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    As a former Dean and appointed Distinguished University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital recruited BOD member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

    Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.



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How Doctors Get Paid

It’s all about Flow [Part 1]

By Dr. David Edward Marcinko; MBA, CMP™dr-david-marcinko


Most patients don’t have a clue about how doctors get paid; it’s not by magic.

Yet, a number of different steps occur during the processing of a medical claim as can be seen in the flow chart below. Each step within the process can be mapped out and each is subject to claim payment-or-claim abortion or rejection.

The steps can also be subjected to a number of variables, depending on a number of different factors including staff competency, time, outside vendors, information management, management decisions in general, or regulatory requirements.

Flow Chart

Of course, any one of these points could lapse, causing the entire process to break down. Like treating patients, when the process has no variables, the end result is very predictable, such as in the flow chart below. When there are variations the end results can be very different.

Treatment is Only the Beginning

Doctor gets the chart

Doctor evaluates patient

Doctor documents visit

Doctor marks billing slip

Doctor gives slip to patient

Patient gives slip to billing clerk

Billing clerk enters information into computer

Office staff submits claim to insurer

Third party payor/Insurance company receives claim

Insurer adjudicates claim

Reimbursement transmitted (electronic or mail) to practice

Reimbursement entered (posted) into practice management system by office staff. 

There are two things that you need understand in order to implement an efficient compliance program.

1] The first is the processes needed to run the organization and the desired outcome of those processes.

2] And second, if the process needs improvement, what can be done to make the process function better?

Office Efficiency Checks

Most small medical and dental practices or clinics have a number of checks and balances in place to control variation.

In an example of an inefficient operation, one practice had the physician-executive open every envelope that came into the office. This was done because of a concern that if someone else did it, then something could go missing.

However, the doctor would then turn the mail over to the payment posting person, who would enter claims into the system. Sometimes the person who entered the claims would become busy with other duties and would not be able to enter claims for a couple of days. This proved to be an inefficient method of managing the billing process for the organization.


A possible solution is to have one person in the front office to open the mail, organize the contents based on who needs to deal with the information (such as claims, refusals, or requests), and then distribute them accordingly.

More on how physcians get paid.

Part 2: https://healthcarefinancials.files.wordpress.com/2010/02/how-doctors-get-paid-in-2010.pdf


Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com


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Emerging Healthcare 2.0 Initiatives

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Questions to Consider

Dr. David Edward Marcinko; MBA, CMP™


Hope Rachel Hetico; RN, MHA, CMP™


Although not always prone to professional introspection, we nevertheless had the recent occasion to ponder the future of the emerging initiative [healthcare business model or philosophy] known as healthcare 2.0.

But, of course, before any discussion begins we must operatively define our terms.


Ever since the term “web 2.0” was used in 2004, there has been an inordinate amount of chatter about what web 2.0 really is and its true impact. No one’s really defined it clearly, but we think the web evolution essentially falls into 3 generations:

Web 1.0 – information is communicated from a company [medical practice or hospital] to its customers [individuals or patients]. This is your basic B2C or [business-to consumer] website. The web becomes one big encyclopedia of information by aggregating all these information repositories.

Web 2.0 – information is communicated between company and individuals AND collaboratively between and among individuals. And so, if web 1.0 was a book, web 2.0 is a live discussion.

Healthcare 2.0 – Scott Shreeve MD of Cross Over Health defines healthcare 2.O as:

 “A New concept of healthcare wherein all the constituents (patients, physicians, providers, and payers) focus on healthcare value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care.”

Questions to Consider:

And so, we offer these questions to consider about Healthcare 2.0:

  • How are Web 2.0 technologies like social networks, wikis, podcasts, blogs and micro-blogs, mash-ups and online communities like this Executive-Post changing the face of the healthcare industry?
  • How are hospital systems, ASCs, medical clinics and physician practices evolving as a result of rapid technological change? 
  • How can health plans evolve in the face of emerging challenges with the help of new technologies and new thinking?
  • What will come of the recent controversies over genetic testing, the human genome project and 23andMe for example, and the privacy of patient data?
  • How does transparent financial and reimbursement data impact the competitive scene?
  • How does transparent physician and hospital quality information affect the competitive scene?
  • Where does the hype over social networks and user-generated content end and the reality begin?
  • Does the initiative enhance or detract from traditional medical care delivery models?
  • Does the initiative enhance or detract from new-wave concierge or retail medical modes?
  • Is this positive or negative for patients, providers, payers and venues?

Healthcare 3.0

Soon it will not be information anymore; it will be intelligence – artificial or virtual intelligence. You’d interact with it almost like another person. The web won’t just blindly do what we tell it do to, it’ll think for you.

Web 3.0 presents some amazing opportunities in healthcare. For example, imagine being able to be diagnosed by your computer or have your toilet run a SMAC 10 or SMAC 20 on you? Imagine going to Costco®, scanning a barcode with your web-enabled phone, and being instantly notified that your purchase is HSA-eligible.

One day, you’ll type into some (probably Google-like Chrome) search engine or MSFT interface:

“I want to find a podiatric surgeon who’s done at least 100 ankle fusions, who operates on Saturdays near my house, who takes my insurance at XYZ surgery center, who has never been sued, and enjoys playing the flute.”

Voi-la! – Your results would be back with an offer to set up an appointment.


Anyway, we digress and don’t have to worry about healthcare 3.0 just yet. Let’s get back to 2008 and see where healthcare is with 2.0.

The primary question really is: where on the web do you go to interact with others about healthcare-related topics? And,is the digital workforce leading, or lagging, in the adoption of social and AI computing for healthcare?


Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com



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