Atlantic Info Services’ Report on Medicare Compliance Information Kansas Physicians’ Group Experience with Recoupment Requests from Secondary Payers

Washington, DC (PRWEB) July 03, 2013

A Medicare audit of a Kansas physician group is raising eyebrows because the audit findings were employed by secondary payers to recoup their share of the purported overpayment, Atlantic Info Servicess Report on Medicare Compliance has learned. Published in the July 1 issue of the weekly newsletter, the physician groups knowledge is a reminder that the use of extrapolation is spreading.

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Their business office manager has a two-foot-higher stack of secondary payer requests for repayment primarily based on the MAC [Medicare administrative contractor] audit, says Richelle Beckman, an lawyer with the Forbes Law Group in Overland Park, Kan., which represents the physician group. As soon as the MAC completed the audit and identified overpayments, all the secondary payers requested their share before the physician practice even received the MACs demand letter or had a chance to appeal the denied claims, she says. If and when the physician practice wins its Medicare appeals, it will have to battle each and every secondary payer separately utilizing whatever appeals process it has established.

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Ernie de los Santos, CEO of the Appeal Academy in Los Angeles, thinks this is a cautionary tale for other providers. In this case, you dont know [the provider] is wrong however. You havent gone by means of due process and they are entitled to due process, he notes. It seems unfair to providers.

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Check out http://aishealth.com/archive/rmc070113-01 to study the article in its entirety.

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About Report on Medicare Compliance&#13

The industry’s #1 supply of timely news and confirmed techniques on Medicare compliance, Stark and other large-dollar problems of concern to well being care compliance officers, the award-winning Report on Medicare Compliance identifies and offers worthwhile guidance on dozens of high-threat billing and documentation issues and foreshadows the subsequent moves of federal enforcers and their armies of RAC, ZPIC and MAC auditors. The best info there is for hospital compliance officers, the 8-web page weekly newsletter consists of insights and techniques not offered anyplace else.

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Given that 1992, Report on Medicare Compliance has been written by Nina Youngstrom, who has a reputation for getting one of the most knowledgeable journalists and incisive writers in the field. With superb contacts at the IG’s workplace and at CMS, and powerful relationships amongst market specialists and compliance officers, every single situation of Report on Medicare Compliance consists of exclusive, inside news.

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About AIS&#13

Atlantic Information Solutions, Inc. (AIS) is a publishing and info organization that has been serving the well being care sector for much more than 25 years. It develops highly targeted news, data and strategic details for managers in hospitals, health plans, medical group practices, pharmaceutical organizations and other health care organizations. AIS items include print and electronic newsletters, internet sites, looseleafs, books, strategic reports, databases, webinars and conferences. Understand far more at http://AISHealth.com.

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Obama Administration Announces Help of Principal Reduction Programs Atlantic Mutual Gives a Resolution

Largo, FL (PRWEB) April 20, 2010

When the Obama Administration announced its help of principal reduction applications in March, Atlantic Mutual, LLC, had already been working on a private sector remedy. Just one year ago, the Administration amended TARP to develop a provision that makes such principal reduction programs possible. Following almost 1 year of research, Atlantic Mutual launched a Principal Reduction Plan in February that will access the Public-Private Investment Program (P-PIP) of TARP to facilitate their system. Sixty days into the plan, Atlantic Mutual supplies an update on the progress of their principal reduction strategy and the particulars of why their Principal Reduction System operates.

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More than the previous two months, Atlantic Mutual has been swiftly expanding to collect files to fill the loan portfolios that they are putting collectively for their interested investors. The portfolios are lender-specific and created to meet the desires of the finish investors. Weve identified a way to underwrite these portfolios of loans so that a qualified investor can decide on the sort of borrower that they want based on capability to pay and borrowing history, rather than utilizing classic underwriting procedures, says Brian Correa, co-founder and CEO of Atlantic Mutual, LLC.

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A Principal Reduction Program ultimately provides an option to the 18 million homeowners across the nation buried in damaging equity that have no other options. Loan modifications have established to be unsuccessful, and lender principal reductions are far and few among (and thats even if a borrower qualifies). Atlantic Mutual is at the forefront of the market by building a Principal Reduction Program that requires the proceeds from Wall Street and brings them to the people of Main Street. The American taxpayer can now advantage directly from the billions of dollars that have been poured into the corporate bailout.

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The premise of Atlantic Mutuals system could look easy: the far more portfolios that are bought via this plan directly translate into far more mortgage principal reductions for struggling property owners. Even so, the number of investors participating is limited. The P-PIP has only nine capital fund managers that can make purchases, and an interested investor must offer the adequate capital and be registered with a single of these nine managers. When qualified as an investor, the plan utilizes federal government TARP cash to assist investment funds acquire huge bundles of toxic assets at a discount from the banks. The savings from the government-financed purchases enables those discounts to pass to homeowners by issuing new loans at, or below, current market place worth.

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The incentives in this program for all parties involved are structured in such a way that its not unrealistic to expect to see principal reductions completed for many certified home owners over the next handful of years, explains Brooke Errett, co-founder and CFO of Atlantic Mutual, but in order for that to happen, a lot more legitimate enterprises will require to supply similar applications and more investors will need to have to step up to the plate. We also plan to continue raising bank participation by way of educating absolutely everyone on this process.

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Through their expansion, Atlantic Mutual, a residential monetary consulting firm at the forefront of mortgage principal reductions, is building the infrastructure essential to deal with the huge influx of inquiries about its exclusive Principal Reduction Program. In reality, (Ms. Errett) and I still take a few incoming calls per day to stay connected with the men and women that we are helping. I feel the biggest disconnect is that Wall Street nevertheless looks at these mortgages as numbers. Whereas, we realize that we are dealing with person home owners, and we want to meet their needs, says Mr. Correa.

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The organization encourages all home owners to get in touch with to inquire about the information of their Principal Reduction System. We pride ourselves on the transparency of our business, says Ms. Errett. We want our consumers to know that they can ask us queries about where we are with our files and what we do differently, and that they know they will get an honest, direct answer.

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As Atlantic Mutuals Principal Reduction Program becomes increasingly well-known, much more and much more home owners, stuck in an upside-down mortgage, are becoming conscious that they have options. At this point, everybody understands that it is basically a matter of acquiring the data out to homeowners. Fortunately, principal reductions are obtaining far more media coverage, and robust national advocates, like President Obama and Representative Barney Frank, support to give credibility to these applications.

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Weve come to rely on the efforts of our Congressmen to make our program possible. (Atlantic Mutuals) Principal Reduction Plan operates far more effectively with the far more progressive initiatives that we see in Congress, explains Ms. Errett. I am excited about Representative Franks initiatives on secondary mortgages encouraging lenders to work with each other only makes our job easier. I encourage all of our customers to attain out to their Congressmen to assistance such initiatives.

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But most property owners do not know about principal reduction programs, and walking away looks like the only actual selection. Mr. Correa explains that [t]hese are folks that may have the resources to make their payments, but cannot see the sense in continuing to pour funds into a hopeless investment. The Principal Reduction Plan developed by Atlantic Mutual was created to assist precisely these folks.

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Unlike the multitude of programs out there only for default borrowers at danger of foreclosure, the Atlantic Mutual Principal Reduction System provides that answer for homeowners who are up-to-date on their mortgage payments and at the moment ignored by public programs. In turn, their plan addresses the concerns of opponents of principal reductions who think such applications will lead to an concern of moral hazard, exactly where borrowers will default on their mortgages to qualify for the applications. Ms. Errett tells that [m]oral hazard isnt an issue with our plan. We encourage our clientele to stay up on their payments in reality, we call for it.

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Atlantic Mutuals Principal Reduction Plan not only demands that clientele be on-time with their payments customers need to also have documentable income and meet a tight debt-to-revenue threshold. Fortunately for most borrowers, the business has other applications (like debt management) that can assist borrowers to remove debt and qualify for the Principal Reduction System.

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When discussing the influx of principal reduction providers, Mr. Correa says, I cant speak for any person else out there, but I do know weve been functioning about the clock building a remedy to this dilemma. Our Principal Reduction System is based on a tight formula that brings taxpayer dollars back to the taxpayerthe American homeowner. In fact, our system is patent-pending. Often it just requires a little private-business enterprise to make a public plan perform. No one else does what we do the way we do it.

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The plan provides a win-win predicament for all involved. Banks win simply because they are in a position to unload their toxic paper with out possessing to clean up foreclosure right after foreclosure. Investors win simply because they are able to acquire at large discounts. Property owners win simply because they can finally get the relief they have sought right after for so long.

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And the taxpayer wins because the country is now in position to resolve the mortgage crisis even though truly utilizing private business as an alternative of spilling out much more government funds to do so. Initial glance says that this Principal Reduction Plan is a winner.

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For concerns or inquiries, please contact info(at)atlantic-mutual(dot)com or get in touch with 888.850.6772. Or, go to Atlantic Mutuals site at http://www.atlantic-mutual.com.

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For media inquiries, please get in touch with Brooke Errett at brooke(at)atlantic-mutual(dot)com.<

Brand-New Atlantic Data Services Report Outlines Exchange Regulations Governing Pharmacy Rewards

Washington, DC (PRWEB) June 28, 2013

Market-top overall health enterprise data publisher Atlantic Details Solutions is pleased to announce the release of Designing Pharmacy Rewards in Health Insurance coverage Exchanges. The book, the first in AISs Management Insight Series, outlines the overall health insurance coverage exchange regulations governing pharmacy positive aspects, and provides approaches for maximizing the value of the pharmacy benefit even though still complying with state and federal guidelines.

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Of the ten important overall health positive aspects that have to be incorporated in little-group and person items sold on health insurance exchanges in 2014, the rules governing prescription drugs have changed the most since HHSs initial guidance. Wellness plans need to develop a much more substantial pharmacy benefit than initially anticipated, which could effect their potential to contain charges.

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Supplying simple advice presented in an easy-to-comply with question-and-answer format, Designing Pharmacy Positive aspects in Health Insurance coverage Exchanges is intended to support pharmacy, clinical services and medical directors strategic planners product development, contracting and marketing and advertising executives and financial and operations executives at wellness plans, PBMs and pharmacy advantage administrators, pharmaceutical makers and consulting firms get to the bottom of crucial troubles such as mid-year formulary alterations and how specialty drugs may possibly be treated beneath the regulations. And relevant regulations and bulletins supply the tools necessary to make positive pharmacy benefit style complies with state and federal exchange needs whilst balancing price with access.

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Designing Pharmacy Rewards in Well being Insurance coverage Exchanges includes material adapted from a December 2012 AIS webinar presented by John Jones, Senior Vice President, Professional Practice and Pharmacy Policy at OptumRx, a UnitedHealth Group Business, and Caroline Pearson, Vice President of Avalere Health LLC, as nicely as appendices of vital overall health rewards information.

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For a lot more info on Designing Pharmacy Benefits in Overall health Insurance coverage Exchanges, including a complete table of contents and a PDF of the foreword to the report, pay a visit to http://aishealth.com/marketplace/designing-pharmacy-benefits-well being-insurance coverage-exchanges.

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AISs Management Insight Series is created to give practical solutions to complex business challenges with the support of the industrys most insightful advisors and managers. See a full list of titles in this series at http://aishealth.com/marketplace/insight-series.

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About AIS

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Atlantic Data Solutions, Inc. (AIS) is a publishing and information company that has been serving the wellness care sector for far more than 25 years. It develops highly targeted news, data and strategic details for managers in hospitals, well being plans, medical group practices, pharmaceutical organizations and other health care organizations. AIS products incorporate print and electronic newsletters, internet sites, looseleafs, books, strategic reports, databases, webinars and conferences. Find out more at http://AISHealth.com.

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