SALES INTEL- valuable lessons to be learned

FYI: Please take a moment to skim the attached two headlines in today’s news and feel free to share them with your sales team:

  1.  Medical Center of Central Georgia, Macon, Georgia agrees to pay $20-million (Modern Healthcare (4-28-15) for improperly billing short-term stays as inpatient rather than outpatient visits. This press release is a very good reminder for everyone in the field to respect that site of service must be determined by the healthcare provider and is solely dependent upon the patient’s clinical need.
  2. Aetna’s profits jump 17% on lower medical costs (Modern Healthcare 4-28-15). Why? Because Aetna is denying pre-certification in many high cost specialties and forcing healthcare providers in active clinical practice to appeal decisions by unqualified non-surgeon reviewers about what is medically necessary. This press release is a good “heads-up” for everyone in the field to appreciate the importance of helping healthcare providers appeal any initial adverse determinations for appropriately selected patients.

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