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Si's Library
This room contains pieces drawn from my experiences at Health Decisions. It offers practical advice for anyone involved in managing group health plan expenses.
From the present, this room contains articles and reports by others that I wanted to share. Reasons for sharing will vary, so expect a potpourri.
This room provides reference points and norms I have observed or documented that can be used by persons trying to get their bearings in the often confusing world of group health.
This room contains my views on the future of the US health care system. My intent is not to convince anyone, but to broaden the discussion beyond the political debate that passes for health reform in America.
This room contains recordings and trasncripts of conversations I've had with interesting people I have had the privilege of meeting. Some are friends, some professional acquantances; all have interesting perspectives worth sharing.
From the past, this room contains some of the talks and articles I have done that I thought were worth sharing.
Use the above navigation buttons to filter Si's Library by category.
Provider Scorecard
Thursday, November 18, 2010 1:07:00 PM
Categories:
Prior Presentations
Finding claim overpayments is easy. Collecting them is not. Claim audits routinely find 5% to 10% in overpayments. But collection efforts typically yield 1% to 3%. Why does this happen? What can be done to improve overpayment collection ...
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Past-Payment Administration: The Missing Link in Health Plan Management and Control
Tuesday, October 26, 2010 1:25:00 PM
Categories:
Prior Presentations
Automation has revolutionized health claims payment. More claims are paid faster by fewer people. Yet administrative costs and payment errors have not gone down and in many instances have actually increased. How can this be? This webinar...
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Complete Enrollment: The Source of Cost Control
Tuesday, September 28, 2010 2:32:00 PM
Categories:
Prior Presentations
The longer you work in health benefits the more you realize that all costs are enrollment driven. That’s right, all costs: premiums, claims, risk, fees, liability, compliance, etc. FACT: Health care cost control requires accurate,...
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Restoring Competition to the Self-funded Market
Monday, August 23, 2010 10:56:00 AM
Categories:
Prior Presentations
Nationwide, the self-funded, group health market has become dominated by high cost administrators who justify their high costs with assertions of larger “provider discounts.” Competition in this market relies on meaningless and misleading...
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Maintaining "Grandfather" Status: Is it Worth It?
Thursday, July 29, 2010 4:03:00 PM
Categories:
Prior Presentations
Health reform is forcing every existing plan to decide whether it wants to maintain its status as a "grandfathered" plan. Not every plan will come to the same answer. This webinar will help attendees weigh the pros and cons of maintaining...
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Administrative Performance Contracts: "Trust but Verify"
Thursday, June 24, 2010 3:38:00 PM
Categories:
Prior Presentations
Every self-funded plan fiduciary places trust in an administrator for day-to-day plan operations. Both the fiduciary and the administrator benefit if they follow President Reagan’s maxim: “Trust but verify.” This free webinar will show...
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Self-Funded Plans and Health Reform: Challenges and Opportunities
Wednesday, May 26, 2010 3:36:00 PM
Categories:
Prior Presentations
Change creates challenges and opportunities. The change brought by the new health reform law is no exception. Self-funded plans will find that parts of health reform are not in their interests. Those that look and prepare will also find...
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Dependent Auditing in the New Age of Health Reform
Thursday, April 15, 2010 3:33:00 PM
Categories:
Prior Presentations
One of the most immediate and significant impacts of health reform for employers will be changes to dependent coverage rules. All dependents are now covered until age 26 regardless of student status, residency, support, or other...
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Managing Medicare Cost Shifting
Monday, March 15, 2010 1:29:00 PM
Categories:
Prior Presentations
Learn from medical claim and enrollment auditing experts Si Nahra, Ph.D., and Judy Mardigian as they share best practices for Dependent Eligibility Auditing. Co-founders of Health Decisions, Inc., the presenters will discuss the Dependent...
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Year-end Auditing
Friday, January 15, 2010 1:38:00 PM
Categories:
Prior Presentations
Auditing is the most fundamental of self-funded plan fiduciary responsibilities. It is also often the most overlooked or ignored. Whether you have just ended a plan year or are preparing for year-end renewals, auditing should be on your...
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