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The FIRM provides professional claims billing services for individual providers, clinics and facilities. We service all disciplines of practice, i.e., medical, dental, diagnostic testing, chiropractic, physical therapy, optometry/ophthalmology, mental health, chemical dependency, and durable medical equipment.

We offer specialty services such as consultation, collections and appeals, contracting and credentialing, verification and preauthorization and personal injury settlement negotiating. We offer form development and revision services, office reorganization and personnel training.

We have extensive experience in all areas of commercial insurance, Workers Compensation, personal injury, Third Party Administrators, Medicare, Medicaid, and other state and federally funded programs. We offer personalized services designed specifically to meet your needs.

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Trump urges insurers to work together to ‘save Americans from Obamacare’

Will Obamacare survive? Washington Post - By Carolyn Y. Johnson and Juliet Eilperin February 27 at 12:19 PM  President Trump met with major health insurers Monday morning, in the midst of political divisions over how to dismantle and replace President Obama's signature health-care law, the Affordable Care Act, and intensifying public pressure to preserve the policy. The meeting included leaders from Blue Cross Blue Shield, Cigna, Humana, UnitedHealth Group, Aetna, Anthem, Kaiser Permanente and the industry lobbying group, America's Health Insurance Plans. "We must work together to save Americans from Obamacare," Trump said in public remarks before the closed-door meeting. He criticized the Affordable Care Act, commonly known as Obamacare, for creating minimal health coverage requirements that restricted the types of plans insurers could sell. "Obamacare forced providers to limit the plan options they offered to patients and caused them to drive prices way up," Trump said. "Now a third of U.S. counties are down to one insurer, and the insurers are fleeing. You people know that better than anybody." Over the past month, more insurers have warned that they could pull out of the Affordable Care Act’s health-care exchanges where individuals can buy government-subsidized insurance. Aetna chief executive Mark Bertolini has described the exchanges as being in a "death spiral." Humana — which insures about 150,000 people on the exchanges this year — announced in mid-February it would exit the exchanges in 2018. In an earnings call, Molina Healthcare disclosed that its exchange business lost $110 million in 2016 and said it would evaluate its participation for next year on a state-by-state basis. A Molina spokeswoman said the company, which insures 1 million members through the exchanges, was not invited to the meeting. Trump gave [...]

The Trump administration just proposed big changes to Obamacare

Will Obamacare survive? Business Insider- Feb. 15, 2017, 9:54 AM- Bob Bryan The Centers for Medicare and Medicaid Services on Wednesday morning announced new proposed rules for the Affordable Care Act's individual insurance exchanges. The proposals from CMS include several changes to enrollment periods and timelines for insurers in an attempt at "stabilizing the individual and small group health insurance markets," according to a press release. The proposed changes would be the first administrative tweaks to the law, also known as Obamacare, under President Donald Trump's administration. They contain a combination of long-considered ideas and serious departures from the previous administration. Perhaps the two most striking proposed changes are cutting in half the exchanges' 2018 open enrollment period and lowering minimum standards for care to qualify for the exchanges. The CMS proposes an open enrollment period — during which people without health insurance through their employer or Medicaid/Medicare can sign up for coverage — from November 1 to December 15, 2017. Open enrollment periods have been three months, from November 1 to January 31. Additionally, the rules would lower the "de minimis range used for determining the level of coverage," according to the release. Essentially, the ACA established minimum standards for coverage (here's a full breakdown from CMS) in order to be certified on the bronze, silver, and gold plan levels. The new rule would allow insurers to cover slightly fewer areas of health and still be at a certain metal level. The CMS projects the rules would result in increased out-of-pocket costs for Americans in the short term but that lower premiums would offset this in the long run. "The proposed change in [actuarial value] could reduce the value of coverage for [...]

As Obamacare Repeal Stalls, Republicans Face New Challenges

Will Obamacare survive? NBC News - Benjy Sarlin -FEB 8 2017, 9:55 AM ET President Donald Trump caused a stir when he suggested Sunday that the Republican Party's quest to repeal and replace the Affordable Care Act might continue through 2018. But some Republicans think he might be on to something. "I know there was some hyperventilating about the president's comments that this could spill into next year, but that didn't bother me," Rep. Charlie Dent, R-Pennsylvania, said as he left a caucus meeting Tuesday. "I thought it was fairly realistic." "I do think slowing down would be wise," Rep. Tom MacArthur, R-New Jersey, told NBC News when asked about Trump's comments. Trump's remarks come as efforts to repeal and replace the Affordable Care Act, which began with a bang after the election, are lagging amid internal debates over the substance of a Republican health care plan and the process used to pass it. The current plan is a delicate multi-step path that requires Republicans to use the budget reconciliation process to partly repeal Obamacare by a majority vote and install some elements of a Republican plan, then negotiate with Democrats later on a full replacement, which would require 60 Senate votes. Republicans can't manage many defections — they have only 52 votes in the Senate — and consensus has so far been elusive. On one hand, conservatives are eager to fulfill the Republican Party's longtime promise to repeal the law and replace it with a less expensive plan with fewer taxes and more free-market principles. On the other hand, more moderate Republicans are concerned that removing too much of the law too fast could wreck the insurance market and that some conservative [...]

Doctors Make the Case for Obamacare or Something Like It

Will Obamacare survive? NBC News -HEALTH- Maggie Fox -FEB 2 2017, 6:20 PM ET Congress should improve Obamacare without taking away what's best about it, doctors said Thursday. Doctors who treat women and children, as well as general practitioners, made a daylong dive across Senate offices to make the case for keeping important aspects of the Affordable Care Act. And they rebuked Republicans in Congress for talking up repeal without having a plan for replacement in place. "Currently insured individuals should not lose their coverage as a result of any action or inaction by policymakers," five medical organizations said in a statement released as part of the lobbying push. "Acceptable reform must continue to ensure access to comprehensive, safe, and affordable care," said Dr. Thomas Gellhaus, president of the American Congress of Obstetricians and Gynecologists. The GOP has vowed to repeal and replace the 2010 Affordable Care Act, former president Barack Obama's signature policy. But since they took firmer control of the Senate, kept control of the House and seated Republican President Donald Trump in the White House, they've faltered, quarreling about how to move ahead. “Potential changes in federal Medicaid funding should not erode benefits, eligibility, or coverage compared to current law.” It doesn't help that the law's become more popular in the polls. Republicans do not want to pull the rug out from under the 20 million people who have gotten health insurance under the law, either on the exchanges where they can buy private insurance, often with a federal subsidy, or through expansions of the Medicaid program. "We didn't hear from anyone who said we want to have the 20 million people who have gained coverage under the Affordable Care [...]