North Dakota Medicaid and the Wrong-Sized Paper

I have posted often about the methods insurance companies use to avoid payment on claims, whether it’s the claim submission process itself in “The 1500 and it’s Sidekick the EOB,” or more recently, increasingly novel ways payers use to deny payment in “North Dakota Medicaid and Erectile Dysfunction.” Physicians often complain about the difficulty of…

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Sent to a Rural Hospital to Die

Rural hospitals are struggling in many areas, in part because the Critical Access Hospital (CAH) designation was created by the Centers for Medicare and Medicaid Services (CMS) to make rural hospitals band-aid stations. CAH staff is there to triage patients and send most to specialists in metropolitan hospitals. As with many CMS schemes, all the…

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Attracting Physicians to Rural Medicine

  “American medicine is probably the best in the world, but they rush too much and do too much unnecessary surgery.” Dr. Bohdran Hordinsky (1991)   Having written about the problems with one-doc towns in rural areas, specifically rural North Dakota, I thought it would be helpful to provide an example of how the town…

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