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Susumu Hachirou
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The Harver Group Management : Cirrus Staffing Services starten mit einem Piloten der Talent-Tonhohe

Cirrus, der ABU-Arbeitsvermittlung für Jobs in der Contact-Center-Branche hat ein Pilot aus der Talent-Pech, die online-Bewerbung-Tool für Contact Center gestartet. Das Ziel des Pilotprojekts ist zu prüfen, ob die Effizienz des Rekrutierungsprozesses verbessert werden kann, während die minimale Qualität gleich bleibt. Ich möchte auch weiter reagieren auf die Tonhöhe mit dem Cirrus-Talent aktuelle Trends und Entwicklungen im Bereich der online-Kommunikation und bewerben.

Einige der Kandidaten, die auf der Suche nach einen Job durch das Talent in Cirrus online Tonhöhe. Es wird erwartet, dass diese Reichweite erstellt werden kann und ein breiteres Publikum richtet, einschließlich derer, die nicht physisch in der Lage zu kommen und aus der Ferne anzuwenden sind. Kandidaten durch die Outbound- oder inbound-Variante aus der Talent-Pech, abhängig von der Funktion, die sie nicht gelten.

Die (vor-) Auswahl basiert auf 3 Kunden Gespräche, die der Kandidat zu unterschiedlichen Fähigkeiten einschließlich Multitasking, Sprachkenntnisse, geht durch Eingabe von Fähigkeiten, sondern auch die Verwendung von Kommunikation-Stilen zu messen. Der Kandidat dann erstellen Sie eine Intelligenz und Persönlichkeitstest. Die Talent-Tonhöhe führt zu einem übereinstimmenden Ergebnis. Das passende Ergebnis ist nicht direkt annehmen oder ablehnen von Grund. Zur Zeit, die der Kandidat vervollständigt wird das Talent der Werber persönlich auf seine Anwendung und Ergebnisse aussehen Pitch.

Die Ergebnisse des Spielfeldes Talent geben einen Überblick über die Erfolgschancen des Kandidaten in der Funktion der Call-Center-Mitarbeiter. Die Videos in der Talent-Pitch geben direkt ein Bild über die Arbeit in einem Call-Center. So wählt den Antragsteller bewusst anwenden und er/Sie weiß, was erwartet wird. Dies erhöht die Chancen für eine Übereinstimmung. Darüber hinaus das Tool wie ein Stück Bestätigung eines Verdächtigen. Auf der Grundlage der CV kann jemand sehr geeignet belegen diese Vermutung kann fehlleiten der Talent-Pitch ermöglicht mehr Sicherheit entsteht. Es gibt auch Bewerber, die noch nicht call Center Erfahrung. Sie können sehr gut geeignet, aber Sie nicht lesen, dass dies aus der CV den Talent-Pitch bietet ein Ziel betrachten das Auswahlverfahren und den Recruiting-Prozess effizienter zu gestalten und so kann es unerwünschte Umsatz reduzieren. Dies kann zuletzt nach 6 oder 12 Monaten gemessen werden.

Erwin Pakar, Direktor des Cirrus sagt: "der ganze Weg der Rekrutierung hat in den letzten Jahren deutlich verändert und wir verwenden Sie für einige Zeit online-Techniken, Videos, BEWERTUNGEN und Tests über das Internet wissen. Wir wollen dies weiter und jetzt entwickeln hilft uns das Talent oder Pitch untersuchen. Das Talent für unsere Kunden und Kandidaten muss nutzen und das Raster der Pilot sollte sag. Allerdings finden wir, dass der Ergebnisbericht eines Kandidaten mit mehr Erklärung der Partituren, so auch leicht verständlich für unsere Kunden erweitert werden kann."

Diese umfassende Ergebnisbericht wird derzeit entwickelt. Personalvermittler und Unternehmen, die indirekt mit dem Talent-Ton, zum Beispiel durch die Arbeitsagentur arbeiten können neuen Bericht Beurteilung des Antrags des Bewerbers gut und die Ergebnisse richtig zu interpretieren.

http://harver.com

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6 tips for å kjøpe helseforsikring gi ikke deg en migrene

Mer enn 8 millioner mennesker er registrert i helseforsikring gjennom regjeringen markedet, ifølge US Department for Health and Human Services. (Alex Williamson/Ikon bilder/Corbis)

Hvis du ikke har tenkt på helsevesenet dekning i 2015, nå er tiden. For planer i regjeringen exchange må du registrere av 15 desember for at dekning å starte 1 januar. Og med flere nye og kommende endringer i planer og forskrifter, gjeldende plan kan ikke lenger være det beste alternativet.

"Selv om du hadde dekning i år som du var veldig fornøyd med, det er en god idé å gå tilbake til markedet for å se hvilke alternativer du har," sier Rachel Klein, direktør for organisatorisk strategi for familier USA, en nonprofit forbruker helsevesenet advocacy gruppe. "I de fleste markedsplasser, fordeler og priser endret mye."

Hvis du er en av de 17 prosentene av amerikanere uten helseforsikring, kan høyere straffer gi deg ekstra insentiv til å melde i år. I 2015 går avgiften for å være uforsikret opp til 2 prosent av din inntekt, versus 1 prosent i 2014. (Noen er unntatt fra straffen.)

Men du trenger ikke å tilbringe timer knaser tall, forbannet på datamaskinen og lidelse gjennom byråkratiet-indusert hodepine å finne riktig helse forsikring for deg og din familie. Yahoo helse snakket med helseforsikring innsidere å lære måter å forenkle søket, spare penger og beskytte din helse i det kommende året.

Beware av klistremerke sjokk

"Mange mennesker bare se på den månedlige premien og glem å se på andre kostnader," sier Klein. "Så når de går til legen for første gang det året, copayments er høyere enn de ventet dem til å være, eller egenandel er mye høyere. Tenker tilbake på det siste året: hvor mange resepter du fylle månedlig? Hvor ofte du ser legen? Velge en plan med en høyere månedlig premie kan spare deg penger samlet ved å dekke mer av kostnadene.

Jakte ned dette skjulte linjeelementet

Premie, copayments og coinsurance, det er en flere store tall å vurdere: årlige lomme grensen, sier Carrie McLean, en helseforsikring ekspert med eHealthInsurance.com. Hvis du bryter benet eller din datter trenger henne vedlegg fjernet, vil du sannsynligvis blåse gjennom din egenandel og måtte betale for en viss prosent av (kalt coinsurance). Heldigvis begrense helseplaner det totale beløpet du må betale i ett år. Når du har truffet at cap, kalt årlig beløp betalt grensen, seg helseforsikring tar av resten. Grensen kan variere alt fra $500 til $ 10 000 eller mer, så det er lurt å ta en titt og spør deg selv, "I en nødssituasjon, ville jeg kunne komme opp med det?"

Angi informasjonen på nytt

Første skritt bør alle gjøre når forsikring er å gå til healthcare.gov og angi informasjonen å se om du kvalifiserer for økonomisk hjelp betale for forsikring, og hvis så, hvor mye hjelp du får, Klein sier. Hvis du ikke tar dette trinnet, vil du automatisk få samme beløp du mottok i fjor (hvis noe). Men endringene i markedet betyr at du kan kvalifisere deg for mer hjelp, selv om din finansielle status ikke er endret.

Vurdere andre typer økonomisk hjelp

Hvis inntekten er under 250 prosent av føderale fattigdomsgrensen ($39,325 for en familie på to), kan du få ekstra hjelp med egenandeler og copayments, som kalles kostnad-deling reduksjon. Dette er forskjellig fra subsidier som hjelpe oppveie kostnadene for premium (beløpet du betaler hver måned). "Du må kjøpe en sølv plan for å få som hjelper, men det gjør kostnadene for å få helsetjenester mye rimeligere," sier Klein.

Hvis du elsker din doc...

Sørg for å kontrollere at han eller hun er i forsikring nettverket. "En stor feil som folk gjorde i fjor er de bare så på prisen på planen, og de ikke se at deres lege akseptert planen," sier McLean. Du kan bruke Ehelses legen søkeverktøy for å se alle de forskjellige planer din lege tar. Ring kontoret å bekrefte før du begår.

Selv om du er stikker med samme forsikring plan, er det en god idé å sjekke med din lege kontor for å sørge for at de godtar det i 2015. "Nettverket kan endre år til år," McLean advarsler.

Betal din premie tidlig

Din første premie betaling gjøres før den effektive datoen. Vente til siste minutt for å få det, McLean sier, og du kan bli sperret for flere timer når du prøver å betale over telefon eller snakke med kundeservice. Pass på å planlegge betalingen med tid til overs.

Hvis du er fast, kan en lisensiert forsaking agent hjelpe deg kjøre tall, McLean antyder. Regjeringens healthcare.gov nettstedet er en annen god kilde for informasjon.

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Harver Health Insurance Group Tokyo News: Tips for a finne rimelig helseforsikring

Når den Affordable Care Act gikk i full effekt i år, det ga uninsured amerikanere en mektig pådriver til å gå ut og få en tilstandspolicy: et gebyr hvis de ikke oppfyller. Og mens straffen var relativt mild i 2014, det er bare går å øke startet i 2015. Resultatet er mange enkeltpersoner som trodde de kunne ha råd til helseforsikring skyves i markedet.

Det er noen gode nyheter for de på et budsjett, men. ACA inneholder flere forsikring alternativer enn før. Og de på den nedre enden av skalaen inntekt kvalifisere for tilskudd som gjør bonuser mye mer håndterlig.

Hvis du er en av de mange amerikanerne ser for forsikring på sine egne fordi de ikke får dekning gjennom arbeid, Hers hva du må vite for å holde betalinger så lavt som mulig.

Se om du kan få et tilskudd

Hvis du kjøper en individuell helsevesenet plan, kan du enten gjøre det den gammeldagse måten-kjøpe det direkte fra en operatør – eller butikk politikk på på statens helseforsikring ( http://hhicfg.com ) exchange. Bytte, eller "markedet," består av private forsikringsselskaper som må tilby standardisert planer for enkeltpersoner, familier og små bedrifter.

Fra et kostnadsperspektiv er går gjennom dette markedet et tveegget sverd. Fordi regjeringen angir minimum standarder for hva dekkes av disse planene, er deres klistremerket pris noen ganger høyere enn planer solgt utenfor utveksling. Men kan noen forbrukere få inntekter-basert skattefradrag hvis de bruker markedsplassen. Av den grunden alene er det verdt å sjekke dem ut når du ser etter en policy.

For å få et tilskudd som privatperson, må du være en statsborger eller lovlig bosatt i USA og tjene mindre enn 400% av føderale fattigdomsgrensen. Foreløpig som beløper seg til $46,680 eller mindre per år for en privatperson og under $95,400 for en familie på fire. Når du går på webområdet for exchange, vil du bli spurt om din inntekt og familiens størrelse å bestemme kvalifiserer.

Bestemme om en enkel plan som passer dine behov

En av de enkleste måtene å holde den månedlige utgifter i sjakk er å velge en høy egenandel helseplan (HDHP). Du har lavere premie, men også mye mer risiko hvis noe uforutsett skulle skje-de kalles høy fradragsberettigede planer for en grunn.

En fin fordelen med HDHPs er at du kan koble dem med et helse sparekonto, som lar deg betale for lomme medisinske utgifter bruke før skatt dollar. Hvis du er i 15% skatt braketten, er det som å få 15% rabatt på alle de helsemessige ( http://hhicfg.com/blog ) kostnadene som påløper, fra lege regninger til briller.

Hvis du er enda mer dristig, kan en såkalt "katastrofale" plan være verdt en titt. Dette gir bare-bones beskyttelse-du er dekket for tre besøker et år- men salen du med høyere egenandeler og co-forsikring utgifter. Ikke alle kvalifiserer, heller. Du må være under 30 år eller få en motgang fritak som demonstrerer du var ikke råd til dekning på exchange.

Se om du er kvalifisert for Medicaid

I sin søken for å øke antall forsikrede, opprettet ACA et minimum kvalifisering for Medicaid, felles føderale og statlige helse program for lav inntekt innbyggere. Nå må at terskelen være minst 133% av den nasjonale fattigdomsgrensen. Det er $15,521 år for en individuell og $31,720 for en familie på fire. Hvis du er historisk i middelklassen, men inntekten har falt nylig-for eksempel, gikk du deltid på jobben fordi du tar klasser-du kan kun kvalifisere. Du er sjansene er enda høyere hvis du bor i en stat som har reist inntekt cut-off over de føderale kravene.

Heldigvis krever å bestemme du er kvalifisert for Medicaid ekstra arbeid. Det samme programmet som fyller du ut for å se om du kan få en skatt kreditt vil fortelle deg om du er berettiget til Medicaid fordeler.

Undersøke forelder plan

Mange universitetsutdannet disse dager har en tough tid oppdagelse en fulltidsjobb helseforsikring. Men gjør ACA det mye enklere for cash-strapped unge voksne til å få dekning.

Nå kan personer delta eller bo på foreldrenes plan til de blir 26. Det er noen begrensninger her. Du må være enkelt og levende under ditt eget tak. Du må også være økonomisk uavhengige og kunne få forsikring gjennom arbeidsgivers plan.

Bunnlinjen

En av de enkleste måtene å spare penger er å sammenligne planer selges på en utveksling og de selges direkte gjennom en transportør. Men husk at politikk med lavere premier er ikke alltid den beste avtalen hvis de mener dramatisk høyere egenandeler og co-forsikring.

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Harver Health Insurance Counter Fraud Group: Cyberattack Targets Health Insurer Records.

One of the US' largest health insurers, Anthem, has announced last week that millions of their employee and client records have been illegally accessed through a sophisticated cyberattack.

While Anthem is still cooperating with ongoing investigations regarding the attack, the initial information given was that around 80 million customer and employee records in a database were compromised. The data apparently include addresses, birthdates, names, employment and income information.

However, they claim that credit card data were not included in the breach and stated that medical records and doctor information were likely not compromised. 

This could be one of the largest breaches in client data to date and the largest in the healthcare sector, noted Harver Health Insurance Counter Fraud Group (http://hhicfg.com/), as Anthem owns a number of brands like Anthem Blue Shield, Anthem Blue Cross, Empire Blue Cross and Blue Cross of Georgia.

According to the health insurer, they learned of the breach by the end of January and have notified the FBI promptly. Cybersecurity firm Mandiant was also called in to secure Anthem's computer systems.

Anthem Chief Executive Joseph Swedish, whose personal data was involved as well, apologized through a letter and emphasized that they are working continuously to ensure their clients' and staff's data.

Security breach threats are particularly concerning in the financial and healthcare sectors that usually collect sensitive information about clients. Even without credit card information, combinations of names, birthdates and Social Security numbers would be more than enough to gain a lot of money in the black market. In fact, the FBI has already ranked cybercrime as a top law enforcement activity.

Technology experts from Harver Health Insurance Counter Fraud Group and other law enforcement officials are saying that getting hacked is inevitable and it's only a matter of when. They admitted that it is a challenge to keep up with the cyber criminals especially since most of them are based abroad.

Anthem promised that it will give free credit monitoring and identity repair services for affected clients.

Read for more related news @ http://hhicfg.com/blog/

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Harver Health Insurance Group Tokyo News: Gesundheit-Anmeldung-Checkliste bietet Tipps, Ratschläge



Wenn Sie keine Krankenversicherung, durch Ihren Job oder ein Regierungsprogramm wie Medicare oder Medicaid haben, sollten Sie weiterlesen. Du musst bis Feb. 1 Shop für Gesundheits-Berichterstattung für das Jahr 2015 durch die Bundesrepublik Krankenversicherung-Marktplatz oder des Staates Austausch.

Der Markt offen Anmeldung Zeit erwischte einen starken Start Mitte November mit Zehntausenden von Menschen jeden Tag jetzt anmelden. Hier sind fünf Dinge, die es wissen:

Dies ist eine umfassende Krankenversicherung, was viele Arbeitgeber ihre Arbeitnehmer bieten ähnliche Vorteile.

Versicherung schützt Sie vor unerwarteten Krankheitskosten. Damit haben Sie Frieden des Verstandes. Ohne ihn würden Sie die volle Hauptlast alle Rechnungen tragen.

Es ist wahr, dass Sie in Ihrem aktuellen Gesundheitsplan automatisch re-enrolled sein werden, wenn Sie nichts tun. Aber der Plan, der Ihre beste Wahl für 2014 wurde möglicherweise nicht für das Jahr 2015.

Blick über die monatlichen Prämien Krankenkassen zu vergleichen.

Pläne vorhanden in Ihrer Nähe, zusammen mit ihren geschätzten Kosten vergleichen am einfachsten, die Healthcare.gov "Schaufensterbummel" Feature zu verwenden.

Überprüfen Sie, ob Sie für eine finanzielle Unterstützung qualifizieren.

Rund 85 Prozent der Menschen, die in einem Markt eingeschrieben planen ein Jahr vor erhalten-Steuergutschriften, die ihre Prämien erschwinglicher gemacht.

Rufen Sie um Hilfe das Markt-Support-Center bei 1-800-318-2596r. Eine Liste der Gruppen, die persönliche Hilfe bieten kann, finden Sie auf localhelp.healthcare.gov/


Siehe mehr Infos
http://hhicfg.com/
http://hhicfg.com/blog/

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Harver Health Insurance Counter Fraud Group: Health insurance options for ACA shoppers


Maine citizens looking to purchase health insurance on healthcare.gov now have more choices for their 2015 plans. We did a quick roundup of the 3 main players in the local health insurance field in Maine.

Anthem Blue Cross and Blue Shield. A veteran in the health insurance industry, Anthem has been around even before the launch of the Affordable Care Act website 3 years ago. In fact, it has registered over 18,000 Maine citizens as individual clients (i.e. customers who bought their own coverage instead of getting it through work benefits). Their enrolment rates is almost twice as high as their closest rival which is not surprising since they are getting corporate backing from WellPoint, one of the national health insurers with a big market share. 

Almost 20% of the enrollees on the ACA site for 2014 plans  were through Anthem. So this year, they seem to be prepared for a big comeback with their premium rates reduced by 1%.

Harvard Pilgrim Health Care. A newcomer in the industry, the non-profit Harvard Pilgrim came to the market with 4 plans for 2015. Though relatively new, it's already familiar with health reforms from its partnership with the now-defunct Dirigo Health (Maine's effort to increase the number of citizens with health insurance).

Harver Health Insurance Counter Fraud Group noted that with 3 health insurers from which to choose from, Maine citizens are benefiting greatly in a growing competitive market, which is incidentally also a goal of the Obamacare.

Maine Community Health Options. This health insurer from Lewiston has around 80% share of Maine buyers in healthcare.gov's website in the primary enrolment period. This startup was created after the ACA (Obamacare) which provides loans for those who want to create health insurance cooperatives. A number of "co-ops" have already registered enrolment rates that are below their targets but Maine Community Health Options seems to be operating as a great example especially in providing reasonable prices.

This year, the premium rate for their most-availed plan decreased by around 0.5%. Their other premium rates were increased albeit on the less popular plans.

Additional hints: http://hhicfg.com/blog/

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#HarverHealthInsuranceCounterFraudGroupGeneralInsuranceTips

Developed countries such as Japan, USA and Canada have high percentages of people who get insurance coverage for various purposes. It is said that the degree of awareness a populace with regard to the value and benefits of insurance coverage determines the level of economic progress. Or, perhaps, it is the other way around. Economic health could be spurred by people investing in their future security.

Insurance is a form of forced savings which allows people to leverage their future in the event that the unexpected or the unforeseen occurs. A lot of people would not have enjoyed their retirement years without having some form of retirement insurance.

Here are some valuable tips about insurance for business-owners which will help them appreciate what insurance can do for them and what they can do with having one:

1. Make it a practice to consider the merits of three or more insurance companies through brokers or free-lance agents. Find out as much as you can about the companies’ corporate culture. Are they earnestly interested in your losses in case you reach that point? Or are they merely eager to get you to sign a policy?

2. For many small business-owners, self-insurance is common. However, it can be counter-productive as the potential for acquiring coverage for the whole business is sacrificed in favor of the individual. With so much capital available today, it is more prudent to get coverage for one’s business.

3. Annual assessment of one’s property is essential as the needs of your company and the liabilities grow. Waiting for several years to have a re-assessment might compromise your firm’s ability to recover in case of loss.

4. Oftentimes, the insurer has the option to recompense your loss in three ways: paying the amount lost, repairing the insured asset or replacing the same. Nevertheless, let the insurer know which option you would prefer as it could be to their advantage to grant your wish in order to keep you as their client.

5. When arbitration regarding the valuation of any loss does occur, make sure you are properly represented by an arbitration judge. If a compromise is not achieved, a lawsuit will ensue and a longer battle will await you. Unfortunately, there is no insurance against a lawsuit.

Just like investing in stocks, insurance can be a complex and demanding endeavour. But in the end, understanding what you are getting into will help you come out a satisfied winner rather than a sour loser.

About Us

The Harver Health Insurance Counter Fraud Group coordinates closely with its local partners, such as the NHS Counter Fraud Service MOU, NHS Counter Fraud Northern Ireland MOU, NHS Counter Fraud Scotland MOU, City of London Police, National Fraud Authority, Insurance Fraud Bureau, and the Insurance Fraud Investigators Group to assist the process of intelligence and conduct common investigations into fraud.

Health care fraud respects no boundaries. The Harver Health Insurance Counter Fraud Group has official connections with health fraud investigation agencies. If your company is interested in becoming a member of the Harver Health Insurance Counter Fraud Group, kindly get in touch through this site.

Reference:
http://hhicfg.com/

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Harver Health Insurance Counter Fraud Group: Lawmakers Join All-Out Push to Combat Medicare Fraud

WASHINGTON, DC - As law enforcement announced a nationwide sting against Medicare fraudsters today, a bipartisan group of lawmakers in Washington was putting the finishing touches on legislation aimed at making a significant dent in the problem.

Federal law enforcement officials in Miami today announced the details of a multi-agency strike force operation that resulted in the arrest of 90 people nationwide for defrauding Medicare out of some $260 million.

U.S. Senate Special Committee on Aging Chairman Bill Nelson (D-FL) and Ranking Member Susan Collins (R-ME), who have spent a great deal of time examining the problem of Medicare fraud( http://hhicfg.com/ ) and ways to curtail it, commended the actions announced today by federal officials while also saying that the crackdown illustrates the need to do more to stop Medicare fraud.

Nelson and Collins, along with Sens. Tom Carper (D-DE) and Chuck Grassley(R-IA), have authored legislation to strengthen the government's hand in stopping Medicare fraud. The lawmakers plan to formally file the legislation on Thursday.

"This is exactly why we're doing the legislation," said U.S. Sen. Bill Nelson (D-FL) who chairs the Senate Special Committee on Aging. "We've got to get the problem under control."

Senator Collins added, "For decades, the GAO has identified Medicare as being at high risk for improper payments. This is unacceptable. The loss of these funds not only compromises the financial integrity of the Medicare program, but it also undermines our ability to provide needed health care services to the more than 54 million older and disabled American workers who depend on this vial program. Our legislation emphasizes a strategy to prevent fraud from happening in the first place."

"Medicare provides lifesaving care to some of our nation's most vulnerable citizens," said Sen. Carper. "Unfortunately, too many unscrupulous individuals take advantage of this vital program and end up costing taxpayers millions and shortchanging beneficiaries. It is critical that we do all that we can to curb fraud while protecting beneficiaries and ensuring effective care. This legislation is an important step in combating Medicare fraud and preserving this essential program for the future generations. I commend Sens. Nelson and Collins for their leadership in this effort."

"Our bill will build on the Physician Payments Sunshine Act that I co-authored," Grassley said. "It requires HHS to use available data, including data from the Sunshine Act, to verify doctors' reported information about ownership interests in organizations that bill Medicare. This will help flush out any doctors who commit fraud from their own facilities."

Specifically, the legislation will require Medicare to verify that those wishing to enroll in the program have not owned a company that previously defrauded the government. Currently, Medicare relies on self-reported information. As a consequence, a provider who previously had an ownership interest in an organization that defrauded Medicare could potentially get back into the program by using a different name and failing to disclose their interest in the previous organization.

The bill will also allow private insurers to share information about potentially fraudulent providers with Medicare, and requires new medical coding systems to be tested before they're deployed to ensure Medicare's fraud prevention systems work properly. Additionally, the Medicare Payment Advisory Commission will be allowed to make recommendations regarding fraud prevention and Medicare will be required to develop a strategy to reliably estimate just how many taxpayer dollars are lost each year to fraud.

According to a recent estimate, fraud in the country's Medicare system takes some $60 billion to $90 billion annually out of the system and puts it into the pockets of crooks.

The lawmakers' legislation already has the support of the National Health Care Anti-Fraud Association, the Coalition Against Insurance Fraud, the National Insurance Crime Bureau, America's Health Insurance Plans( http://hhicfg.com/blog/ ), Humana and theBlue Cross Blue Shield Association. Continue reading: http://insurancenewsnet.com/oarticle/2014/06/16/lawmakers-join-all-out-push-to-combat-medicare-fraud-a-518362.html

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The Harver Group: More Insured, but the Choices Are Narrowing

In the midst of all the turmoil in health care these days, one thing is becoming clear: No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.

These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans. While the sizes of the networks vary considerably, many plans now exclude at least some large hospitals or doctors’ groups. Smaller networks are also becoming more common in health care coverage offered by employers and in private Medicare Advantage plans.

Insurers, ranging from national behemoths like WellPoint, UnitedHealth and Aetna to much smaller local carriers, are fully embracing the idea, saying narrower networks are essential to controlling costs and managing care. Major players contend they can avoid the uproar that crippled a similar push in the 1990s.

The Times would like to hear from Americans who have signed up for health care under the Affordable Care Act.

“We have to break people away from the choice habit that everyone has,” said Marcus Merz, the chief executive of PreferredOne, an insurer in Golden Valley, Minn., that is owned by two health systems and a physician group. “We’re all trying to break away from this fixation on open access and broad networks.”

For more info: http://hhicfg.com/blog/
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