A denied claim can be a financial shock for employers and employees alike. In this episode Dr. John and Peter discuss why claims get denied, how often this happens and how lack of cost transparency fuels surprise bills. Find out how we keep our...

In this episode, Dr. John and Peter discuss the fears that many employers have about switching to a self-funded plan, thinking mistakenly that they are going to pay for every dollar the group incurs for medical claims. Learn how stop-loss prote...

The ACA is on track to raise premiums up to 30% in 2026. This will cause legacy carriers to raise rates as well, with employers and employees ultimately paying the price. The good news is, there are alternative ways to obtain health care for th...

In this episode Dr. John and Peter discuss the issues related to healthcare fraud and how this directly impacts both members and employers. Find out how prior authorizations can help minimize fraud and also lead to better patient outcomes. ...

In this episode, Dr. John explains the real reason preauthorizations are necessary and how this relates to quality of care and cost transparency. 

Why do Americans pay substantially higher costs for prescriptions and medical care than other countries?  Tune into Part 3 of the series on "Understanding US healthcare costs", as Dr. John and Peter explore the issues related to "Price Tra...

Why do Americans pay substantially higher costs for prescriptions and medical care than other countries?  Tune into Part 2 of the series on "Understanding US healthcare costs", as Dr. John and Peter explore the issues related to "Price Tra...

Have you ever wondered why Americans pay substantially higher costs for prescriptions and medical care than other countries? Tune into Part 1 of this series on Understanding US healthcare costs, as Dr. John and Peter discuss the healthcare syst...

Innovative technologies were designed to streamline and increase efficiency in healthcare, and government regulations put in place to safeguard patients. So why do healthcare costs continue to rise? In this episode, Dr. John and Peter discuss h...

The holidays can be a stressful and anxiety provoking time for many people. Tune into this episode as Peter and Dr. John discuss improved access to mental health services through telemedicine via phone and video chat, and how we can support one...

In this episode, Dr. John interviews his father Don McCormick who shares the history and evolution of health insurance as we know it today... and the lessons learned from his experience in the healthcare industry. 

Are you expecting a rate increase again? You can't control the rising costs of healthcare but you can choose who you partner with. With tailored benefit plans and active cost containment efforts, Ovation Health has groups that have not seen a r...

In this episode, Dr. John shares the history of the first network and the evolution of networks in the healthcare industry. He explains the issues with networks and price transparency, and how they have nothing to do with access to health care ...

In this episode, Dr. John and Peter discuss the issues of price transparency and why the pricing for a medical procedure or service is so greatly varied, depending on where you go to get your care and how it is being paid for. Find out how true...

In this episode Dr. John and Virginia, (Claims Administrator with Ovation Health), discuss the use of age stratification by legacy carriers in determining health plan rates and the surprising statistics from claims data.

In this episode, Dr. John and Peter discuss the advantages of integrating Direct Primary Care (DPC) into health care. This model improves the patient experience, lowers healthcare costs, and enhances health outcomes. 

Dr. John introduces Hannah, the newest member of the team. They discuss her role in the Care Team, the healthcare industry and work culture, and how this relates to Member Services and positive member experiences.

Dr. McCormick interviewed an expert in veteran benefits who offers a free service to help vets and their spouses access in home care through the Aid and Attendance program.

In this episode, Dr. John and Peter discuss prescriptions as they relate to coordination of care for better outcomes, costs, side effects, low adherence rates and how to be more proactive in your healthcare.  

Deciding between an urgent care center and the emergency room can be tough. In this episode, Dr. John and Peter talk about emergency situations and how to decide when to go to an emergency room and the different costs members may incur. 

Dr. John and Peter discuss steerage and referrals, explaining why they are made and how they can be good for members, when price and quality of care are considered in the decision making.

Our host Peter discusses with Dr. John the advantages and disadvantages of prior authorizations and how they relate to member services.

Dr. John is joined by Chad to discuss the benefits of a Health Plan that works directly alongside its TPA and PBM, and how these direct connections can help the consumer know the prices that they will have to pay for their plan and health servi...

Dr. John is joined by Patient Advocate Chad to discuss price transparency in the medical market. Listen in to discover why healthcare costs may be increasing and what you can do to get the best service for the best deal just by being a smart co...

Dr. John is back to this week to sit down and introduce you to the department head for Claims at Ovation. They discuss Virginia's experience in the field and dive a bit into the world of Claims processing.