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Renuka Rayasam | (TNS) KFF Health News In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online baby message boards and other social media forums , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the Patient Advocate Foundation . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the American College of Obstetricians and Gynecologists . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to spread out one-time payments over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the Peterson-KFF Health System Tracker . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the 100 million U.S. people with health care debt, 12% attribute at least some of it to maternity care, according to a 2022 KFF poll . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said Joy Burkhard , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the timing of the pregnancy , plan benefits, and health complications, said Erin Duffy , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said Sabrina Corlette , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, Lacy Marshall , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Related Articles Which health insurance plan may be right for you? California case is the first confirmed bird flu infection in a US child What’s up with that brown haze across Colorado’s Front Range when it’s not summer ozone season? Your cool black kitchenware could be slowly poisoning you, study says. Here’s what to do Does fluoride cause cancer, IQ loss, and more? Fact-checking Robert F. Kennedy Jr.’s claims Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.Primech Holdings Receives NASDAQ Minimum Bid Price Requirement Extension
Matt Gaetz says he won't return to Congress next year after withdrawing name for attorney general
Maple Leafs superstar Mitch Marner opened up about his selection to Team Canada as they prepare for the 4 Nations Face-Off. With Canada, USA, Sweden, and Finland gearing up for the 4 Nations Face-Off Tournament in February, the Maple Leafs have one representative on each roster. It's a great sign that not only is the team succeeding but that these players are trusted enough to lead their country. Mitch Marner Deserved A Team Canada Roster Spot With him being selected to Team Canada, it was another bright spot in a great season so far for the Leafs superstar. Opening up about the selection, Marner was thrilled to be asked to participate in such an occasion: It will be Marner's 4th time representing Canada on the international stage, and he deserves it for his season so far. On a blistering 100+ point pace, he has 36 points in 25 games and a big reason for Toronto sitting atop the Atlantic Division. Team Canada is with no shortage of firepower too, as Marner gets to join Connor McDavid , Sidney Crosby, Nathan MacKinnon, Cale Makar, and several other All-Stars and future Hall of Famers. It will be interesting to see how head coach Jon Cooper uses Marner given how many stars he has on his team. With the tournament not taking place until February 12, the Maple Leafs star winger will be able to showcase even more of his abilities as he continues to lead the team toward a long playoff push. If Marner can dominate even more, there's no telling the type of success he could help lead Canada to. Toronto's other representatives for the tournament are: Auston Matthews (Team USA) William Nylander (Team Sweden) Jani Hakanpaa (Team Finland) While Auston Matthews, William Nylander, and Mitch Marner are names you'd expect, Jani Hakanpaa's inclusion is a great story as well for the defenseman as he has dealt with some career-threatening injuries. It will be a battle of superstar teammate wingers as Team Canada takes on Team Sweden to kick off the tournament to kick off the tournament at the Bell Centre on February 12 with Marner looking to help the red and white come home with the gold. This article first appeared on Hockey Patrol and was syndicated with permission.WINDSOR, Conn. , Dec. 9, 2024 /PRNewswire/ -- SS&C Technologies Holdings, Inc. (Nasdaq: SSNC) today announced an initial agreement with Insignia Financial (Insignia) to deliver superannuation member administration services. Insignia Financial supports around 1.1 million superannuation fund members through its wealth management offerings. Upon signing a final binding agreement, more than 1,000 team members in seven offices across Australia will transfer from Insignia to SS&C. The team will then leverage SS&C's in-house technology to automate processes and streamline operations while providing top-notch service delivery to Insignia's customers alongside SS&C's experts. "As a leading global provider of retirement solutions, SS&C is a trusted partner with extensive expertise in fund administration. We anticipate the collaboration with SS&C will provide our more than 1.1 million members with an improved experience delivered by contemporary technology, our people with the opportunity to be part of a large global enterprise, and greater cost efficiencies," said Insignia Financial's CEO Scott Hartley . "We look forward to welcoming Insignia Financial staff to the team and working closely with our new colleagues," said Bill Stone , Chairman and CEO. "Insignia Financial is one of the largest wealth management businesses in Australia and will be our largest client in Australia . This collaboration will put SS&C one step closer to becoming the leading superannuation administration provider in the region. As more funds look to partner with trusted external providers, we look forward to delivering the best technology and service to optimize superannuation administration for Australia's investors." About Insignia Financial Ltd. With origins dating back to 1846, today the Insignia Financial is a leading Australian wealth manager. Insignia Financial provides financial advice, superannuation, wrap platforms and asset management services to members, financial advisers and corporate employers. Further information about Insignia Financial can be found at www.insigniafinancial.com.au About SS&C SS&C is a global provider of services and software for the financial services and healthcare industries. Founded in 1986, SS&C is headquartered in Windsor, Connecticut , and has offices around the world. Some 20,000 financial services and healthcare organizations, from the world's largest companies to small and mid-market firms, rely on SS&C for expertise, scale and technology. Additional information about SS&C (Nasdaq: SSNC) is available at www.ssctech.com . Follow SS&C on Twitter , LinkedIn and Facebook . View original content to download multimedia: https://www.prnewswire.com/news-releases/ssc-signs-agreement-with-insignia-financial-302326720.html SOURCE SS&CMatt Gaetz says he won't return to Congress next year after withdrawing name for attorney general
President-elect Donald Trump has signed onto an agreement that will help create a smooth transition of power between administrations. The agreement — known as a memorandum of understanding — was announced by Susie Wiles, Trump’s incoming chief of staff, in a Nov. 26 statement. “After completing the selection process of his incoming Cabinet, President-elect Trump is entering the next phase of his administration’s transition by executing a Memorandum of Understanding with President Joe Biden’s White House,” Wiles said. What exactly does the agreement provide? It allows for Trump’s Cabinet nominees to begin coordinating with the federal departments they are poised to take over in less than two months. The nominees — who include Sen. Marco Rubio for secretary of state and Scott Bessent for treasury secretary — will now be able to deploy “landing teams” to these departments. “The Transition landing teams will quickly integrate directly into federal agencies and departments with access to documents and policy sharing,” Wiles said. “Per the agreement, the Transition will disclose the landing team members to the Biden Administration.” Wiles also said that the Trump transition team “will operate as a self-sufficient organization.” To that point, the team will not sign a separate agreement with the General Services Administration, which is required by law to offer federal funding, office space and other support to presidents-elect during the transition period. “The agreement dictates that the Trump Vance Transition will utilize private funding,” Wiles said, “providing cost savings to American taxpayers. Donors to the Transition will be disclosed to the public.” The memo also revealed the existence an ethics plan , which includes promises that incoming officials will avoid conflicts of interest and safeguard classified information, among other things. The agreement comes three weeks after Trump won the presidential election, defeating Vice President Kamala Harris. In comparison, Biden signed onto a similar memorandum with the first Trump administration in early September 2020, weeks before the presidential election, according to The Washington Post. Additionally, Trump’s team has not formalized an agreement with the Department of Justice that would authorize the FBI to perform background checks on nominees, according to Reuters. “Circumventing background checks would buck a long-established norm in Washington, but the president has the final authority on whom he nominates and picks to conduct background checks,” according to the outlet. Wiles, in her statement, said Trump’s team has “existing security and information protections built in, which means we will not require additional government and bureaucratic oversight.” Trump vowed to shut down Department of Education. Can he actually do that? Who wants to talk about politics at Thanksgiving? Here’s what a new poll found Who can the president pardon? Here’s what to know as Biden wraps up his termFACT FOCUS: Posts misrepresent Biden administration spending on EV charging stations
Former Kilkenny senior hurler Walter Walsh has credited a flexible mindset as key to his successful 13 year stint with the Cats. Walsh joined the senior panel in 2012 and over a glittering career in the black and amber, the Tullogher-Rosbercon forward won eight Leinster titles, four National League titles and three All-Ireland titles as well as an All-Star in 2016. But in a journey full of highs, there was also bumps in the road with sitting on the sidelines at certain periods of his career a challenge for the recently retired inter-county star. "I wanted to start, I wanted to play the full games, sure every player is the same but you kind of take what you can get," he told the Kilkenny People Sport Podcast at the launch of the AIB GOAL M ile which he is supporting this Christmas. "It's funny how your mind changes with the situation, you want to be starting but then you get a setback and you're just delighted to be part of it and training," he added. "I find the mind changes very quickly with the situation," Walsh continued. But how did the three time All-Ireland winner manage to cope during those setbacks? Listen to the full interview below to find out:
JUST SPAMMING | A year that made politics more farcical than ever
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