Healthcare Services

Many Patients Billed for Preventive Care That Should Be Free

People are being charged for preventive health care, health care that should be at no cost to them. That’s the headline from an article in the US News & World Report by Robert Preidt, HealthDay Reporter.

The article stated, “Out-of-pocket charges for preventive care that should be free under the Affordable Care Act can discourage patients from receiving recommended care…”. While a majority of patients are receiving preventive care for free, those who were charged only paid about $20 or less.

Unexpected charges were also common for routine screenings for cancer, diabetes, cholesterol, depression, obesity, and sexually transmitted infections, as well as pregnancy-related services.

The primary conclusion of the study was these charges were discouraging future health care screenings.

 

Employee Benefit Advisors provides, employee benefits, Healthcare Consumption Audits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services. We can customize a wellness plan for your budget and culture.

No More Surprises

Shock by your hospital bill?The No Surprises Act, a ban on surprise medical bills, will take effect beginning in 2022.

Surprise Medical Bills

Surprise medical bills occur when patients unexpectedly receive care from out-of-network health care providers. – A patient goes to an in-network hospital for surgery or emergency care, and an out-of-network doctor is involved in the patient’s care. Patients are not able to determine the network status of providers, such as emergency room doctors or anesthesiologists. The patient is simply not involved in the choice of provider.

No Surprises Act

The Act applies to surprise bills from doctors, hospitals, and air ambulances. It prohibits these providers from billing patients who have health coverage for unpaid balances. Providers will have to work with the health insurance issuer carrier to determine the appropriate amount to be paid by the plan.

(The No Surprise Act was included in the stimulus bill signed by President Trump on Dec 27, 2020.)

EBA will continue to keep you updated as information becomes available on the details of the law.

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services. We can customize a wellness plan for your budget and culture.

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.

Back to top

Submit your Feedback

      Sending...
x