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Al Lewis

23 Podcast Episodes

Latest 16 Oct 2021 | Updated Daily

Weekly hand curated podcast episodes for learning

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EP331: Employers Buyer Beware! Six Tricks Wellness and Point-solution Vendors Use to Overstate Their Results, With Al Lewis, Cofounder and CEO of Quizzify

Relentless Healthcare Value

My guest in this health care podcast, Al Lewis, was telling me before we hit record that employer customers are vastly worse at evaluating wellness and point-solution vendors today than they ever have been in the past. Let’s break this down. One aspect leading up to the “worse than ever” is the proliferation of point-solutions lately and all the PE (private equity) dollars flowing into the health care space. You pick up any rock and you’ll find 25 health care startups underneath it. A second aspect is this: and this is not going to be a newsflash for many, but employers really trust their brokers and their EBCs (employee benefit consultants) to put together a good benefit package on their behalf. If an EBC says, “buy it,” employers click their heels and buy it a lot of times. And with that great power comes great... opportunity. We see an uptick in brokers and employee benefit consultants, enjoying themselves a little arbitrage-ish money grab by taking money from these startups/vendors under a variety of umbrellas while at the same time they call the employers their customers. This is especially profitable and also slimy when done under the cover of darkness because, as with so many aspects of health care, these backroom deals often happen without the employer customer knowing that there’s a vig involved in the recommendation process. Al Lewis says he works in the “Integrity Segment” of the market. He is well known for outing vendors for basically lies they tell in their marketing. The thing is though, if a vendor comes to Al and asks questions about how to do it right, Al is always happy to help. He has said that he wants people to learn and if you’re asking questions, it means you’re interested in learning. Al has been on the show before, actually multiple times, but one full episode was episode 245, and we dig into wellness that’s done “to” employees, not “for” them in that episode. So, check that out after you listen to this one, if you want more Al. Al also founded the Validation Institute and he’s also CEO over at Quizzify. On the show in this health care podcast, Al explains the six major logical fallacies, computational flaws, tricks, if you will, that wellness vendors or point-solution vendors may deploy to inflate their “proven cost savings.” The six “watch outs” I’d guess I say for employers are: Regression to the mean Participants vs nonparticipants or matched controls or propensity scoring The trend inflation trick Plausibility testing Actuaries and validation Overstating engagement These six things are all of the different logical fallacies some vendors employ in order to overstate their results or outcomes. The Validation Institute has a PDF write up of each of these flaws which you can find in the show notes. Bottom line? Buyer Beware. And, also, get a broker or an EBC who you know for a fact they’re working for you if you’re an employer because they’ve committed in writing to not taking payola from the vendors that they’re recommending to you. One footnote is that if you haven’t listened to episode 329 with Joe Connolly you might want to go back and do so. Joe gets into the trend of some services who could, potentially, start taking on risk. Said another way, if services like these create their own bundles of point solutions and take on the risk of offering said bundle to employers, that could be nice. You can learn more at the Validation Institute. You can connect with Al by emailing al@quizzify.com, visiting the website at quizzify.com, on LinkedIn, or on Twitter at @quizzify and @whynobodybeliev.  Al Lewis wears multiple hats, both professionally and also to cover his bald spot. Hat #1: Employee Health Literacy. He is the founder and “quizmeister-in-chief” of Quizzify, whose mission is to help companies teach their employees to utilize health care services appropriately, using a format best described as “Jeopardy meets Choosing Wisely meets Comedy Central.” Quizzify is the only vendor authorized to display the Harvard Medical School “Veritas” shield and has received excellent reviews from users. Quizzify is also well known for its surprise billing “Prevent Consent” solution, which was recently featured in the New York Times. It can be taped to an insurance card, used as a stand-alone card, or downloaded into your Apple Wallet. Starting in 2022, use of this language prevents forced arbitration under the Surprise Billing Act and instead allows payment of 2x Medicare for non-elective care.  His quiz-specific background includes authorship of the best-selling Newsweek Presents the Ultimate Trivia Game, which Games magazine lauded as having the best questions of any trivia game; hosting two quiz shows on Boston network affiliates; and appearing on Jeopardy. Hat #2: Outcomes Measurement. As an author, his critically acclaimed category best-selling book on outcomes measurement, Why Nobody Believes the Numbers, chronicling and exposing the innumeracy of the health management field, was named digital health book of the year in Forbes. Cracking Health Costs, written in conjunction with Walmart alum Tom Emerick, was also a trade best seller. He was the cofounder of the World Health Care Congress’s Validation Institute. His expertise in outcomes measurement got him named one of the unsung heroes changing health care forever.  He graduated Phi Beta Kappa with honors from Harvard, where he taught economics as well. He also graduated from Harvard Law School, albeit with no honors that time—other than winning their annual trivia contest, of course. 04:49 Are brokers going to have to become more transparent about where their money is coming from? 07:33 Are carriers transparent? 08:09 What’s the goal of the Validation Institute? 08:55 “You either get a true statement put up or learn what you have to do in order to get a true statement put up.” 11:18 How is Regression to the Mean (RTM) used in a flawed way? 16:32 “If you do wellness for employees instead of to employees, the people who want the wellness will be able to access it.” 21:13 What is plausibility testing? 23:17 What about actuaries and validation? 23:40 “That’s one of the reasons the Validation Institute exists, is because actuaries are easily corrupted.” 25:18 What is a prime example of population health economics? 26:20 What does it mean to overstate engagement? 27:15 “How often did you use this and was it useful?” 28:55 “Are you validated by the Validation Institute, and if not, why not?” You can learn more at the Validation Institute. You can connect with Al by emailing al@quizzify.com, visiting the website at quizzify.com, on LinkedIn, or on Twitter at @quizzify and @whynobodybeliev.  @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth Are brokers going to have to become more transparent about where their money is coming from? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth Are carriers transparent? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth What’s the goal of the Validation Institute? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “You either get a true statement put up or learn what you have to do in order to get a true statement put up.” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth How is Regression to the Mean (RTM) used in a flawed way? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “If you do wellness for employees instead of to employees, the people who want the wellness will be able to access it.” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth What is plausibility testing? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth What about actuaries and validation? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “That’s one of the reasons the Validation Institute exists, is because actuaries are easily corrupted.” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth What is a prime example of population health economics? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “How often did you use this and was it useful?” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “Are you validated by the Validation Institute, and if not, why not?” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth

32mins

29 Jul 2021

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Big Little Lies Of Healthcare Business With Al Lewis

Heads Up Adviser

What is your "secret weapon" against your competitors this fall? We've got some pretty good solution - signed, sealed, and delivered to you by Al Lewis & The Heads Up Adviser Show!Many benefit advisors are more concerned about the appearance of helping employees than actually assisting them. We offer you to:bring this fact - backed up with science and data - to lightcraft a useful consultation with your prospectsimpress them with your competence on the subject.Don't waste a minute - TUNE IN for the latest episode: [BIG LITTLE LIES OF HEALTHCARE BUSINESS]  Links & Additional Information >>SDF - Silver Diamine FluorideFree resources on the topic for brokers - https://www.quizzify.com/brokersHEALTHCARE BROKERS - Arrange a virtual call with John Sbrocco. Let us help you scale your business https://bit.ly/34YbfAq1. Sign Up For The Expert Session "Achieve Health Consortium"👉 https://bit.ly/34QECUV2. Join Heads Up Adviser Facebook Group 👉 https://bit.ly/37hJFyk3. Visit Heads Up Adviser Website 👉 https://bit.ly/36cYv7C

46mins

13 Oct 2020

Similar People

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How Al Lewis Rebuilt His Database and Closed 60 Transactions with a Single System

Keeping It Real

In this episode Al Lewis shares with us how after a 30 year career as an Illinois broker, then moving to Florida to retire he soon found himself back in real estate! In a new market, he doubled down his efforts, built a small team, set up a new system to start building his database, and started closing deals all over again!  Here are some of the things we cover:  – Leveraging email, text, and live chat to build relationships with your clients – Building a database from scratch – Hiring and training an efficient team – Having an exceptional work ethic and a positive mindset to succeed We want to thank Al and Jason for sharing their knowledge with us and the real estate community! It’s important for us now more than ever to band together and support one another through these uncertain times. You can follow us and get updates on more upcoming events on Facebook, Keeping it Real, Twitter, or now on iTunes as well. See you at the next event!

53mins

9 Sep 2020

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Protect Yourself | Doug Aldeen & Al Lewis | Surprise Billing – The COVID Edition – How to protect your employees & plan from extraordinary and unreasonable charges.

Solving Healthcare

Podcast Show NotesOur podcast discussion today between Michael Andrade,  Al Lewis, and Doug Aldeen, esq.  This podcast is meant to educate employers, plan sponsors, and individuals about some of the well-intended elements of the CARES act and the impact it could have on healthcare costs and more importantly the impact it could have on your own benefit plan and costs to employees and their families.  In our discussion we review: How the CARES Acts creates an incentive for billing abuses How employees may not even know that it’s happening What you can do as an employer to protect your plan and your employees How to mitigate billing issues with a Payment Integrity process that includes medical bill review, surprise bill protection, and communication elements for your employees. If you’re a plan sponsor, you should be very concerned about what is going to your plan without you taking measures now to mitigate unreasonable claims.  This translates into wasting money that you need to run your business and to pay legitimate claims.If you’d like to learn how this and other programs can fit into your benefit strategy please feel free to contact me: Michael Andrade (832) 236-8966.fusion-button.button-37 .fusion-button-text, .fusion-button.button-37 i {color:#ffffff;}.fusion-button.button-37 .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-37:hover .fusion-button-text, .fusion-button.button-37:hover i,.fusion-button.button-37:focus .fusion-button-text, .fusion-button.button-37:focus i,.fusion-button.button-37:active .fusion-button-text, .fusion-button.button-37:active{color:#ffffff;}.fusion-button.button-37:hover .fusion-button-icon-divider, .fusion-button.button-37:hover .fusion-button-icon-divider, .fusion-button.button-37:active .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-37:hover, .fusion-button.button-37:focus, .fusion-button.button-37:active{border-color:#ffffff;}.fusion-button.button-37 {border-color:#ffffff;border-radius:25px;}.fusion-button.button-37{background: #002859;}.fusion-button.button-37:hover,.button-37:focus,.fusion-button.button-37:active{background: #002859;}.fusion-button.button-37 .fusion-button-text {text-transform:none;}iHeart (coming soon).fusion-button.button-38 .fusion-button-text, .fusion-button.button-38 i {color:#ffffff;}.fusion-button.button-38 .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-38:hover .fusion-button-text, .fusion-button.button-38:hover i,.fusion-button.button-38:focus .fusion-button-text, .fusion-button.button-38:focus i,.fusion-button.button-38:active .fusion-button-text, .fusion-button.button-38:active{color:#ffffff;}.fusion-button.button-38:hover .fusion-button-icon-divider, .fusion-button.button-38:hover .fusion-button-icon-divider, .fusion-button.button-38:active .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-38:hover, .fusion-button.button-38:focus, .fusion-button.button-38:active{border-color:#ffffff;}.fusion-button.button-38 {border-color:#ffffff;border-radius:25px;}.fusion-button.button-38{background: #002859;}.fusion-button.button-38:hover,.button-38:focus,.fusion-button.button-38:active{background: #002859;}.fusion-button.button-38 .fusion-button-text {text-transform:none;}iTunes.fusion-button.button-39 .fusion-button-text, .fusion-button.button-39 i {color:#ffffff;}.fusion-button.button-39 .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-39:hover .fusion-button-text, .fusion-button.button-39:hover i,.fusion-button.button-39:focus .fusion-button-text, .fusion-button.button-39:focus i,.fusion-button.button-39:active .fusion-button-text, .fusion-button.button-39:active{color:#ffffff;}.fusion-button.button-39:hover .fusion-button-icon-divider, .fusion-button.button-39:hover .fusion-button-icon-divider, .fusion-button.button-39:active .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-39:hover, .fusion-button.button-39:focus, .fusion-button.button-39:active{border-color:#ffffff;}.fusion-button.button-39 {border-color:#ffffff;border-radius:25px;}.fusion-button.button-39{background: #002859;}.fusion-button.button-39:hover,.button-39:focus,.fusion-button.button-39:active{background: #002859;}.fusion-button.button-39 .fusion-button-text {text-transform:none;}Google.fusion-button.button-40 .fusion-button-text, .fusion-button.button-40 i {color:#ffffff;}.fusion-button.button-40 .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-40:hover .fusion-button-text, .fusion-button.button-40:hover i,.fusion-button.button-40:focus .fusion-button-text, .fusion-button.button-40:focus i,.fusion-button.button-40:active .fusion-button-text, .fusion-button.button-40:active{color:#ffffff;}.fusion-button.button-40:hover .fusion-button-icon-divider, .fusion-button.button-40:hover .fusion-button-icon-divider, .fusion-button.button-40:active .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-40:hover, .fusion-button.button-40:focus, .fusion-button.button-40:active{border-color:#ffffff;}.fusion-button.button-40 {border-color:#ffffff;border-radius:25px;}.fusion-button.button-40{background: #002859;}.fusion-button.button-40:hover,.button-40:focus,.fusion-button.button-40:active{background: #002859;}.fusion-button.button-40 .fusion-button-text {text-transform:none;}Spotify The post Protect Yourself | Doug Aldeen & Al Lewis | Surprise Billing – The COVID Edition – How to protect your employees & plan from extraordinary and unreasonable charges. appeared first on Solving Healthcare.

24mins

18 May 2020

Most Popular

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Episode # 66 – Al Lewis, CEO of Quizzify has a 100% Renewal Rate for Major Employers Subscribing to his Healthcare Quizzes. Educated Employees Spend Less by Knowing More from the Guy who has Written 50,000 Questions Endorsed by Harvard

Primary Care Cures

In this episode Ron chats with Al Lewis, the CEO of  Quizzify. Here they discuss how the Quizzify platform enables employees to become more educated in healthcare and their healthcare spending. Their platform has even received endorsement from Harvard! Al dives into the importance of making intelligent yet humorous trivia questions. Quizzify helps healthcare consumers to arm themselves with knowledge to help prevent against unnecessary testing or fight against surprise billing. Ron and Al have a brilliant conversation on unique and creative ways to educate healthcare consumers. Al wears multiple hats, and not just  to cover his bald spot. He’s an author whose critically-acclaimed bestseller on outcomes measurement, Why Nobody Believes the Numbers, was named 2012 healthcare book of the year in Forbes. Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care, released in 2013, was also a trade bestseller. His 2014 book Surviving Workplace Wellness, co-authored with Vik Khanna, has also received accolades, with excerpts appearing in the Harvard Business Review and elsewhere. As a consultant, he is widely acclaimed for his expertise in population health outcomes and strategy. In 2013, Al was named one of the “unsung heroes changing healthcare forever“. As a validator of outcomes, he has been able to obtain Gold Standard certification for many of his clients, and Quizzify, from Intel’s Validation Institute. He is also one of the population health field’s most-acclaimed speakers, as well as a prolific author and interviewee on outcomes economics, having been featured in almost every major lay and healthcare publication. Before entering the population health field, Al was a partner at Bain & Company. He holds two degrees from Harvard, where he also taught economics, and his economic policy book was made into a show on the Washington, DC NPR affiliate. Read the Transcript The post Episode # 66 – Al Lewis, CEO of Quizzify has a 100% Renewal Rate for Major Employers Subscribing to his Healthcare Quizzes. Educated Employees Spend Less by Knowing More from the Guy who has Written 50,000 Questions Endorsed by Harvard appeared first on Primary Care Cures.

29mins

29 Apr 2020

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EP271: COVID-19—A Surprise Billing Defense Strategy for Patients AND Employers in the Middle of a Pandemic, With Al Lewis, Rachel Miner, David Contorno, and Doug Aldeen

Relentless Healthcare Value

In this health care podcast, I’m talking to Al Lewis from Quizzify. This episode also guest stars Rachel Miner from Thrive Benefits, David Contorno from E Powered Benefits, and Doug Aldeen, a health care attorney in Texas. This episode started out being about surprise billing in the emergency room (ER) and a potential defense strategy that patients and employees can use to protect themselves from egregious billing practices. Surprise bills are when a patient gets “balance billed” for a sum above what their insurance carrier will pay. Usually this transpires when an out-of-network provider somehow or another gets involved in their care. Usually the patient has no idea this happens until after the bill comes—the big bill, in many cases, thus the surprise. But here’s where surprise billing and COVID-19 connect. You might not have thought of this because you might know that patients who present in the ER with COVID-19 and then test positive are protected from surprise bills, for the most part, by the CARES Act. But there’s a couple of wrinkles. What if the patient does not actually have COVID-19? Then whatever treatment they wind up getting in the notoriously expensive ER is business as usual. Here’s another wrinkle: The cost of treatment for COVID-19 is not like it’s capped. So even if an employee doesn’t get a surprise bill, the self-insured employer or health plan might. And the CARES Act explicitly states that the employer or plan is on the hook to pay for it. And one last wrinkle: Dealing with this pandemic among other things leaves about 0.0 chance that the national surprise billing legislation is gonna happen this year. But it’s not like kids have stopped running into the side of the pull-out couch and needing stitches, or drug overdoses or heart attacks have suddenly vanished. There was a news article just the other day about a private equity–run ER in the Midwest continuing to dish out nasty surprise bills to their community of taxpayers at the exact same time that they were lobbying to get a piece of the federal bailout paid by taxpayers. Al Lewis and his team over at Quizzify created this handy wallet card that patients or employees can use when they have the unfortunate experience of going to the ER themselves or with a loved one. It protects them from egregious surprise bills, thus its moniker, the surprise billing defense strategy. But nothing for nothing, this wallet card, this surprise billing defense strategy, also protects employers and health plans from these large bills in the age of COVID-19.  Al Lewis and I start our conversation talking about a New York Times article (also available here for those who don’t subscribe to the New York Times) that came out recently featuring Al as well as myself and chronicles my visit to an emergency room wherein I deployed the surprise billing defense strategy/wallet card.  You can learn more at quizzify.com or connect with Al on LinkedIn. You can also connect with Al on Twitter at @quizzify and @whynobodybeliev.   You can also connect with Rachel and David on LinkedIn and with Doug on Twitter at @AldeenDoug and on LinkedIn.  Al Lewis wears multiple hats, both professionally and also to cover his bald spot. Hat #1: Employee Health Literacy. He is the founder and “quizmeister-in-chief” of Quizzify, whose mission is to help companies teach their employees to utilize health care services appropriately, using a format best described as “Jeopardy meets health benefit education meets Comedy Central.” Quizzify is the only vendor authorized to display the Harvard Medical School “Veritas” shield and has received excellent reviews from users.  Quizzify is best known today for its employee coronaquizzes (now exceeding 100,000 plays!) and its surprise billing “Prevent Consent” solution, which was recently featured in the New York Times. It can be taped to an insurance card, used as a stand-alone card, or downloaded into your Apple Wallet.  His quiz-specific background includes authorship of the best-selling Newsweek Presents the Ultimate Trivia Game, which Games magazine lauded as having the best questions of any trivia game; hosting two quiz shows on Boston network affiliates; and appearing on Jeopardy. Hat #2: Outcomes Measurement. As an author, his critically acclaimed category best-selling book on outcomes measurement, Why Nobody Believes the Numbers, chronicling and exposing the innumeracy of the health management field, was named digital health book of the year in Forbes. Cracking Health Costs, written in conjunction with Walmart alum Tom Emerick, was also a trade best seller. Surviving Workplace Wellness has also received great accolades, and excerpts appeared in Harvard Business Review and elsewhere.  He was the cofounder of the World Health Care Congress’s Validation Institute.  His expertise in outcomes measurement got him named one of the unsung heroes changing health care forever.  He graduated Phi Beta Kappa with honors from Harvard, where he taught economics as well. He also graduated from Harvard Law School, albeit with no honors that time—other than winning their annual trivia contest, of course. David Contorno is founder of E Powered Benefits. As a native of New York, David began his career in the insurance industry at the age of 14 and has since become a leading expert in the realm of employee benefits over the last 22 years. Most recently, David was Benefits Selling magazine’s 2015 Broker of the Year; and in March 2016, Forbes deemed him “One of America’s Most Innovative Benefits Leaders.” David is a member of the board of directors for both the Charlotte Association of Health Underwriters and HealthReach Community Clinic. He served on the NC Insurance Commissioners Life and Health Agent Advisory Committee, as well as participated in the Technical Advisory Group that helped with the market reforms required under the Affordable Care Act in North Carolina. He is a longtime member of the Lake Norman and South Iredell Chambers of Commerce as well as the National, North Carolina, New York, and Long Island Associations of Health Underwriters. David contributes to numerous publications, including Forbes, Benefits Selling magazine, Business Leader magazine, and Insurance Thought Leadership. David is committed to giving back to his community and actively participates in the membership drive for the United Way, assisting the local chapter of Habitat for Humanity, and supporting The Dove House Child Advocacy Center. When he is not working, he enjoys boating, traveling, and being with his wife, Heather, and their two children, Hannah and Ethan. Rachel Miner became engaged with the health care system seven years ago as her son, Jackson, was consistently ill. Her frustration with the complexity of the health care system and expensive bills made her think about how helpless employees must feel. So, she set out to find a benefits firm that helped employees understand how to be educated consumers of health care year-round—and she didn’t find one. Thus, Thrive Benefits was born. Her mission is twofold: to help employers and employees. Rachel understands that companies need to have good benefits to attract and retain employees and makes it her mission to help employers save money so they can offer good benefits year over year. In addition, she helps employees to navigate the health care system so that they can have the highest quality of care at the lowest possible cost. Rachel says that her true passion is helping people and her purpose is to challenge the mindset of others so that they can overcome adversity, take risks, and achieve their goals. Health care is confusing, but it doesn’t have to be. For organizations to thrive, employees must thrive, too. Doug Aldeen is an Austin, Texas–based health care and Employee Retirement Income Security Act (ERISA) attorney who recently served as ERISA counsel on behalf of the Berkeley Research Group in New York City to the $7.7 billion May 2016 acquisition of Multiplan and its medical bill repricing product Data iSight by the private equity firm Hellman and Friedman. Since 1997, he has represented reference base pricing organizations, a bundled payment software platform, PPO networks, medium to small self-funded plans, third-party administrators, and provider-sponsored health maintenance organizations in various capacities, including Herdrich v. Pegram, which was argued before the US Supreme Court in 2001. Moreover, he serves as a resource to national news organizations regarding issues on health care and as a consultant with the Governmental Relations Committee at the Self-Insurance Institute of America in Washington, DC, and as an adviser to RIP Medical Debt, which has abolished over $1.2 billion in medical debt. Doug received his JD from the University of Illinois. 04:26 What is the likelihood of a surprise bill in the time of coronavirus? 07:41 What the surprise billing wallet card looks like and what it does when you use it.09:55 Rachel Miner’s experience with the Quizzify surprise billing wallet card. 14:42 EP249 with Dale Folwell.15:33 Should employers be advocating for the use of the Quizzify wallet card? 16:22 How an employer should get the wallet card out to their employees. 17:29 David Contorno explains the inspiration behind the Quizzify wallet card. 19:29 “Because of that federal law, you do not need to sign that financial consent.”—David 19:42 “Don’t obligate yourself financially to some unknown amount.”—David 19:56 The legal standard: a battlefield consent. 21:18 Negotiating vs not negotiating. 22:38 Why employers should care about surprise billing. 22:58 Best practices for employers educating employees on why this wallet card is important. 24:19 “This is not something your employer is doing to you; this is something your employer is doing for you.”—David 24:25 EP186 with David Contorno.27:19 Doug Aldeen on what happens after using the wallet card and then gets the balance bill. 30:47 What happens after you sign the financial contract after editing. 32:01 Asking for the director of revenue cycle management after getting your surprise bill. 36:36 “It’s not as daunting as people think.”—Doug 36:56 “The general rule … is that the more you do in advance, the better.”—Al 37:49 Why 2x Medicare is the sweet spot for reasonable price. 38:38 What employers should be doing right now to distribute these Quizzify wallet cards. You can learn more at quizzify.com or connect with Al on LinkedIn. You can also connect with Al on Twitter at @quizzify and @whynobodybeliev.   You can also connect with Rachel and David on LinkedIn and with Doug on Twitter at @AldeenDoug and on LinkedIn. Check out our #healthcarepodcast with @whynobodybeliev of @quizzify and featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What is the likelihood of a #surprisebill in the time of #coronavirus? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What does the #surprisebill #walletcard look like and what does it do? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling Should #employers be advocating for the use of the Quizzify wallet card? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling How should an #employer distribute the wallet card to his/her #employees? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What was the inspiration behind the Quizzify wallet card? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “Because of that federal law, you do not need to sign that financial consent.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “Don’t obligate yourself financially to some unknown amount.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What is battlefield consent? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling Negotiating vs not negotiating surprise bills. @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling Why should employers care about surprise bills? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “This is not something your employer is doing to you; this is something your employer is doing for you.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What happens when you use the Quizzify wallet card? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “It’s not as daunting as people think.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “The general rule … is that the more you do in advance, the better.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling Why is 2x the Medicare rate the sweet spot for reasonable price? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What employers should be doing right now. @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling

41mins

23 Apr 2020

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AEE11: COVID-19 Billing, With Doug Aldeen and Al Lewis

Relentless Healthcare Value

On Friday, March 27, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act—otherwise known as CARES. This CARES Act covers the whole $2 trillion megillah stimulus package, but in this health care podcast episode, we’re talking quickly about a provision in that Act. I speak first with Doug Aldeen, an attorney specializing in helping employers settle hospital bills. Doug works with clients across the country. And then at the end of the episode, you will also hear from Al Lewis, who is a founder over at Quizzify. Al Lewis, as many of you may or may not know—but if you don’t know, you should—created a “surprise billing wallet card” that is actually super relevant to this discussion as you will see. There’s actually going to be a whole surprise billing episode coming up soon where we discuss this wallet card, so you can consider Al’s short commentary today as kind of a coming attraction. The provision that we’re going to talk about in this episode is the No Cost Sharing for COVID-19 Testing and Vaccines provision. This is where insurers are required to cover testing for COVID-19 without cost sharing to their enrollees, and they must pay for the tests based on contracts or the posted pricing of labs. So, the thing is, hospitals and diagnostic testing companies can essentially basically name their price on COVID-19 tests; and employers and insurers will be required to pay for it. This is in Section 3202, the Price of Diagnostic Testing, in that CARES Act. The plot thickens this week as health insurers—including Aetna, Cigna, and Humana—are now waiving patient cost sharing on all treatment for coronavirus, not just the testing, including hospitalizations and ambulance transfers. And they’re doing this for their insured members and employer plans at their in-network health systems—emphasis intended on the “in-network” part. So, you might be thinking, “Great … no costs to anybody!” But I did emphasize that last part for a reason. If you think for a minute about this, just because patients are not paying co-pays for COVID treatments first of all doesn’t mean that while they’re in the hospital that their diabetes won’t flare up … or their MS or their RA. COVID-19 is just one thing, and the US has a patient population that has, let’s just say, no shortage of chronic conditions—otherwise known as underlying conditions, otherwise known as the people most likely to be in the ICU. My concern is that there’s nothing to say that co-pays and coinsurance for treatment of other things while being treated for COVID are going to suddenly vanish, too, even if it’s an in-network health system. Furthermore, there is that problem of a patient going to a hospital that’s not contracted with the employer plan or the patient’s insurance carrier. At that point, I’m not seeing anything that would suggest that patients with COVID-19 are going to get any different treatment billing-wise than patients with anything else. We’ve seen COVID-19 bills that are, for uninsured patients, $34,000 and $73,000 in the press. What if the patient doesn’t have out-of-network coverage, for example? What if the patient’s out-of-network deductible is tens of thousands of dollars like some of them are? I don’t see anything in this bill to suggest that those are suddenly going to go away. And, oh, by the way, exactly as the bill pretty much states explicitly, regardless of what the patient pays, the employer’s on the hook to pay for whatever the hospital chooses to charge—at least as far as testing goes. You can connect with Doug on Twitter at @AldeenDoug and on LinkedIn.  You can learn more at quizzify.com or connect with Al on LinkedIn. You can also connect with Al on Twitter at @quizzify and @whynobodybeliev.   Doug Aldeen is an Austin, Texas–based health care and Employee Retirement Income Security Act (ERISA) attorney who recently served as ERISA counsel on behalf of the Berkeley Research Group in New York City to the $7.7 billion May 2016 acquisition of Multiplan and its medical bill repricing product Data iSight by the private equity firm Hellman and Friedman. Since 1997, he has represented reference base pricing organizations, a bundled payment software platform, PPO networks, medium to small self-funded plans, third-party administrators, and provider-sponsored health maintenance organizations in various capacities, including Herdrich v. Pegram, which was argued before the US Supreme Court in 2001. Moreover, he serves as a resource to national news organizations regarding issues on health care and as a consultant with the Governmental Relations Committee at the Self-Insurance Institute of America in Washington, DC, and as an adviser to RIP Medical Debt, which has abolished over $1.2 billion in medical debt. Doug received his JD from the University of Illinois. Al Lewis wears multiple hats, both professionally and also to cover his bald spot. Hat #1: Employee Health Literacy. He is the founder and “quizmeister-in-chief” of Quizzify, whose mission is to help companies teach their employees to utilize healthcare services appropriately, using a format best described as “Jeopardy meets health benefit education meets Comedy Central.” Quizzify is the only vendor authorized to display the Harvard Medical School “Veritas” shield and has received excellent reviews from users.  Quizzify is best known today for its employee coronaquizzes (now exceeding 100,000 plays!) and its surprise billing “Prevent Consent” solution, which was recently featured in the New York Times. It can be taped to an insurance card, used as a stand-alone card, or downloaded into your Apple Wallet. His quiz-specific background includes authorship of the best-selling Newsweek Presents the Ultimate Trivia Game, which Games magazine lauded as having the best questions of any trivia game; hosting two quiz shows on Boston network affiliates; and appearing on Jeopardy. Hat #2: Outcomes Measurement. As an author, his critically acclaimed category best-selling book on outcomes measurement, Why Nobody Believes the Numbers, chronicling and exposing the innumeracy of the health management field, was named digital health book of the year in Forbes. Cracking Health Costs, written in conjunction with Walmart alum Tom Emerick, was also a trade best seller. Surviving Workplace Wellness has also received great accolades, and excerpts appeared in Harvard Business Review and elsewhere.  He was the cofounder of the World Health Care Congress’s Validation Institute.  His expertise in outcomes measurement got him named one of the unsung heroes changing health care forever.  He graduated Phi Beta Kappa with honors from Harvard, where he taught economics as well. He also graduated from Harvard Law School, albeit with no honors that time—other than winning their annual trivia contest, of course. 04:12 Hospital billing as it relates to COVID-19. 05:45 Who is “on the hook” for paying these COVID-19 bills. 08:17 “Reasonable payment” in the case of COVID-19. 08:45 Is COVID-19 different than every other billing situation? 10:12 What’s going to come out of the out-of-network COVID-19 costs? 11:29 What employers should be doing right now. 12:50 The takeaway for everyone “bankrolling” COVID-19. 13:26 “This whole thing is tilting towards, ‘Who’s going to pay for all this stuff?’” 13:53 Connecting the dots with COVID-19 billing. 15:25 Using the Quizzify wallet card, and how this can help avoid COVID-19 surprise billing. 16:17 Download the wallet card at quizzify.com.  You can connect with Doug on Twitter at @AldeenDoug and on LinkedIn.  You can learn more at quizzify.com or connect with Al on LinkedIn. You can also connect with Al on Twitter at @quizzify and @whynobodybeliev.   Check out our newest #AnExpertExplains #healthcarepodcast with @AldeenDoug and @whynobodybeliev of @quizzify as they discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling Who is on the hook for #coronavirus billing? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast What is #reasonablepayment in the age of #coronavirus? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast Is billing for #coronavirus different than all other billing? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast What’s going to come out of the out-of-network COVID-19 costs? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast “This whole thing is tilting towards, ‘Who’s going to pay for all this stuff?’” @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast Connecting the dots with #covid19billing. @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast

17mins

7 Apr 2020

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44: Healthcare Literacy: What Don't We Know, and How Is It Hurting Us? w/ Al Lewis

Healthcare Simplified

How many added sugars are there in a Quaker quinoa granola bar? Not many, right? Quaker's a healthy company, and you can't get more nutritious than quinoa, after all. In fact, there's 10 different kinds of sugars sprinkled in. That's just one example of how what we think we know about health may not be accurate. On today's episode of Healthcare Simplified, Al Lewis, CEO at Quizzify, joins us to discuss healthcare literacy  — what don't we know about our health and how is that affecting us? 

27mins

18 Mar 2020

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The Full Court Press – Utah State Men’s Basketball – Al Lewis – February 6, 2020

Full Court Press

Legendary Aggie radio voice Al Lewis joins The Full Court Press to talk about his time with the Aggies, greatest games, players, almost technical called on himself, Jaycee Carroll, Sam Merrill, Wayne Estes, The Spectrum & more!

28mins

7 Feb 2020

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Surprise Emergency Room Bills | Al Lewis |

Solving Healthcare

Sorry, your browser doesn't support embedded videos.Podcast Show Notes Our podcast discussion today between Michael Andrade and Al Lewis, CEO of Quizzify.   Some of you may have listened to the podcast interview of Quizzify and remember that his company seeks to improve health literacy through an interactive and fun quiz that’s delivered directly to employees through a monthly quiz.  Al however is passionate about bringing validity and transparency to the healthcare system.  In our interview today we discuss an issue that affects a staggering amount of individuals, Surprise Medical Billing and offers a solutions for what you can do as an employer and individual to protect yourself from surprise Emergency Room Billings.  Al is offering a simple solution that you can easily provide to your employees.  This can lent to solving a big problem for folks that inadvertently get surprise bills from unscheduled emergency room visits. In our discussion we review the size of the problem, how it affects individuals, plus how EMTALA, the Emergency Medical Treatment and Labor Act (EMTALA) sets a precedent for your own protection and how taking reasonable precautions can protect you from egregious surprise bills. Link to Surprise Balance Billing agreement: The Problem:  Hospital emergency rooms (ERs) are required to treat anyone who comes in the door. Before they do, ERs will typically make your employees sign a whole contract, electronically, which your employees will likely treat as though it were a “terms and conditions” document that doesn’t even have to be read…when in fact they are actually agreeing to be responsible for total charges. Quizzify’s Solution: Employees can insist on signing a printed copy of the consent, and insert the word “reasonable” where it says “I understand I will be responsible for charges not covered by insurance” and add “…up to 2 times the Medicare rate.” Or simply cross out that line altogether and sign the rest. They still have to treat you. However, in the heat of the moment, employees have to first of all remember to do that. And if they do remember to ask for the printout and cross out the offending language, they also need to push back when the ER intake person says: “You can’t do that,” or something similar. All while your employee or a family member might be bleeding. Not a good time to get into a debate. If you have any questions about this feel free to contact me: Michael Andrade (832) 236-8966 Downloadable Labels for you, your family, and employees. If you would like a downloadable document that you can use to print of labels and attach to your id cards please feel free to use this one. Note you may have to reformat based off your ID card.  Also, it’s best to use clear labels. Surprise Billing Label.fusion-button.button-65 .fusion-button-text, .fusion-button.button-65 i {color:#ffffff;}.fusion-button.button-65 .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-65:hover .fusion-button-text, .fusion-button.button-65:hover i,.fusion-button.button-65:focus .fusion-button-text, .fusion-button.button-65:focus i,.fusion-button.button-65:active .fusion-button-text, .fusion-button.button-65:active{color:#ffffff;}.fusion-button.button-65:hover .fusion-button-icon-divider, .fusion-button.button-65:hover .fusion-button-icon-divider, .fusion-button.button-65:active .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-65:hover, .fusion-button.button-65:focus, .fusion-button.button-65:active{border-color:#ffffff;}.fusion-button.button-65 {border-color:#ffffff;border-radius:25px;}.fusion-button.button-65{background: #002859;}.fusion-button.button-65:hover,.button-65:focus,.fusion-button.button-65:active{background: #002859;}.fusion-button.button-65 .fusion-button-text {text-transform:none;}iHeart (coming soon).fusion-button.button-66 .fusion-button-text, .fusion-button.button-66 i {color:#ffffff;}.fusion-button.button-66 .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-66:hover .fusion-button-text, .fusion-button.button-66:hover i,.fusion-button.button-66:focus .fusion-button-text, .fusion-button.button-66:focus i,.fusion-button.button-66:active .fusion-button-text, .fusion-button.button-66:active{color:#ffffff;}.fusion-button.button-66:hover .fusion-button-icon-divider, .fusion-button.button-66:hover .fusion-button-icon-divider, .fusion-button.button-66:active .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-66:hover, .fusion-button.button-66:focus, .fusion-button.button-66:active{border-color:#ffffff;}.fusion-button.button-66 {border-color:#ffffff;border-radius:25px;}.fusion-button.button-66{background: #002859;}.fusion-button.button-66:hover,.button-66:focus,.fusion-button.button-66:active{background: #002859;}.fusion-button.button-66 .fusion-button-text {text-transform:none;}iTunes.fusion-button.button-67 .fusion-button-text, .fusion-button.button-67 i {color:#ffffff;}.fusion-button.button-67 .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-67:hover .fusion-button-text, .fusion-button.button-67:hover i,.fusion-button.button-67:focus .fusion-button-text, .fusion-button.button-67:focus i,.fusion-button.button-67:active .fusion-button-text, .fusion-button.button-67:active{color:#ffffff;}.fusion-button.button-67:hover .fusion-button-icon-divider, .fusion-button.button-67:hover .fusion-button-icon-divider, .fusion-button.button-67:active .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-67:hover, .fusion-button.button-67:focus, .fusion-button.button-67:active{border-color:#ffffff;}.fusion-button.button-67 {border-color:#ffffff;border-radius:25px;}.fusion-button.button-67{background: #002859;}.fusion-button.button-67:hover,.button-67:focus,.fusion-button.button-67:active{background: #002859;}.fusion-button.button-67 .fusion-button-text {text-transform:none;}Google.fusion-button.button-68 .fusion-button-text, .fusion-button.button-68 i {color:#ffffff;}.fusion-button.button-68 .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-68:hover .fusion-button-text, .fusion-button.button-68:hover i,.fusion-button.button-68:focus .fusion-button-text, .fusion-button.button-68:focus i,.fusion-button.button-68:active .fusion-button-text, .fusion-button.button-68:active{color:#ffffff;}.fusion-button.button-68:hover .fusion-button-icon-divider, .fusion-button.button-68:hover .fusion-button-icon-divider, .fusion-button.button-68:active .fusion-button-icon-divider{border-color:#ffffff;}.fusion-button.button-68:hover, .fusion-button.button-68:focus, .fusion-button.button-68:active{border-color:#ffffff;}.fusion-button.button-68 {border-color:#ffffff;border-radius:25px;}.fusion-button.button-68{background: #002859;}.fusion-button.button-68:hover,.button-68:focus,.fusion-button.button-68:active{background: #002859;}.fusion-button.button-68 .fusion-button-text {text-transform:none;}Spotify The post Surprise Emergency Room Bills | Al Lewis | appeared first on Solving Healthcare.

20mins

13 Jan 2020

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