://www.medicare.gov/coverage/coronavirus-test

3 Day Hospitalization Waived for Skilled Nursing Facilities – The waiver of the requirement for a 3-day prior hospitalization for coverage of a SNF stay provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who are evacuated, transferred, or otherwise dislocated as a result of the effect of disaster or emergency. In addition, for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period (Blanket waiver for all impacted facilities). Click here to download the full CMS memo.

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Coronavirus – easy to understand info for employees

Symptoms people may experience:
1. runny nose (Not to be confused with allergies)
2. sore throat
3. cough (develop the habit of coughing into your sleeve or handkerchief – never your hand!)
4. fever
5. tightening of chest / difficulty breathing (severe cases)

What can you do?
• Emergency Room – very expensive
• Urgent Care – less expensive than ER but more cost-effective options exist
• Primary Care Physician – generally a low flat copy; at most the contracted rate between the physician and insurance company
Because COVID-19 is highly contagious to prevent contaminating health care service workers, it is not recommended you go directly to the              ER, UC or PCP.
Telemedicine – no cost! – If you need emergency care or any additional care the doctor will advise you.
(According to the Centers for Medicare & Medicaid Services (CMS), Essential Health Benefits (EHB) coverage generally includes coverage for the diagnosis and treatment of COVID-19.)

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Should you get a second opinion?

If you find yourself asking questions like:

  • Do I have the right diagnosis?
  • Am I on the best treatment path and medications?
  • Is this surgery or procedure the best option for me?
  • How can I find the best local doctor for my medical needs or my surgery?

2nd.MD will get you help and answers.

Here are some quick stats:

  • 24% of consults lead to an alternate diagnosis
  • 82% of consults result in an improved treatment plan
  • 29% of surgery consultations result in surgery cancellation

2nd.MD provides support for any condition. Your support starts with a Care Team Nurse. Within days, 2nd.MD will collect your pertinent medical records and imaging and connect you via phone or video to a world-class specialist, uncovering all the possibilities and taking control of your health outcome through local and national in-network referrals.

Service is at no cost to if you are enrolled with a participating organization/employer as part of your benefits package. Many people have their service through their insurance carrier and don’t even know it! The benefit of 2nd.MD is also available to individuals. Contact them directly for pricing.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Telemedicine – Impact your health care costs

Group health insurance premium are expected to rise 15-18% in 2019 and Telemedicine can be an important cost containment tool, for both employer and employee.

In a study of 17,000 telemedicine participants, hospital admissions dropped by 30% and doctor visits were reduced by 60%, for a savings of 45% in unnecessary doctor and emergency room visits. The American Medical Association states that 70% of doctor visits can be handled over the phone, and 50% of the emergency room visits are non-emergencies. Telemedicine’s savings in claim costs range from $300 for a single employee to more than $1,000 per year for a family of 4.

Telemedicine provides 24/7 medical access to employees as part of their benefit package. Advances in communication technologies make accessing professional medical opinions easier. This is particularly important if the network is strictly local, employees live in rural areas, or employees are worried about access to doctors while traveling.

In addition to the obvious convenience – patients/employees do not have to take time away from work for a medical appointment, sitting in the doctor’s waiting room, eliminating travel time – patients/employees have increased access to medical experts in many fields. Telemedicine puts the employee in touch with US Board Certified physicians in their state to treat common ailments; cold/flu, sinus infections, allergies, pink eye, etc.

What can employers do? – Employee Benefit Advisors recommends companies build a communication program to educate employees. In addition to informing employees the services that can be accessed via telemedicine be sure to include instructions on downloading your health insurance carrier’s app and login.

Interestingly, a bill submitted in New York proposes creating a task force to study how telehealth and telemedicine might help employees in workers comp. The task force would examine how connected health technology could improve outcomes for workers on worker’s comp, increase access to care providers and enable those providers to improve compliance with worker’s comp guidelines. The committee would also explore how telehealth and telemedicine could help employers and reduce fraud.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Cologuard vs Colonoscopy

Concerned about being at risk for colon cancer? Don’t like the idea of a colonoscopy? You may want to consider learning more about Cologuard, an at-home testing kit that screens you for colon cancer.

 What it is.
Cologuard is a noninvasive, prescription-only test. It’s designed for adults 50 years or older who are at average risk for colon cancer.

What it’s not.                 
Cologuard is not a replacement for diagnostic or surveillance colonoscopy in high risk individuals. If you have a medical history that includes colon cancer, polyps, or related cancers, it isn’t right for you.

How to tell if it’s for you.
The first step is to discuss the Cologuard testing kit with your healthcare provider. Once your healthcare provider approves the prescription, your kit can be ordered. It will be delivered right to your door.

How effective is it?
In 10,000 testing cases, Cologuard screenings discovered 92% of colon cancers and 42% of high-risk pre-cancers. Since both false positives and false negatives occur, Cologuard encourages positive-results patients to follow-up with a diagnostic colonoscopy. Negative-results patients are encouraged to participate in additional screenings at intervals.

 Will your insurance cover it?
Preventative Care / Screenings are covered at no cost under the Affordable Care Act. Cologuard is covered by most insurers with no co-pay or deductible for eligible patients (ages 50-75; at average risk for colon cancer; without symptoms). Cologuard is covered by Medicare and Medicare.

If your insurance provider doesn’t cover it or only covers part of the costs, Cologuard’s appeal department will assist you in creating an appeal letter to send to your insurance company.

The Cologuard screening is FDA-approved and has been in use since 2014.

 

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

Dietary Impact on Health

Meet Jeanette, she has lupus. (A chronic autoimmune disease in which the body’s immune system becomes hyperactive and attacks normal, healthy tissue. This results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs.)

(Jeanette mentions PatientsLikeMe in her video. PatientsLikeMe is a free website where people can share their health data to track their progress, help others, and change medicine for good. It’s an online community with over 2,500+ conditions.)

Now, the rest of the story.

Jeanette says she turned to dietary changes when she stopped taking Plaquenil due to severe side effects, including retina damage. She started logging her food intake for a few weeks, she noticed how some of her favorite foods were causing issues ranging from stomach pains to full inflammation. That’s when she started paying close attention to what her body was telling her and realized she needed to do something about it.

Jeanette didn’t go on any specific diet at first, she started eliminating certain foods like sugar (which was causing major fatigue and pain), garlic (causing major inflammation in her knees), eggplants (fatigue and pain in her feet), bean sprouts (stomachaches) and alfalfa (full inflammation and full flare) — some of the known foods that lupus patients shouldn’t eat [learn more at lupus.org].

Then Jeanette noticed how meat was causing fatigue and noticed inflammation directly in her knees. She gave up red meat for two weeks, felt good and noticed a reduction of pain. Then she gave up chicken the following two weeks and felt even better. “It was so amazing that I decided to give it up for good.” After the first few months without meat, my doctor started noticing my blood work was improving drastically, so she began reducing her medications since she was no longer flaring or feeling pain. After a full year she reduced all medications to zero and even stopped infusions.

(Everyone is different, so these foods and dietary changes may not affect you the same way. Talk with your doctor or a registered dietitian about finding foods that work for you.)

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