Telehealth and Insurance – It’s Not Complicated!

Telehealth, telemedicine, e-health, online therapy is a major force in healthcare. As healthcare continues to evolve, one of the primary drivers of healthcare change is technology. Technology has helped cure diseases, increased life expectancy and countless other things. Today, one of the newest and up-coming ways in which technology is changing healthcare is through Telehealth.

According to the AMA, “telehealth has the power to transform health care…” for both providers and patients. In the comfort of one’s own home, a patient can speak to a doctor, receive a diagnosis and treatment at a fraction of the cost of a doctor visit. The cost does not include money; it also includes time, effort, sacrifice. Organizations such as the American Telehealth Association have grown in tremendous size to promote the use of and advance telehealth. From both a cost and efficiency standpoint, telehealth is a “win-win” for both providers and patients.

Justin GainesTelehealth and Insurance – It’s Not Complicated!
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The Business of Healthcare is Unavoidable

No matter what field you are in, there will always be a business element to it that is unavoidable. Some fields are simpler than others. For example, if you owned a store selling bolts, the business of running your store would be quite simple. Likewise in many other businesses; it’s just simple & easy. Unfortunately, healthcare is not simple and easy.

Justin GainesThe Business of Healthcare is Unavoidable
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The Republican Controlled House Passed the AHCA. Now What?

By a slim, 217-213 majority, the Republican controlled House of Representatives today passed the American Health Care Act, or AHCA. This is the same bill that failed to get a vote at the end of March, albeit with some minor tweaks. Many must be asking, what happens now? Is the bill law? How will everyone be impacted? I’ll do my best to answer those questions below.

Justin GainesThe Republican Controlled House Passed the AHCA. Now What?
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Where do we stand on AHCA heading into tomorrow’s vote?

As I wrote in my headline yesterday, the House punted the vote on AHCA to Friday. This should not have come as a surprise because the vote tally was way short, and the ultra-conservative House Freedom Caucus refused to back the bill. the HFC has anywhere from 30-40 members and if within the caucus 80% vote a certain way, then the full caucus will vote that way. At this point, the HFC is leaning no.

Justin GainesWhere do we stand on AHCA heading into tomorrow’s vote?
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The House Votes on AHCA Tomorrow (Maybe). My Thoughts…

The Republican controlled House of Representatives, led by Speaker Paul Ryan, is set to vote on the American Health Care Act tomorrow. The American Health Care Act will repeal many of the provisions of the Affordable Care Act and fulfill the campaign promises of the last 7 years from Republicans of “repealing and replacing” Obamacare. The legislation still would need to be voted on in the Senate and signed by the President before becoming law.

Justin GainesThe House Votes on AHCA Tomorrow (Maybe). My Thoughts…
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GreenpointMed Opening New Office in Deerfield Beach, FL


Deerfield Beach, FL: Today, GreenpointMed, Inc., a leading provider of medical billing and credentialing services to healthcare providers, announced the opening of a new office in Deerfield Beach, FL which will serve as the company’s headquarters. Since it’s founding in early 2016, GreenpointMed has enjoyed tremendous growth which necessitated the move to a more permanent home. The new corporate headquarters is conveniently located in the southwest corporate plaza off of I-95 & SW 10th Street at 1350 East Newport Center Drive.

Justin GainesGreenpointMed Opening New Office in Deerfield Beach, FL
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Do you submit PQRS codes for Medicare reimbursement?

If the answer is yes, and you are an LCSW, Clinical Psychologist or Clinical Psychiatrist, you no longer have to.

CMS (finally!) confirmed to me last week that since the PQRS program was “sunset” on 12/31/2016, PQRS codes no longer apply towards reimbursement adjustments. The new program in MACRA, called MIPS (Merit-Based Incentive Payment System), has a quality measurement component that accounts for a large portion of a provider’s MIPS rating. This quality measurement for all intents and purposes is PQRS.

Justin GainesDo you submit PQRS codes for Medicare reimbursement?
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Obamacare Enrollment Skyrockets Across South Florida

Recent figures out from CMS indicate that Obamacare enrollment through the federal exchange soared over the last two months of 2016 across South Florida. This includes Dade, Broward, Palm Beach and Martin counties.

A total of 1.6 million Floridians signed up for coverage or re-enrolled in November & December, 2016, with just under 50% of that number being new enrollment. Miami-Dade and Broward had nearly 600,000 new enrollments, with another 184,000 new enrollments up the treasure coast.

Justin GainesObamacare Enrollment Skyrockets Across South Florida
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MACRA Exemptions

There’s been a lot of focus on what MACRA is. I’ll leave that to the millions of other articles out there describing it. I’m going to focus on a less covered, but equally important topic: exemptions.

You are exempt if you see less than 100 Medicare patients OR collect less than $30,000 in Medicare payments in a calendar year. The key word is OR – a provider only has to be below one threshold to qualify for an exemption. This will impact sole practitioners the most, and fields such as mental and behavior health.

Justin GainesMACRA Exemptions
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The Future Of Health Insurance in a Trump world

Tuesday, November 8th delivered a shocking result in the presidential race which will impact the healthcare landscape almost immediately after January 20th, 2017. While the healthcare industry has spent the last 6 years adjusting and implementing the Affordable Care Act (aka Obamacare), it’s almost guaranteed that one of the first priorities of the Trump administration will be to repeal ACA. With a Republican controlled House & Senate, it is highly likely that large portions of the law will be rolled back, with the entire law repealed not entirely out of the questions. What this means for healthcare providers though is relatively unknown at this point.

Justin GainesThe Future Of Health Insurance in a Trump world
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