Born on May 8, 1950 in Bangor, Maine to John J. Nahra and M. Hilda (Fowler) Nahra, Si Nahra attended St. John’s Grammar School. He spent his high school years at Sacred Heart Juniorate, Ipswich, MA, anticipating a future as a seminarian for the... read more

PLYMOUTH, MI – June 12, 2019 – Health Decisions, Inc., a company with more than 30 years helping employers and trusts discover, recover, and remove waste, abuse, and fraud in their health plans, announced the sale of select assets to Part D... read more

We have exciting news to share with you. For more than 33 years, Health Decisions, Inc. has successfully helped employers, trusts, plan fiduciaries, and health payers reduce wasteful expenditures with our cost-containment services. We recently... read more

This article makes a good case for billing and payment reform. Reference-based pricing using Medicare is a vast improvement over meaningless PPO “discounts” that currently dominate the self-funded market. Providers have completely co-opted PPO... read more

Check out Michael Frank’s personal experience with health care billing. The fact that he is very familiar with how the health care system works makes his comments even more powerful. This is not an unusual event. What is unusual is that someone had... read more

We couldn’t have said it better. Audits are how you find and fight the waste, abuse, and fraud in every health plan. When is the last time you audited your plan claim and enrollment spend? It should be every year. If you haven’t audited in over... read more

We'll be keeping an eye on this case making its way through the legal system. It may help resolve one of the biggest impediments to payment reform: provider balance billing. read more

This article in the latest MyHealthGuide Newsletter warns of hidden TPA fees. Hidden fees are more common and costly now than ever before. That growth is tied to PPO agreements that let payers and providers agree on how to spend plan money without... read more

While not garnering the headlines of the “repeal-and-replace” debate, in his "MyHealthGuide” Newsletter Ernie Clevenger shares reporting on a significant development – bi-partisan Congressional action! The House passed a bill, (HR 1304) “The... read more

The Republican controlled Congress announced yesterday that it has taken the first steps toward repealing the Affordable Care Act (ACA) and replacing it with the American Health Care Act (AHCA). There will be a lot of steps and a lot of time between ... read more