Healthcare in the United States

RabbleHealth Appoints Former Kaiser Permanente Executive Mitch Ross to Advisory Board

Tuesday, August 3, 2021 - 11:30am

THOUSAND OAKS, Calif., Aug. 3, 2021 /PRNewswire/ -- RabbleHealth announced today that it has appointed Mitch Ross, former Vice President, Individual and Family Plans for Kaiser Permanente, to its Advisory Board.

Key Points: 
  • THOUSAND OAKS, Calif., Aug. 3, 2021 /PRNewswire/ -- RabbleHealth announced today that it has appointed Mitch Ross, former Vice President, Individual and Family Plans for Kaiser Permanente, to its Advisory Board.
  • Mitch is an experienced healthcare executive, consultant, and advisor.
  • Prior to that, Mitch held various executive and leadership roles at healthcare organizations including Blue Shield of California and CareAmerica Health Plans.
  • Mitch earned his MBA from the Anderson School of Management at UCLA and his Bachelor of Arts Degree in Economics from UC Irvine.

Zing Health Joins SelectQuote in Medicare Advantage Outreach

Tuesday, August 3, 2021 - 10:00am

CHICAGO, Aug. 3, 2021 /PRNewswire/ -- Zing Health is partnering with SelectQuote, Inc. (NYSE: SLQT) to provide more exposure to its Medicare Advantage plans in Illinois, Indiana and Michigan, promoting community health in greater Chicago and other metropolitan areas.

Key Points: 
  • CHICAGO, Aug. 3, 2021 /PRNewswire/ -- Zing Health is partnering with SelectQuote, Inc. (NYSE: SLQT) to provide more exposure to its Medicare Advantage plans in Illinois, Indiana and Michigan, promoting community health in greater Chicago and other metropolitan areas.
  • By adding SelectQuote to its insurance broker network, Zing Health is simplifying the buying process for those who may be new to Medicare Advantage or uncomfortable with buying health insurance, making it easier for them to choose and enroll in the coverage they need.
  • "Zing Health designed its Medicare Advantage products to be the best of breed for diverse populations in each of its target counties," said Dr. Eric E. Whitaker, founder and CEO of Zing Health.
  • With a mission to help provide the best Medicare plan at the best price to meet customers' healthcare needs, SelectQuote joins Zing Health in outreach to underserved populations, helping seniors understand their health options and making an important difference in their lives.

Kaiser Permanente mandates COVID-19 vaccination for all employees and physicians amid resurging pandemic

Monday, August 2, 2021 - 11:01pm

Making vaccination mandatory is the most effective way we can protect our people, our patients and the communities we serve.

Key Points: 
  • Making vaccination mandatory is the most effective way we can protect our people, our patients and the communities we serve.
  • Unvaccinated employees and physicians will be required to become fully vaccinated for COVID-19 or apply for medical or religious exemption.
  • The Kaiser Permanente organization includes more than 216,000 employees and more than 23,000 Permanente Medical Group physicians.
  • Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health.

Stop Leaving Revenue On The Table: Simplifying Behavioral Health Insurance Billing -- A Free Webinar By TenEleven Group & OPEN MINDS

Monday, August 2, 2021 - 4:00pm

GETTYSBURG, Pa., Aug. 2, 2021 /PRNewswire/ --On August 31, 2021 at 1:00 pm EDT, OPEN MINDSwill host a webinar, Stop Leaving Revenue On The Table: Simplifying Behavioral Health Insurance Billing , courtesy of TenEleven Group.

Key Points: 
  • GETTYSBURG, Pa., Aug. 2, 2021 /PRNewswire/ --On August 31, 2021 at 1:00 pm EDT, OPEN MINDSwill host a webinar, Stop Leaving Revenue On The Table: Simplifying Behavioral Health Insurance Billing , courtesy of TenEleven Group.
  • During this event, Jonathan King, Director of Revenue Cycle Management at TenEleven Group, will dive into the best practices for maintaining a healthy revenue cycle for behavioral health organizations.
  • A complicated insurance billing landscape and the disconnect between payers and providers have compounded the stress providers experience surrounding revenue generation.
  • Don't miss Stop Leaving Revenue On The Table: Simplifying Behavioral Health Insurance Billing onAugust 31 at 1:00 pm ETto understand why insurance billing is so complicated and learn how to avoid common mistakes.

St. Vincent Health Moves its Operations to the Cloud with Infor

Monday, August 2, 2021 - 2:00pm

St. Vincent Health leaders recognized that moving to Infor CloudSuite Healthcare, built on Amazon Web Services (AWS), would help them better manage their most vital resources: people, supplies, clinical data and financial assets.

Key Points: 
  • St. Vincent Health leaders recognized that moving to Infor CloudSuite Healthcare, built on Amazon Web Services (AWS), would help them better manage their most vital resources: people, supplies, clinical data and financial assets.
  • "St. Vincent Health decided to partner with Infor because their solutions offer cost savings while freeing up local resources, and our teams are able to remain agile in an ever-changing industry.
  • "Having this key business information together in real time will help decision makers at St. Vincent Health make more-informed decisions.
  • In addition to primary care and urgent care at St. Vincent Family Health Center, the new St. Vincent Health will offer emergency medicine, rehabilitative therapies, laboratory, imaging, inpatient care, sleep studies and wound care.

Constantine Cannon LLP: US Justice Department Intervenes in Whistleblower Suits Against Kaiser Permanente Alleging Extensive Fraud in Its Multi-Billion-Dollar Medicare Advantage Business

Monday, August 2, 2021 - 1:30pm

CMS risk-adjusted payments for members with certain conditions under Medicare Advantage (also known as Medicare "Part C") average roughly $3,000 per year per condition.

Key Points: 
  • CMS risk-adjusted payments for members with certain conditions under Medicare Advantage (also known as Medicare "Part C") average roughly $3,000 per year per condition.
  • The government's intervention focuses on unsupported diagnosis codes that Kaiser allegedly improperly added through addenda to patients' medical records.
  • Similar one-way chart reviews are at the core of the United States' massive lawsuit against UnitedHealth Group (UHG), in which Constantine Cannon represents the whistleblower.
  • Constantine Cannon also represents Kathy Ormsby in a False Claims Act suit against Sutter Health and its affiliates over similar claims of Medicare Advantage fraud.

Centene Affiliate Wellcare Of North Carolina To Partner With Selected Behavioral Health I/DD Tailored Plans

Monday, August 2, 2021 - 12:00pm

ST. LOUIS, Aug. 2, 2021 /PRNewswire/ -- Centene Corporation (NYSE: CNC) announced today its North Carolina subsidiary, WellCare of North Carolina, will help coordinate physical health services for multiple Local Management Entities/Managed Care Organizations (LME/MCOs) for the state's Behavioral Health and Intellectual/Developmental Disability Tailored Plans (Behavioral Health I/DD Tailored Plans).

Key Points: 
  • ST. LOUIS, Aug. 2, 2021 /PRNewswire/ -- Centene Corporation (NYSE: CNC) announced today its North Carolina subsidiary, WellCare of North Carolina, will help coordinate physical health services for multiple Local Management Entities/Managed Care Organizations (LME/MCOs) for the state's Behavioral Health and Intellectual/Developmental Disability Tailored Plans (Behavioral Health I/DD Tailored Plans).
  • The North Carolina Department of Health and Human Services announced that awardees are anticipated to begin operating as Tailored Plans on July 1, 2022.
  • WellCare of North Carolina began operations for DHHS' Medicaid Managed Care program as a Standard Plan on July 1, 2021.
  • With the implementation of North Carolina's Behavioral Health I/DD Tailored Plans, WellCare of North Carolina will contract withits LME/MCO partners as a Standard Plan partner.

ChrysCapital-backed GeBBS Healthcare Acquires Aviacode

Monday, August 2, 2021 - 11:00am

Aviacode clients will benefit from GeBBS' end-to-end revenue cycle management services, workflow/automation tools and large geographic footprint.

Key Points: 
  • Aviacode clients will benefit from GeBBS' end-to-end revenue cycle management services, workflow/automation tools and large geographic footprint.
  • Through this acquisition GeBBS Healthcare will expand its US based delivery capabilities and its medical coding/audit/CDI services portfolio.
  • GeBBS and Aviacode share a common vision of improving coding quality and reducing the administrative burden on providers," said Milind Godbole, CEO and Managing Director, GeBBS Healthcare.
  • GeBBS acquisition of Aviacode will create a national leader in the fully outsourced end-to-end revenue cycle services and technology market," said Keith Hagen, CEO, Aviacode.

Highmark Health, Highmark Inc. and Allegheny Health Network announce new members to boards of directors

Thursday, July 29, 2021 - 5:15pm

PITTSBURGH, July 29, 2021 /PRNewswire/ --Highmark Health, Highmark Inc., and Allegheny Health Network (AHN) announced today several appointments to and retirements from their boards of directors, effective immediately.

Key Points: 
  • PITTSBURGH, July 29, 2021 /PRNewswire/ --Highmark Health, Highmark Inc., and Allegheny Health Network (AHN) announced today several appointments to and retirements from their boards of directors, effective immediately.
  • "Joseph, Farnam, and Morgan bring a great variety of skills and experience to the Highmark Health board," shared Joseph Guyaux, chairman of the board of Highmark Health.
  • Highmark Health, a Pittsburgh, PA-based enterprise that employs37,000 people who serve millions of Americans across the country, is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions.
  • Allegheny Health Network (AHN.org), a Highmark Health company, is an integrated health care delivery system serving the greater Western Pennsylvania region.

Commission for Case Manager Certification's new board leadership confirms commitment to certification value and accessible, practical professional development

Thursday, July 29, 2021 - 11:35am

MOUNT LAUREL, N.J., July 29, 2021 /PRNewswire/ -- The Commission for Case Manager Certification announced its slate of 2021-2022 officers today.

Key Points: 
  • MOUNT LAUREL, N.J., July 29, 2021 /PRNewswire/ -- The Commission for Case Manager Certification announced its slate of 2021-2022 officers today.
  • The Commission oversees the organizations that provide certification for more than 50,000 professional case managers and disability management specialists nationwide.
  • The Commission for Case Manager Certification is the first and largest nationally accredited case management certification organization, credentialing more than 50,000 professional case managers and disability management specialists.
  • The Commission is a nonprofit, volunteer organization that oversees the process of case manager certification with its CCM and CDMS credentials.