Healthcare technology, delivery, and knowledge
Miami, FL
Joined May 2019
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Are you losing money because of poor contract management? 73% of providers don't actually know what they are supposed to be paid. We break down how complex payer rules and system errors create significant revenue leakage, often occurring entirely outside the scope of your initial agreement. Learn how to audit your fee schedules to protect your bottom line.
youtube.com/shorts/HUUDCMyZk…
Loneliness of Chronic Illness: Losing Friends #shorts youtube.com/shorts/OseHebxwY…
Someone asked me: Volume drives power youtube.com/shorts/vQCOkcSEt… via @YouTube
See this Instagram post by @carenodes instagram.com/p/DcwM5QQmuQQ/…
Carenodes retweeted
Would 500 patients be enough to walk into a payer negotiation and actually win?
For primary care, yes. For specialty groups, you need closer to 1,500.
Most providers never calculate this number — which is exactly why health plans hold all the leverage in rate discussions.
Here's the threshold that flips the power dynamic:
📍 Primary care: 500+ patients per provider
📍 Specialty groups: 1,500+ patients per provider
Individual provider or group contract, the math doesn't change. Know your number before your next negotiation.
@carenodes
🎥 Watch: youtube.com/shorts/vQCOkcSEt…
#PayerContracting #ValueBasedCare #HealthcareNegotiation #ProviderLeverage
Healthcare admin is super tribal.
You can educate all you want, but without clarity on roles, you won't access the info you need.
With the AI wave coming, what’s your direction? Be specific about what you’re searching for!
What’s your take?
Your payer contract says "coordinate benefits per its standard COB policy." Standard by what measure? Nothing defines it — because state law determines COB primacy, not payer boilerplate. Cite it. Push back. 🎥 Full breakdown:
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#RevenueCycle #HealthcareBilling #COB
5 Star Review: Keep it up
"I’m learning a lot" vbcapodcast.com/reviews/1414…
The Lindsay Clancy medical records dispute is an example of how US healthcare system fails. Defense attorneys and the clinic clash over Dr. Jennifer Tufts' files in this heated courtroom exchange.
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A child in New Jersey is medically cleared for discharge. There's no nurse to send them home with. This is what a "ghost network" actually costs.
Such a real and major issue— I had a conversation with @BTWFoundation regarding this same issue. We need to galvanize efforts.
When 64% of substance use disorder denials are overturned, that's not a mistake—it's intentional delay. Carve behavioral health out of Medicaid managed care NOW. @SenatorBrouk & @JoAnneSimonNY are fighting to pass Senate Bill 8309A & Assembly Bill 8055A.
She wanted to lose weight, but ended up in the hospital #health #ozempic youtube.com/shorts/OC_AXHjY3… via @YouTube
New Episode! "Deciding to Contract with a Payor: Joining "the Network""
Got a contract. The fee schedule is fine. Not great — fine. And now the question isn't can we do this. It's should we, and on …
podcasts.apple.com/us/podcas…
A better approach is to evaluate every state using a structured framework before committing capital. Below is an 8-factor playbook for choosing behavioral health markets more intelligently. healthcare-wiki.com/?p=15408 via @carenodes
Check out the latest article in my newsletter: From Ancient Wisdom to Modern Economics: The Case for Doulas in Healthcare linkedin.com/pulse/from-anci… via @LinkedIn
