High deductibles and your practice. With the increase in the number of High Deductible Health Plans (HDHP), it has become increasingly difficult for patients to meet their healthcare expenses. High deductibles result in increased out-of-pocket expenses. This means that the patient will hesitate at least once before consulting a physician, to avoid paying out of his own pocket. To avoid that, a practice needs a strategy which educates patients about the essentiality of healthcare. But it is easier said than done. Convincing patients to pay from their own pockets despite of paying health insurance premiums is a difficult task. But, at the same time, it is essential that you clear these things up with patients in the first meeting itself, because failure to pay the bills would put you directly at loss. So, …show more content…
Now that your patient has agreed and decided to go ahead, it is a good idea to discuss co-pay or co-insurance. It is a good practice to collect these amounts up front. This reduces the burden of sending statements and saves a lot of money on collection. And, it will have a positive impact on your revenue cycle. 3. It is also a good idea to make the patient aware of the benefits of regular healthcare. Stress on its importance. Make sure the patient realizes how regular checkups ensure a better life. Many plans cover preventive services like cancer screening, diabetes screening and infant immunizations, regardless of deductibles. 4. Anticipate patients asking for discounts and payment plans. If they patient is convinced to go through with the healthcare service, it is likely that they will request some discount or an affordable payment plan to conveniently pay the expenses. It has also been found that some patients present themselves as uninsured, despite of having an insurance plan. Care must be taken to avoid such situations. Moreover, it is a good idea to have some payment plants that are affordable for the patient and at the same time beneficial to
To lower the deductible costs of your health insurance, choose a plan whose network includes your primary care doctor as well as your preferred
They are scared. Dealing with health insurance is very frustrating when someone is ill. Show compassion, and if needed, help the patient with their questions regarding insurance This group does not need extra stress of physicians telling them that their health insurance does not cover certain treatments and or medications. Physicians should try to connect with the patient and be sensitive to the hardships faced by those with long-term illnesses (Kowalczyk).
...l bill, the remainder of the cost will not have to be paid, and physicians will all receive a fixed fee per patient no matter the cost of the visit and exams provided (Ghosh, Chandak 70).
In order to fully understand the uninsured and underinsured problem that hospital administrators face the cause must be examined. The health outcomes of uninsured individuals are generally worse than those who are insured. Uninsured persons are more likely to experience avoidable hospitalizations, diagnosed at later stages of disease, hospitalized on an emergency or urgent basis, and more seriously ill upon hospitalization (Simpson, 2002) Because the uninsured often lack an ongoing relationship with a health-care provider, they are less likely to receive preventive care and diagnostic tests (Kemper, 2002). Many corporations balance their budget through cost cuts and other moves, but have been slammed with an increasing load of uninsured patients, coupled with reduced payments from government and private insurance programs. In 2000, 564,476 uninsured patients came through Health and Hospitals Corporations health care centers, a 30 percent increase from 1996. In the same period, Congress reduced Medicare reimbursements to hospitals, while Medicaid reimbursements to primary care clinics remained basicall...
They really look out for the best for the patient and make sure that they are receiving the best quality of care by their physicians. One major benefits of managed care is that they have lower costs for you as the patient. You typically think that if you pay less you are going to get less, however with managed care they want you to pay less but still receive the same quality of care. Managed care plans keep the costs down by contracting with providers and referring these providers to their patients. Employers tend to lean towards these types of benefits. That is why many employers have switched to managed care plans (Cyrene, 2015). Under most managed care plans, they encourage their patients to get annual preventive physicals and get early treatment when sick so it doesn’t progress into something more (University Human Resources, 2015). For patients under managed care plan providers are always readily available to them. All these healthcare providers are all credentialed (Cyrene, 2015). Managed care plans also lower the prices on prescriptions for their patients as well. Managed care plans typically lean towards providing the generic prescriptions and lowering their copays too (Jackson,
Health insurance, too many American citizens, is not an option. However, some citizens find it unnecessary. Working in the health care field, I witness the effects of uninsured patients on medical offices. Too often, I see a “self-pay” patient receive care from their doctor and then fail to pay for it. Altogether, their refusal to pay leaves the office at a loss of money and calls for patients to pay extra in covering for the cost of the care the uninsured patient received. One office visit does not seem like too big of an expense, but multiple patients failing to pay for the care they receive adds up. Imagine the hospital bills that patients fail to pay; health services in a hospital are double, sometimes triple, in price at a hospital. It is unfair that paying patients are responsible for covering these unpaid services. Luckily, the Affordable Care Act was passed on March 23, 2010, otherwise known as Obamacare. Obamacare is necessary in America because it calls for all citizens to be health insured, no worrying about pre-existing conditions, and free benefits for men and women’s health.
Healthcare plays an important role in almost every person’s life at one point or another. Many times, one can get caught without, or underinsured and it can be detrimental to their livelihood. With the rising cost of healthcare, it is likely that having a national healthcare policy in place, and as an individual, being able to afford and obtain adequate health insurance has not been required until now. With the new national healthcare plan, it is required for all citizens to obtain and maintain some sort of public or private insurance policy. The rising costs can be attributed to many things. A significant reason for the astronomical cost of health care is because of the staggering amount of uninsured or underinsured individuals receiving medical attention and almost many never paying the bill. Those who do have insurance have seen a gradual increase in their premiums and deductibles to make up for this.
Health Insurance is essential to your Personal Well Being and your Health. For a large proportion of uninsured people, health insurance can and is most often a matter of choice. Uninsured Americans normally tend to delay and even go without doctors' visits, prescription medications, and other effective treatments, even if they know they have a serious or life-threatening condition. Institute of Science and Technology (Institute 2009). 20 to 30 percent of uninsured children are more likely to need certain shots, prescription medications, asthma care, basic dental care and other things that we would consider a must have.
Health insurance provides benefits for sickness, injury, surgery, and prescription medication. There are a variety of plans with different
The United States health care system ranks 37th in the world. Statistically, it’s bizarre how United States is amongst one of the most advanced nations in the world and the fact that it spends more on its healthcare than any other country, yet its standards are incomparable to other European nations. Unlike most countries, America doesn’t have universal coverage for health care. This means that it is the responsibility of an average American to obtain health insurance either through private insurance companies or through their employer. Under this system, there is a notion of a certain premium due at regular intervals of time but the insured may need to “co-pay” or pay a certain deductible for their treatment before their insurance takes care of the rest.
Among them is its emphasis on productivity. Fee for service encourages the delivery of care and maximizing patient visits. As a payment mechanism, it is relatively flexible in that it can be used regardless of the size or organizational structure of a physician’s practice, the type of care provided such in clinic visit, surgery, therapy session, and the place of service such as physician’s office, nursing home, hospital, surgery center or the geographical location of care. Fee for service does support accountability for patient care, but it is often limited to the scope of the service a particular physician provides at any point in time. Although fee for service is easy to understand conceptually, it can be difficult to understand in practice. Patients may struggle to decipher the coding and nomenclature involved in billing, manage the numerous bills and explanations of benefits they might receive, and understand its application in inpatient settings, especially for lab, radiology, and anesthesia services. Because payment is limited to one provider for one interaction, fee for service does little to encourage management of care across settings and among multiple
There are several factors that contribute to the complexity of the revenue cycle. Frequent changes in contracts with payers, legislative mandates, and managed care are just a few examples of reasons why revenue cycle in the healthcare industry is so complex. Furthermore, the problems that arise in the steps of the revenue cycle further complicate the whole process. For example, going through the steps of the revenue cycle efficiently is extremely difficult when it is managed by poorly trained personnel. Furthermore, if a healthcare provider does not have the proper information system to track patient records and billing, receiving reimbursement can become difficult. In addition, one of the main factors that delay payments is denial from the insurance companies. The reason for Denial includes incorrect coding, the certain sequence of care and medical necessity or even delay in submitting claims. Lastly, inefficient patient correspondence can not only hinder the process of revenue cycle but also result in many patient complaints (Wolper, 2004).
reimbursement determinations. As a result, the camaraderie among physicians has developed into a more aggressive approach to impede competition (Shi & Singh, 2012). Little information is shared with patients in regards to procedures or disease control. The subjects are forced to rely on the internet for enlightenment on the scope of their illnesses (Shi & Singh, 2012). Furthermore, the U.S. health care system fails to provide adequate knowledge on billing strategies for operations and other medical practices. The cost in a free system is based on supply and demand and is known in advance of hospital admission (Shi & Singh, 2012). The need for new technology is another characteristic that is of interest when considering the health care system. Technology is often v...
Saving:-Along with the support of medical care that a policy provides, it is also important to note financial benefits that it gives. You save in two different ways with a medical insurance
Health Insurance Plans Premium Insurance is important to everyone in the country. Health insurance covers the certain amount of money to the insured person upon a certain event such as hospitalization and surgery. Commonly health insurance premium buying choices cover a simple resolution in purchasing the private health insurance. The premium is the amount that needs to be satisfied by either the households or the authority to become underwrite. While of career the payment should be affordable, there are many other trials that exigency be respected while makeup one's mind the premium.