Kirk Czonstka

Is your fully insured health plan struggling to understand terms and considerations related to obesity management? As part of Digital Health New York's obesity working group, FlyteHealth is proud to support DHNY's leadership to empower employers to consider comprehensive obesity care. Check out this five-point framework that enables decision-makers to have meaningful discussions with health plans, pharmacy benefit managers (PBMs) and third-party vendors about what coverage is in place and what can be done to implement, improve or manage that coverage. Read more: https://lnkd.in/gpFnr7Pm

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How do you move beyond just the “what” in claims data? With Amplity Health's qualitative, HIPAA-compliant database, you can get to the “why” treatments are started, switched, or stopped for a richer patient view. Hear Brian O'Donnell explain how accessing unfiltered, candid patient-provider interactions can help manufacturers make faster, smarter decisions for more effective patient care. Learn how Amplity Health can help your commercial teams use intel to drive deeper engagement and better outcomes. https://lnkd.in/gWfK-RkV #datadrivendecisions #gettothewhy #qualitativedatabase #betterpatientoutcomes

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Cigna, eviCore, and Excellus Blue Cross Blue Shield plans have announced coverage for closed-loop #spinalcordstimulation. IPSIS, as part of the Multisociety Pain Workgroup, provided medical directors with substantial evidence of the efficacy of #SCS therapy. https://lnkd.in/ewDH_JVm #IPSISAdvocacy #neuromodulation #InterventionalPainMedicine #PainMedicine #InterventionalPainManagement #PainManagement

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As #GLP1s show promise for cardiovascular health, employers and insurers are navigating how to improve #CVD outcomes without blowing up their benefits budget. On the latest Friends with Your Benefits podcast, John Coleman, CEBS and Hello Heart's VP, Health Strategy Jenn Roberts explore strategies companies are using to protect hearts *and* budgets. ❤️ 💰 Watch here: https://lnkd.in/erUgvRXz #EmployeeBenefits

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For #MedicareAdvantage and #DSNP plans, Health Risk Assessments shouldn’t be treated as a year-end checkbox. In this clip, Dr. Robert Mirsky, Icario’s Chief Medical Officer, highlights why early HRAs are essential: they provide actionable insights upfront—long before claims data is ready.   Discover how early engagement sets the foundation for better outcomes in our webinar: https://lnkd.in/gN-epigK   #MemberEngagement #StarRatings

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As health care costs continue to rise, many employers are turning to virtual and hybrid care options to enhance employee benefits while managing expenses. Our CEO Frank McGillin spoke with Crain's Cleveland Business about how virtual second opinions are helping patients receive accurate diagnoses and timely treatments, which can reduce long-term costs and improve outcomes. Read the article (subscription required): https://lnkd.in/eUH__XgP #digitalhealth #healthcarecosts #employers #virtualcare 

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Join Silvia Sacalis, PharmD, BS, VP of Clinical Services at Healthe, and Scott Parulski, AVP, WC Claim Product Development at Travelers, for an exciting educational presentation at National Comp! Tuesday at 11:00 AM "Crunching Data, Transforming Claims: Driving Better Outcomes with Analytics and AI" In this session, we’ll dive into: 1. Using predictive models to triage and allocate claims based on severity 2. Optimizing provider networks by collecting outcomes data 3. Enhancing clinical review with AI to uncover drug risks 4. Organizing data to combat fraud, waste, and abuse Don't miss this opportunity to learn how data and AI are reshaping the future of claims! #NationalComp

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Today’s the day! 🚨 Join Joe Boyle from Penstock and Kevin Deutsch from Softheon at the New York Health Plan Association webinar as they dive into strategies to help health plans thrive in ACA markets. Don’t miss this opportunity to gain actionable insights to set your plan apart. There’s still time to RSVP 👉 https://bit.ly/3APpZG3 #ACA #HealthPlans #Healthcare

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Total Control Health Plans is a not a product, but a philosophy built around the understanding that when employers have more visibility and control over their health plan they can leverage various strategies to enhance benefits and control costs more effectively than a large insurance company can. We believe the solutions to controlling costs and improving access to high quality care exist, but they will be implemented one employer at a time. We appreciate that Priority Health has increased the options employers in MI have with their new TPA partnership, and we are pleased to advise the first employer in Michigan to implement this new solution. TCHP also advises the first two employers who implemented a self-funded plan with the TPA, Blue Water, when they became the TPA partner of Blue Cross Blue Shield of Michigan a few years ago. Additionally, we are implementing one of the first groups to utilize the Nomi Health network with ASR health benefits effective 12/1. The common theme among all of these employers is a desire to gain more flexibility and control, however there are many differences from there based upon the needs and goals of each employer. We appreciate Crain's Grand Rapids Business and Mark Sanchez for continuing to shed light on the need for new solutions in #healthcare and #healthinsurance.

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🏥 While insurance is a crucial part of Revenue Cycle Management (RCM), it's only one piece of the puzzle. 🧩 Innovative MedTech recognizes that effective RCM encompasses the entire patient journey, from pre-admission to final collection and beyond. We go beyond claims submission, focusing on key areas like contractual agreements, patient volume management, data analysis for both rejections and accounts receivable, collection strategies, case management, and a continuous cycle of improvement. Our expertise, combined with a deep understanding of the medical landscape, helps healthcare providers optimize their entire revenue cycle, leading to financial stability delivering exceptional, patient-centered services, the foundation for patient satisfaction. 📈 يعتبر التأمين الصحي جزءاً مهماً من إدارة دورة الإيرادات. ندرك أن الفعالية تشمل جميع مراحل رحلة المريض، مع التركيز على مجالات مثل اتفاقيات التعاقد، وإدارة حجم المرضى، وتحليل البيانات، واستراتيجيات التحصيل، مما يساعد مقدمي الرعاية الصحية على تحسين دورة الإيرادات وتحقيق استقرار مالي وتقديم خدمات متميزة تركز على رضا المرضى #InnovativeMedTech #RevenueCycleManagement #HealthcareInnovation #PatientJourney #MedicalBilling #ClaimsProcessing #FinancialStability #PatientSatisfaction #DataAnalysis #HealthcareProviders #ContinuousImprovement

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🎥 SPOTLIGHT CLIP: Healthcare providers face several challenges today, including denials or delays of #patient claims. ⚕️👩‍⚕️ Recent statistics show that nearly 15% of all claims submitted to private payers for reimbursement are initially denied. Nearly 50% of those denials are ultimately overturned, but not before 𝐜𝐨𝐬𝐭𝐥𝐲 𝐫𝐨𝐮𝐧𝐝𝐬 𝐨𝐟 𝐚𝐩𝐩𝐞𝐚𝐥𝐬 with the #insurance companies. 💵 💵 💵 Now, developments in #AI and #blockchain #technology are 𝐫𝐞𝐯𝐨𝐥𝐮𝐭𝐢𝐨𝐧𝐢𝐳𝐢𝐧𝐠 𝐭𝐡𝐞 𝐟𝐮𝐭𝐮𝐫𝐞 𝐨𝐟 𝐡𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 𝐩𝐚𝐲𝐦𝐞𝐧𝐭𝐬, enabling a transparent and secure process for both hospitals and payers. 💲 💲 We’re spotlighting Veuu, a #fintech ecosystem for the #healthcare industry that uses a suite of AI tools 𝐭𝐨 𝐜𝐨𝐝𝐞 𝐜𝐥𝐚𝐢𝐦𝐬 𝐚𝐧𝐝 𝐝𝐞𝐭𝐞𝐫𝐦𝐢𝐧𝐞 𝐭𝐡𝐞 𝐟𝐢𝐧𝐚𝐧𝐜𝐢𝐚𝐥 𝐫𝐢𝐬𝐤 𝐨𝐟 𝐝𝐞𝐧𝐢𝐚𝐥/𝐚𝐝𝐣𝐮𝐬𝐭𝐦𝐞𝐧𝐭 𝐢𝐧 𝐣𝐮𝐬𝐭 𝐬𝐞𝐜𝐨𝐧𝐝𝐬, providing claim adjudication the day a patient is discharged from the hospital. 🏥 “𝙍𝙚𝙞𝙢𝙗𝙪𝙧𝙨𝙚𝙢𝙚𝙣𝙩𝙨 𝙛𝙧𝙤𝙢 𝙞𝙣𝙨𝙪𝙧𝙖𝙣𝙘𝙚 𝙘𝙤𝙢𝙥𝙖𝙣𝙞𝙚𝙨 𝙖𝙧𝙚 𝙩𝙝𝙚 𝙡𝙞𝙛𝙚𝙗𝙡𝙤𝙤𝙙 𝙤𝙛 𝙥𝙧𝙤𝙫𝙞𝙙𝙚𝙧𝙨 𝙩𝙤𝙙𝙖𝙮. 𝙏𝙤 𝙜𝙚𝙩 𝙩𝙤 𝙩𝙝𝙚 𝙧𝙤𝙤𝙩 𝙤𝙛 𝙩𝙝𝙚 𝙥𝙧𝙤𝙗𝙡𝙚𝙢, 𝙩𝙝𝙚𝙧𝙚’𝙨 𝙣𝙤 𝙩𝙧𝙖𝙣𝙨𝙥𝙖𝙧𝙚𝙣𝙘𝙮. 𝙋𝙧𝙤𝙫𝙞𝙙𝙚𝙧𝙨 𝙛𝙤𝙪𝙣𝙙 𝙩𝙝𝙖𝙩 𝙥𝙖𝙮𝙚𝙧𝙨 𝙙𝙤𝙣’𝙩 𝙬𝙖𝙣𝙩 𝙩𝙤 𝙥𝙖𝙮 𝙘𝙡𝙖𝙞𝙢𝙨. 𝙋𝙖𝙮𝙚𝙧𝙨 𝙨𝙖𝙮 𝙩𝙝𝙖𝙩’𝙨 𝙖𝙗𝙨𝙤𝙡𝙪𝙩𝙚𝙡𝙮 𝙣𝙤𝙩 𝙩𝙝𝙚 𝙘𝙖𝙨𝙚 - 𝙩𝙝𝙚𝙮 𝙟𝙪𝙨𝙩 𝙘𝙖𝙣’𝙩 𝙥𝙖𝙮 𝙘𝙡𝙖𝙞𝙢𝙨 𝙩𝙝𝙖𝙩 𝙖𝙧𝙚 𝙬𝙧𝙤𝙣𝙜.” Watch short snippets from our recent segment with Veuu CEO and Chief AI Architect Terence Mills; Veuu COO Jane Nemcova; Huntington National Bank CFO Zachary Wasserman, CFA; and Senior Managing Director of Corporate Healthcare Banking at HNB, Daniel R. Storer. #coding #software #ArtificialIntelligence #automation #innovation #tech 🎬 𝗗𝗠𝗚 𝗣𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻𝘀

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The No Surprises Act (NSA) has reshaped how payers handle claim pricing. Tune into this podcast as Zelis' experts share strategies for successfully adapting to changing regulations 👉 https://bit.ly/4fEqVvz #Healthcare #Legislation

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From Medicare Advantage and pharmacy benefit managers to prior authorizations and payor-dominated industry consolidation, it can seem like the deck is stacked against providers. But the game is not lost. There are ways provider organizations can stand up for themselves and their patients and reclaim control of their revenue strategy. On our blog we look at what it will take for hospitals and health systems to pull out of this revenue tailspin and regain a growth trajectory. Read more here: https://lnkd.in/gYer4RPe

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Understanding your insurance coverage and out-of-pocket costs before you’re treated should be table stakes in healthcare. Unfortunately, it often isn’t. That's why healthcare leader Ro has stepped in to fill this gap for one of the biggest blockbuster drug classes to ever hit the market — GLP-1s for type 2 diabetes and obesity. Ro built a free tool to empower patients with the coverage information they need at the beginning of their journey with GLP-1s. Learn more and check out the tool at the link below. https://lnkd.in/eXrTrp6Q

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Without accurate payer insights, strategies to increase market access, therapy adoption, and evidence generation may not be strategic at all. Komodo Patient Insurance uses the one source of truth — patient-level enrollment data — to untangle conflicting information in claims data and identify the “Unknown Payer.” Learn more: https://lnkd.in/gU5qANEm #marketaccess #pharmaceuticalindustry #pharmaceuticals #lifescience  

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Here's today's Healthcare News: 🚨 CMS Proposes Rule to Tackle Health Insurance Scams on ACA Marketplace 🛑 The Centers for Medicare & Medicaid Services (CMS) is cracking down on deceptive health insurance brokers who enroll consumers in low-value plans without informed consent. A new proposed rule would give CMS the power to suspend brokers and agents who fraudulently sign people up for health plans, often switching patients from better plans without their knowledge. Key Points: CMS aims to block brokers who pose a risk to consumers by enrolling them in scammy ACA plans. Complaints are rising about consumers being switched to low-value plans without consent. The proposed rule adds stricter consent requirements for brokers. CMS is accepting public comments on the rule until Nov. 12. 🛡️ Stay vigilant and informed during this open enrollment period! #ACA #HealthInsuranceScams #HealthcareFraud #CMS #MCG #SBMU #SBM101 #ConsumerProtection #OpenEnrollment https://lnkd.in/g8HMp6S7

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