It all started on September 1, 2008 when Palmetto GBA took over the Medicare contract from NHIC to process claims and payments for providers. This marked the beginning of a plethora of problems and massive frustrations for thousands of Medicare billing providers. Payments have been delayed for months causing financial hardships to many Medicare billing providers and healthcare facilities. To date, the bureaucratic nightmare of red tape and rejected claims saga continue with no end in sight.

Weeks into the transition, Palmetto GBA was overwhelmed with phone calls which they did not anticipate. Medicare billing providers encountered constant busy signals and when they did get through, they are either sent to a full mailbox where they cannot leave messages. Another tactic is a representative would take down their numbers with the promise to call back but only to never to be heard from again. Those who do get through faced wait times of as much as three hours to six hours and this happened in all departments from Claims, EDI, to Medicare Provider Enrollment.

Fortunately, the Centers for Medicare and Medicaid Services (Medicare CMS) finally intervened and convinced Palmetto GBA to add more phone lines and staff and extend call in hours. However, new staff presents new problems such as training issues. There have been reports of staff telling Medicare providers they are not trained to handle certain problems and/or passing off the call to another department which resulted in more waiting time.

Aside from call center backlog, there are a multitude of other problems including a failed conversion of the NPI crosswalk file that mysteriously dropped off 25% of Medicare providers from the list to the backlog of over 26000 pending providers' applications. Medicare codes and modifiers that have been previously accepted by NHIC are now being rejected for different reasons. One common response is the Medicare coverage database is being updated and simply to resubmit the claims after the update.
Another major problem is the IVR (interactive voice response) system for obtaining Medicare patients' eligibility. It is not voice activated and poorly configured. In contrast to the old NHIC system that used to take approximately one to two minutes for a Medicare patient eligibility, it now takes six to seven minutes more.

On a brighter note, Palmetto GBA and Medicare CMS has been made aware of the problems and are working to solve them along with physicians and medical associations groups across the board. Medicare CMS also has a financial hardship program for which some providers may be qualified to get thru this bureaucratic maze.

So did Palmetto GBA break the Medicare payment system? Only time will tell.
Conversion pains usually will pass and hopefully the rocky start is not a sign of how this ‘Partner in Excellence’ will be servicing this contract and the Medicare community at large.





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A good healthy skin reflects a healthy body and lifestyle, the way we treat our body on the inside will reflect what we see on the outside. This is true because if you have a healthy lifestyle you will have a strong immune system that will destroy free radicals, keep your skin hydrated and prevent most of the aging damage.

Natural skin care remedies should be part of your daily lifestyle and not just used once in a while or when you feel that your skin is not looking good.

To be in great health your body needs enough water intake and enough fiber. Lack of any of those elements will directly affect our skin.

Most people just eat junk food, drink alcohol and dont exercise, that kind of lifestyle will damage your immune system and your skin in the long term. Is very important to have a diet rich in fiber, it is recommended to take 38 grams of fiber every day if you have 19-50 years old.

For example here is a natural skin care remedy:

Before shower, brush your skin gently with a soft brush. This will remove dead skin cells that clog the pores and detoxify the skin, improves blood circulation and removes puffiness.

Stay active, exercise regularly, this is important in order to avoid stress and improve your general health. Sitting for large periods of time can cause acne, puffiness, bloating and more.

Avoid Eating too much sugar, because it is one of the major causes of aging, it causes glycation which reduces elasticity and causes wrinkles.

Over the Counter Skin care Creams

On the other hand you can take another approach and use just over the counter anti aging creams like the ones advertised by big brands. However the reason that i dont like those creams is that they have high concentration of chemical ingredients and the ones that have little concentration do not work at all.

Chemical ingredients cause side effects, irritation, inflammation and dryness, there are many people that have had bad experiences with their creams so they opt to try a new one without getting any significant improvement.

Natural Skin care Creams

However there are skin care creams that actually work and have been proven to reduce wrinkles, smooth your skin and make you look younger. Those creams are made with just natural ingredients like Manuka Honey, Shea Butter, CynergyTk, Coenzyme Q10, Vitamin E, Wakame Kelp and other natural sources.

There is a company from New Zealand (Xtendlife.org) that produces creams with just natural ingredients, they are highly effective and do not cause any side effect. So my best recommendation is to apply natural skin care remedies on a daily basis and use a natural cream to reduce wrinkles and other signs of aging.



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Benefits from improvements in Information Technology (IT) systems should not be limited to big international businesses and large corporations. Small business owners can benefit from IT systems just as much by embracing and using the technology to their advantage. As time marches on, business owners are finding that they are using services like the World Wide Web and other information technology systems more and more often thus leveraging the advantages that technology can offer. Adopting IT systems are good for small businesses for the many reasons, some of which we highlight below.

IT Systems Save Time.

Information technology systems need only a few simple key strokes to input information, analyse it and draw useful commercial conclusions from it. There are programs that have been designed to keep track of client information (such as CRM - Customer Relationship Management packages), finances (many book keeping and accounts software are available) and communications and marketing. Not long ago most business people had to rely on written notes and calculate finances longhand. Now, thanks to e-mail and computer software, finances can be automatically calculated and communication can happen in an instant.

New Programs Ensure Accuracy

Accounting programs are just one example of IT systems that allow small business owners to ensure that their profits, revenues and expenses are accurately calculated. Customer Relations Software allows business owners to track client contact information and a history of their purchases. Information technology systems help guarantee accuracy in record keeping and calculations, which saves the business owners from having to worry about potential human errors and provide live status overview of the business at any point in time.

IT Systems Help Increase Productivity

Thanks to even basic programs that take care of client information, calculating profits and filing reports, business owners can free up time to focus on more important activities like growing the business, improving operations and generally focus on long term rather then short term issues. One of the most popular information technology systems, the internet, allows business owners to reach clients far beyond their local borders and to outsource simple tasks like data entry or book-keeping saving them time and money by not having to source and hire local help.

Save Money with IT Systems

There is a large variety of information technology systems that help small business owners save money. Thanks to readily available computer hardware and software programs, business owners are able to create their own marketing materials (e.g. leaflets) instead of hiring professional printers to do the job. Other technology solutions can also help business owners by reducing expenses such as postage and phone services.

There are plenty of business owners who want to control every aspect of their companies. IT systems allow them to do this quickly freeing up time for more important tasks. New systems allow business owners to keep control over their company's activities, save money, save time and free them from having to worry about human error.





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