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  • David E. Marcinko [Editor-in-Chief]

    As a former Dean and appointed 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 and 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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Off-Road Touring with Dr. Marcinko [Part V]

About the Ship USNS COMFORT
By Dr. David Edward Marcinko; MBA, CMP™
Dateline: August 4, 2009USNS Comfort Canton, Maryland

The official Navy ship USNS COMFORT [“Medical Treatment Facility”] has the primary mission to provide a mobile, flexible and rapidly responsive capability for acute medical and surgical care in support of amphibious task forces. These forces include the Marine Corps, Army and Air Force elements, forward deployed Navy elements of the fleet, and activities located in areas where hostilities may be imminent. Operations are governed by the principles of the “Geneva Convention for the Amelioration of the Wounded, Sick, and Shipwrecked Members of the Armed Forces at Sea”, as of August 12, 1949.


As a secondary mission of the ship COMFORT is providing a full hospital service asset for use by other government agencies involved in the support of relief and humanitarian operations worldwide. These mission statements are accountable to both the Reduced Operating Status (ROS) and Full Operating Status (FOS) military personnel staffed at National Naval Medical Center, Bethesda Maryland until the ship is activated. However, the ROS personnel’s immediate and number one priority is to fully activate the ship to a FOS Echelon III Medical Treatment Facility within a prescribed 5-day time frame.


In meeting these missions, the ROS personnel perform the following functions:

  • Serve as the nucleus of the critical core required to execute activations;
  • Develop, test, and maintain systems and procedures to support activation process;
  • Orient and train FOS augmenting staff;
  • Monitor/assess the medical treatment facility’s overall ability to fully activate/perform mission.


The ship is commanded by CAPT James J. Ware DDS, with Executive Officer Captain Larnerd, and Master Chief Lohner. The home base is Baltimore, Maryland.  Upon arrival at the dock, the ME-P and I planned to meet onboard with Master David Lieberman. But, an interview was cancelled due to a last minute scheduling conflict. However, we were placed in the competent hands of our civilian tour guide, Shaun B. of Virginia. He noted 70 civilian and 700 military personnel.US Comfort


Shaun B, informed me that despite advanced age, my application for a four month tour would be gladly reviewed. And, it is under serious future consideration as my nurse sister is a recent Bronze Star Award winner from a Combat Army Surgical Hospital [CASH] unit stationed in Iraq. I also did my trauma surgery training in Martin Army Hospital, at Fort Benning Georgia, back-in-the-day.

About Off Road with Dr. Marcinko

These sporadic off-road segments will continue through-out my 2009 summer promotional tour. Attendance at several formal and informal engagements increased since the early summer. The previously noted sales spike for our texts, handbooks and dictionaries www.HealthDictionarySeries.com continued and interest in our online www.CertifiedMedicalPlanner.com program and premier quarterly guide: Healthcare Organizations [Journal of Financial Management Strategies] www.HealthcareFinancials.com remained high.

Part IV: https://healthcarefinancials.wordpress.com/2009/08/13/off-road-touring-with-dr-marcinko-part-iv/


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Understanding Deviations in Medical Billing

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Appreciating Normative Comparisons

[By Patricia A. Trites; MPA, CHBC, CPC, CHCC, CHCO ]

tritesDeviation in medical billing can be detected through utilization data that insurance companies produce on all providers that submit a claim for payment of services.

Insurance companies track utilization through a variety of parameters, including CPT codes, ICD-9-CM, or number of referrals. Different programs utilize certain benchmarks to trigger a review.


For example, a physician who sees patients in the office from 8:00 a.m. until 8:00 p.m., seven days a week and has the highest billing amounts in the region can be subjected to a review. This doctor’s activities would be scrutinized. The utilization review department would probably flag this doctor’s provider number and request more information on a sampling of his or her claims, based on the volume.

Utilization Review

Some utilization review activities may occur due to the type of services that a doctor may offer. For example, if a cardiologist should suddenly start billing for a large number of incision and drainages of abscesses, this might trigger a review, since that might not be a typical scope of service for this doctor in this locality. The same could be said for a pathologist, triggering a review due to the high volume of wound care or ulcer debridement.

Audit Trigger Thresholds Vary

Thresholds vary from locale to locale regarding what triggers an audit. There are consultants who have suggested querying the local carrier for provider specific information regarding utilization activity to compare against community performance. Some Carrier Advisory Committee (CAC) representatives have indicated that this may bring undesirable attention from the Medicare program and trigger an audit. Consult professional associations. and, if possible; local CAC representatives to obtain most current information in your area.


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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