Results for Medical Claims

NAHGA is a Third Party Administrator (TPA) that is nationally recognized for processing claims with a personal touch. While we value technology, we know that automation cannot take the place of a friendly voice and a personal connection with your adjuster.

LONG BEACH, California — The law of unintended consequences is playing out in the wake of the Patient Protection and Affordable Care Act as ramifications “trickle down” through the property/casualty space.

NEW YORK, June 3, 2013 — Riding a bike to work or school is a great way to get some exercise, save money on commuting costs and cut back on your carbon foot print. Regardless of how you plan to use your bicycle, it is important to know the rules of the road and properly insure your bike, according to the Insurance Information Institute (I.I.I.)
And it’s a fact that bike riding is gaining in popularity. The League of American Bicyclists points out…

The AMA has come out with a report stating that one in five medical claims submitted to health insurance companies are paid incorrectly.

How do I find out what insurance covers and how much I owe
We send Blue Cross Blue Shield of North Dakota (BCBSND) members an Explanation of Benefits form (also known as an EOB), in the mail after they receive medical care. EOBs, which you can also sign up to receive electronically , include important information about how your medical claims were processed.
EOBs explain where and when you received medical care with your insurance coverage, how much of the original claim your…

The concept of being “at risk” has to do with the level of financial risk the entity has in funding the care its patients receive. As profit-oriented enterprises, insurance companies generally assess the insured’s risk and base the premium on the anticipated cost of care with the ultimate goal of minimizing that risk. MedicareAdvantage plans are insurance companies, in a sense, that are paid a capitation…

How Are My Premiums Used
One common question we receive from our members is how the premiums they pay are used.
The answer can be a little complicated, but we hope this will help explain it.
Members pay premiums in exchange for health insurance coverage. If you have health insurance through your job, you might see on your paycheck stub that your premium was deducted from your paycheck.
Breakdown
Here is a look at how Blue Cross Blue Shield of North Dakota premium…

While there is a great deal of focus on resource availability and handling a potential influx of severe inpatient cases resulting from COVID-19 infections, the majority of the United States saw a dramatic reduction in healthcare services around March and April 2020 and measurable reductions continue with great variation across the nation
As with many prospective risk adjustment models, Medicare Advantage (MA) and Part D (PD)…

People often ask us what happens to the health insurance premiums our members pay. Here is an explanation
Blue Cross Blue Shield of North Dakota charges premiums in exchange for providing our members with health insurance coverage. If you get insurance through your job, your premiums may be deducted from your paycheck or direct deposit.
Here is a look at how BCBSND premium dollars were used in 2014. For every premium dollar BCBSND members paid:
87.2 cents went to cover the costs of…

Did you know your dental health can give clues into what’s happening throughout your entire body
Numerous studies have found a correlation between oral health and health issues elsewhere. It turns out the health of the mouth has an effect on your risk for serious conditions like diabetes and cardiovascular disease. That’s why it’s critical to understand this connection between overall health and the state of…

Healthcare is becoming increasingly expensive, and no one is more familiar with this issue than employers offering sponsored health plans. While there is much published data that outlines the justification for raised premiums, many rising healthcare expenses are most often the result of unnecessary procedures and human error. These high costs charged to businesses are often inconsistent and unrepresentative of healthcare data, which is intentionally concealed…

This presentation features a compilation of national medical malpractice claim data from 2006 to 2015. It highlights the three most prevalent chief medical factors and patient outcomes by specialty.

Advantages of PPO Network Claims in International Medical Insurance. Cashless direct billing when visiting participating providers within a PPO network in International Medical Insurance.

Pinpointing whether a particular injury was work-related challenges physicians and employers. Some schemers take advantage.

Misdiagnosis: An Important Factor in Medical Malpractice Claims

At the 2015 SIIA Annual Conference, a panel presented a session entitled “How Medical Red Herrings and Over-Diagnosis Drive Poor Outcomes and Big Losses”. The panel was: Dr. David Ross, Chief Medical Officer from NeuroPas Global LLC Keith Rosenbloom, Senior Strategist Workers Comp and Risk Control from Lockton Companies LLC Dr Jennifer Christian, President of …

Infinity Auto Insurance explains what to do in a car accident. These important steps can prevent delayed insurance claims and help your car insurance company...

Radiologists are involved in 15% of diagnosis-related medical malpractice claims, second only to those of general medicine health care providers, according to a report released by Coverys.

Are you confused about how much money you will have to pay for a travel medical insurance claim? Read on to learn how a deductible, medical maximum, and coinsurance work in relation to a claim.