Archive for January, 2016
The National Weather Service says this has been the warmest twelve months on record, but I don’t think you’ll get an “AMEN!” from people under mounds of snow, or dealing with wind chills of twenty to thirty below. In Chicago: A ninety-year-old woman froze to death on her stoop, wearing sandals without a coat. An […]Read More
We have put nurses on the front line of care management (CM) without the information and skills they need to succeed. This gives them grief from both sides as providers feel harassed by their questions, and administrators gripe about L3nt5h of Stay (LOS). CM nurses also seem to struggle with the fast-paced, information-dense requests for […]Read More
Straight Talk with Dr. Cheryl: Trying to Develop Health Care Partnerships; You Can Take the Doctor Out of North Philadelphia, but…
I usually get along with everybody, but since I’ve been on the insurance side, I’ve run into health professionals who act like I have horns and a tail. A major health system racked up a ton of denials because providers failed to get pre-authorization for tests and procedures. When they appealed, they got denied again; […]Read More
STRAIGHT TALK WITH DR. CHERYL- You May Not Like Physicians, but an Auto Mechanic Can’t Do This For You.
Recently, another health care payor decided to outsource its medical management functions. This is just another example of health-related businesses failing to recognize their companies’ actual product. Insurance companies think they are generating covered lives, premiums, and claims management structures when their real product is population health that decreases the cost of health care. These […]Read More