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PDF Editor FAQ

How do Donald Trump supporters respond to allegations that Trump University was a "a fraudulent scheme" and "a total lie"?

I think there are those that support D Trump based on his platform and ideas, but I think the answer to your question has more to do with the claims against Trump U. Why didn't you invest in Trump UHC? You probably didn't need a lawsuit to tell you that it would be worthless. Frankly the claims against Trump sound like they could be made against any university (lack of promised access to the elite, poor course development, excessive and deceptive fees and tuition).If you are voting in this election you know what you will get from HRC, she is a skilled and tactful politician with the #1 stud of the past 50 years in her corner. You probably accept all of the suspicious yet unproven rumors of the Clinton foundation, the old whitewater scam, stolen Whitehouse furniture etc because in the end she represents your vision for the US. If you don't like or want that...then you are probably willing to overlook whatever else is going on with the other candidate in exchange for some change (sounds like 2008?)

What are the US healthcare fundamental key topics?

Member Onboarding:1. Outline of Member Life Cycle2. Roles of Sales Team3. Billing Enrollment Process4. Eligibility Enrollment Process5. Member Enrollment ProcessMember Calls:1. What is Advocate 4 Me2. M&R (PDP/MA) and E&I (Prime/KA) Plans and Call Drivers3. M&R (PDP/MA) and E&I (Prime/KA) Systems and Platforms4. Member LifecyclesProvider:1. Overview2. Provider Types3. Provider Life Cycle4. Out-of-Pocket5. Work Type6. Provider AreasClaims:1. Overview of Insurance2. Medicaid & Medicare3. Claim Life Cycle4. UHC Claim businessesAppeals & Grievances:1. Overview2. Appeals Types3. Handling an Appeal4. Timeframe to file an Appeal5. E&I Appeals & it's plans6. M&R Appeals & it's rolesCoding:1. Overview2. Purpose3. Eligibility Criteria to be a Medical Coder4. Future of Medical Coding5. Coding Essentials6. HCC CodingClinical:1. Overview of UHC & Optum Clinical landscape2. WellMed Intake3. Quit for Life Program4. Women's Health Line of Business5. Maternity Support Program6. Capabilities in UCS7. UM Process Flow8. Process Flow of Clinical Coverage Review & Medical Claims Review9. United Clinical ServicesPharmacy:1. Overview2. Roles & Responsibilities of Pharmacy Benefit Manager3. Different OptumRx businessesPayment Integrity:1. Overview2. Payment Integrity Life Cycle3. Vision and ProgramsRevenue Cycle Management (RCM):1. Overview2. Processes used to generate revenue3. COB4. Case study of Patient Eligibility5. Payment Collection process

Once we (hypothetically) get to single payer universal healthcare, will we not see a reduction in costs per average taxpayer?

not if it is Medicare platformmaybe / maybe not if it uses the Medicare Advantage modelbut since we are adding 34 million people when we go to UHC - don’t hold your breath-if we use original Medicare as it is today, and collapse all of the costs into MedicareThe only thing that changes is the entity processing the claimsNo savings, but higher loss due to fraud, waste and abuse, and possibly higher employee costs, since govt wages and benefits are + 20%-here is relevant dataMedicare - original Medicare - which is what the claimed savings is on - only insures 20 million peopleMedicare Advantage - which is what uses the same money per person as Original Medicare, to do more per person, is a demonstration of Private efficiency - and it also covers about 20 millionAll those “other” private insurerscover about 300 million people - 15x as manycover all the medical costs except for deductibles and max out of pocketcover drugscover dentalcover visoncover hearingSo they are two drastically different levels of insuranceMedicare is the Yugo in the insurance world - it is the bare basic-*But Medicare gives more care for every dollar, and does a better job of controlling costs.*roflmaoNope - not even closeIssue 1 - uncounted Medicare imposed expenseMedicare does not pay doctors to do the reportingDoctors are spending $ 15.4 Billion to do Medicare’s reports. Quality reporting costs doctors more than $15.4 billion a year, Health Affairs says (Quality reporting costs doctors more than $15.4 billion a year, Health Affairs says)private insurance is carrying that costUnder a Medicare 4 All - that would be shifted to MedicareMedicare shifted the reporting cost to private pay-issue 2 - different measuring method on losses and wasteMedicare self reports about 10% loss due to fraud waste and abuseThat is not counted in Administration cost claimsMedicare accepts that loss, and although it tries to stop it, it does not exert the same efforts Private insurers doMedicare Funds Totaling $60 Billion Improperly Paid, Report Finds (Medicare Funds Totaling $60 Billion Improperly Paid, Report Finds)Medicare: Actions Needed to Better Manage Fraud Risks (Medicare: Actions Needed to Better Manage Fraud Risks).Insurers are required to count the costs of loss prevention and losses in administration costsThey must also count that in the fixed % they are allowed to use to calculate premiumsThat is a different yardstick-issue 3 - different measuring method on efficiencyYour assertion ignores that Medicare reports data in a totally different format than all other insurersThat is because Medicare does not cover or do what other insurers cover and doMedicare measurers performance per claim - for the claims it processes., and that is how it comes up with the administration costs.But it does not process the majority of claims for most Medicare insured. It only does major medical claims.So because the claim dollar amounts are higher - the per claim dollar amount, Medicare’s % of a claim used for administration, is lowerPrivate insurers are required to report administration costs per patient.Since they also pay that 4.00 prescription claim, or that 50.00 dental claim - the cost to process the claim - even if it were equal - would be a higher % of the claim it was processing.Again - That is a different yardstick-issue 4 - shifted claims costsMedicare does not pay the full cost of a sickness, or diagnosed illness, or the cost of treatmentIt shifts a major portion of the illness to private payAgain - you can have Medicare - but it only processes major medical claims. Everything else - including your monthly medication - is pushed to Private insurers for the SAME Medicare patientI listed my own medical issue - so you could see the actual number of claims on one medical issueAcute DiverticulitisMedicare processed 3 claimPrivate insurers processed 11 claims from 7 providersbut the same diagnosis and treatment planSo a medical claim of a digestive issue - $136,000 for a week in the hospital was my bill, plus $ 20K for in home care. Medicare costs at a glance (Medicare costs at a glance)Medicare A pays $ 1,000, because of the payment schedule, which is one line on claim 1 Acute Inpatient PPS (Acute Inpatient PPS)it’s explained in plan language by KFF A Primer on Medicare: Key Facts About the Medicare Program and the People it Covers - How does Medicare pay providers in traditional Medicare? (A Primer on Medicare: Key Facts About the Medicare Program and the People it Covers - How does Medicare pay providers in traditional Medicare?)Medicare B pays 80% of medical - 80% of 133,580 - one line on claim 1 to process for for $ 106,864Medicare part B pays 80% of the following outpatient servicesremoval of pic line, claim 2doctor visit closing out care, claim 3So Medicare processes 3 claimsPrivate insurance pays 1420.00 deductible for part A - one line 1st on claimPrivate insurance pays Part B deductible - 2nd line on 1st claimPrivate insurance pays 20% of $ 133,580 - third line on 1st claim for $ 26,716Private insurance pays outpatient servicesin home visits over 3 months - claim 2, 3 and 4in home care equipment - claim 5IV medications, 3 months, claims 6, 7, 8oral medications, 3 months, claim 9removal of pic line, claim 10doctor visit closing out care, claim 11all incurred over over 3 months - about $ 20KPrivate insurers processed 11 claimsSame patient, same condition, but different careSo in this case - the administration costs - even at the same per claim administration cost - were 3 Medicare to 11 private insurer for the same medical issueMedicare shifts most care and admin to Private or Medicaid insurances-As you can see - a large part of the day to day part of the Medicare patient’s claims are done by private insurance.So if a private insurer processes 100 claims, and20 are for drug coverage for Medicare patients - and drugs costs are 4.00 to 45.0020 are for add on careand 60 are for patients with medical, dental, vision and Rxand each claim costs 20.00 to processand by law Private insurers measurement is by patientwhile Medicare measures by claimWho do you think would have higher admin costs?andWhat do you think would happen to Medicare Admin costs when Medicare 4 All went in - and Medicare had to do all of the claims it does not do today?There are many articles on thisThe Myth of Medicare's 'Low Administrative Costs' (The Myth of Medicare's 'Low Administrative Costs')Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance (Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance)Medicare is No Model of Administrative Simplicity or Efficiency (Medicare is No Model of Administrative Simplicity or Efficiency)Is Medicare for All the Answer to Sky-High Administrative Costs? (Published 2018) (Is Medicare for All the Answer to Sky-High Administrative Costs? (Published 2018))Comparing Public and Private Health Insurance: Would a Single-Payer System Save Enough to Cover the Uninsured? | Manhattan Institute (Comparing Public and Private Health Insurance: Would a Single-Payer System Save Enough to Cover the Uninsured? | Manhattan Institute)https://www.washingtonpost.com/news/fact-checker/wp/2017/09/19/medicare-private-insurance-and-administrative-costs-a-democratic-talking-point/ (https://www.washingtonpost.com/news/fact-checker/wp/2017/09/19/medicare-private-insurance-and-administrative-costs-a-democratic-talking-point/)Saving Medicare from Itself (Saving Medicare from Itself)

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