Donald Salerno
West Chicago, Illinois, United States
6K followers
500+ connections
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DONALD A. SALERNO JR.
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First Notice of Loss (American Alliance Casualty Company (Rosemont IL)
First Notice of Loss (American Alliance Casualty Company (Rosemont IL)
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American Alliance is Hiring
American Alliance is Hiring
American Alliance Insurance Company seeks an experienced Auto Claims /Liability Adjuster. We are looking for…
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Today, I had to step down from the very firm that I poured my heart, soul, and blood to create. 🥲 While Tresa Motors may have been legally…
Today, I had to step down from the very firm that I poured my heart, soul, and blood to create. 🥲 While Tresa Motors may have been legally…
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Promo for The Crypt of Destiny https://lnkd.in/gy3xfhKq
Promo for The Crypt of Destiny https://lnkd.in/gy3xfhKq
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Experience
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Education
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All Lines Texas Adjuster Licesning
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Insurance Generalist Certification (ACN)
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Ryan Bojrab, DPT, LSSBB
Price Transparency in Indiana for 2 Large Health Systems: IU Health & Parkview Focus is ER visits comparing Anthem PPO and UHC PPO contracted rates benchmarking to Medicare Adjusted Rates CPT 99283 Anthem Range % of Medicare: 366%-520% UHC Range % of Medicare: 410%-1,119% CPT 99284 Anthem Range % of Medicare: 639%-794% UHC Range % of Medicare: 631%-1,011% CPT 99285 Anthem Range % of Medicare: 440%-551% UHC Range % of Medicare: 490%-727% Additional Insight: CPT codes 99285, 99284, and 9923 generated $339,301,095 in billed charges through July 2024 YTD for IU Health System All three CPT codes were in the top 13 of utilization and generated the most in billed charges #employeebenefits #pricetransparency
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Curt DeVries
**Nice to hear the Insurance Journal say it:** Social Media Investigations Are a Winning Strategy for Insurers https://hubs.li/Q02PjHvl0 #socialmediainvestigations #subrosa #claimsdefense #riskmanagers #workerscomp #wcdefense #insurancedefense #liabilitydefense #Fraudsniffr
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Kimberly Carleson
CMS' audit uncovered errors in Aetna's calculation of qualified payment rates for out-of-network emergency services under the No Surprises Act. Aetna based the amounts on claims paid instead of contracted rates, prompting CMS to instruct a self-audit for refunding members if necessary. Additionally, Aetna failed to provide proper notice to providers for dispute resolution, raising concerns about compliance with the law. The American Hospital Association urges increased oversight, highlighting the need for thorough payer audits, adding it is "deeply concerning that the departments have not completed a single audit of payers when the law has been in effect for nearly two full years." #BUCASENSE #Healthcare #Compliance #NoSurprisesAct #Audit #claimsintegrity #overpayments
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