Wisconsin Gov. Tony Evers is set to reject legislation that would allow...

...advanced practice registered nurses to treat patients and write prescriptions without physician oversight.

 The Wisconsin Assembly passed the Senate version of SB 145, called the APRN Modernization Act, Jan. 25. The bill would modernize the state's practice model to add licensing for APRNs in four practice roles, allowing them to practice without supervision by a physician or dentist and issue prescription orders.

Top 10 payers by Medicare Advantage enrollment in 2024

UnitedHealth Group: 9.5 million (1%)
Humana: 5.9 million (2%)
CVS Health: 3.9 million (15%)
Elevance Health: 2 million (-1%)
Kaiser Permanente: 1.9 million (0%)
Centene: 1.2 million (-11%)
BCBS Michigan: 696,000 (4%)
Cigna: 597,000 (-1%)
Highmark Health: 417,000 (4%)
Florida Blue: 332,000 (0%)

Do you have any issues with underpayment recovery from insurers on accounts older than 90-days?

Larry G. Potter
Senior Underpayment Recovery Advisor
Lgpotter33@gmail.com
Text: 1-847-872-4047

10 hospitals closing departments or ending services.

 A number of healthcare organizations have recently closed medical departments or ended services at facilities to shore up finances, focus on more in-demand services or address staffing shortages.

Some of these might have been prevented with a simple call.

Larry G. Potter

Senior Underpayment Recovery Advisor

Lgpotter33@gmail.com

The largest payers are 10x the size of the largest health systems.

The negotiating imbalance continues to grow in favor of the payers. One 2023 analysis found the market-leading insurer in the least competitive insurance markets pays 15 percent less to hospitals than the market-leading insurer in the most competitive markets, for example. Negotiated rates are just one part of the problem hospitals face amid growing payer power, along with denials and reimbursement policies that make a growing portion of payment slow, costly and inconsistent. At the same time, payers are finding the world more difficult in terms of profitability than they were. The most advantageous payers are a mix of payers and providers.

Well, over 1000 hospitals have turned to the underpayment recovery platform with no upfront fees.

The minimum considered is $2M from a hospital's or medical center's top three insurers. A simple call will get the process started on accounts that have been basically written off!!

Larry G. Potter

Senior Underpayment Recovery Advisor

Lgpotter33@gmail.com

Text: 1-847-872-4047

St. Louis-based Ascension has reported a $3 billion operating loss on revenues of $28.35 billion in fiscal year 2023 as...

...it struggled to address high operating costs and sustained revenue challenges.

Larry G. Potter

Senior Underpayment Recovery Advisor

Lgpotter33@gmail.com

Text: 1-847-872-4047

Maine health system laying off 31 employees.

 

Lewiston, Maine-based St. Mary's Health System, a member of Knoxville, Tenn.-based Covenant Health, is laying off 31 employees and reducing working hours for additional employees.

In an effort to address financial challenges and ensure long-term sustainability, the health system, which includes a 233-bed acute care community hospital, will also end 2023 with a negative operating margin. The pandemic, low patient numbers and revenue, rising supply and labor costs were also listed as reasons for the layoffs.

The underpayment recovery platform was designed to help hospitals & other medical facilities recoup millions from underpayments by insurers.

They only engage remittance files that clients expect no further revenues. Therefore, their services compliment all other RCM efforts and provides new revenues…100% of the time.

Larry G. Potter

Senior Underpayment Recovery Advisor

Lgpotter33@gmail.com

Services being cut....

 A number of healthcare organizations have recently closed medical departments or ended services at facilities to shore up finances, focus on more in-demand services or address staffing shortages.

Larry G. Potter

Senior Underpayment Recovery Advisor

Lgpotter33@gmail.com

Text: 1-847-872-4047