Front Street Hospital: Uninsured Charges and Collections (pg. 237 of Cases in Healthcare Finance, 5th edition) It is quite clear from the text’s exposition on the policy, billing, and collection habits of certain not-for-profit hospitals that serious injustices were being committed against uninsured patients. These injustices were primarily financial in nature – although physical and psychological trauma almost always followed – and they reveal the systematic nature of the abuse. By setting “rack rates” – an extremely expensive set rate for medical procedures – as the ‘standard fare’ for all patients, while simultaneously granting clear and enormous discounts for those insured through third-party entities, the not-for-profit hospitals unconscionably…
Billing issues at this point in time was a bit drastic to everyone from the doctors to the patients. With the constant changing of medical billing and coding requiring physicians and administrators to spend time and money on continuing education, software, or staff training to stay current, having a direct effect on the cash flow and profits of a practice. Mostly it was the cause of the PCIS system. PCIS was very outdated at this point when entering anything from addresses to insurance information. When entering certain patients addresses and insurance information through PCIS it got misconceived, patients getting billed other patients billing statements and also patients getting charged more or less for their services.…
The MD –affected role role relationship has been and corpse a mainstay of tending : the medium in which data are gathered, diagnoses and program are made, compliance is accomplished, and healing , patient role role activation, and support are provided. To managed maintenance brass s, its grandness rests also on market place savvy: atonement with the Doctor of the Church –patient relationship is a critical gene in people's determination s to join and stay with a specific organization. The rapid incursion of managed caution into the health charge market raises care for many patients, practitioners, and scholars about the effects that different financial and organizational features might have on the doc –patient relationship. Some such concerns…
Insurance companies: Insurance companies are expected to come in a pay for the treatment of all medical problems, often that could have been treated at a much earlier state of possibly prevent with proactive health care, increased public education…
In the article “What Happens When Doctors Only Take Cash Everybody, Especially Patients, Win,” by Nick Gillespie states his opinion on the benefits of when doctors only take cash as the only form of payment for non-emergency medical services. Gillespie favorably speaks that by physicians only taking cash, therefore removing the health insurance company, allows for the doctors to provide clear pricing on medical procedures. Currently, in the healthcare market, prices for medical procedures are high because pricing for procedures is elusive that no one, but the insurance company, knows what these procedures cost. However, two anesthesiologists, Kevin Smith and Steven Lantier open a medical practice, Oklahoma City Surgery Center, to do business…
In the world of healthcare there are many different bills that get passed, some for the better of the people and then some are in place to not help the people at all. With the different health care bills that we have they have to go through congress to get passed so that at the end of the day the bills will be beneficial to everyone. We as healthcare providers should know these different healthcare bills and understand them to the fullest being that they affect us on a daily basis. The healthcare bill that stands out the most is the Patient Protection and Affordable Care Act.…
Is having insurance worth all the out-of-pocket costs we as patients get blind-sided with? There is a huge debate regarding seeing a physician that is in a provider network but the physician is not. Balance billing has started to rise as physicians want to cash in more for a patients care that the insurance will not cover. Balance billing is affecting many patients that have to pay thousands of dollars after a visit. “The Patient Protection and Affordable Care Act, informally known as ObamaCare, is a step in the right direction.…
The proposed bill will not only benefit healthcare in a positive way, but will greatly impact patients as well. First, patients will get the help they need, and will less likely be readmitted to an inpatient facility. As a result, the overall cost that a healthcare organization would have to pay for hospitalization would be decreased. Secondly, patients will receive further care by having an on-call case manager on standby if needed.…
Concerns about cost have led to the popularity of managed care options, first by corporations for their employees and now by governments, through the Medicare and Medicaid programs. Despite recent federal budget surpluses and proposals to expand funding and benefits in Medicare, there is serious concern among economists, legislators, and bureaucrats about the long-term solvency of both publicly funded programs. Concerns about cost are present in every form of nursing practice; they affect how work is organized, treatment plans for patients, and patients' perceptions of and participation in care. For example, even individuals with health insurance are wary of increased out-of-pocket expenses and no covered services. And there is heightened concern about pharmaceutical costs, fueled, in part, by the development of sophisticated new drugs.…
Describe the roles, functions, and liabilities of the board in a managed care organization. The roles of the managed care organizations are used to reduce the cost of health care services through several forms of methods such as incentives that are useful through patient doctor relationships to develop a better form of care for the patients. “Gale Cengage Learning (2013) reports Managed care” refers to that type of health care system under which medical care and treatment is managed by the entity paying the bills, and not the medical care or treatment provider (physician, hospital, etc.). It is a system dominated by acronyms that identify different services or components, such as HMOs, PPOs, and EPOs.…
As medical debt rises and the demand for healthcare reform increases, it has become imperative now more than ever to learn about the factors that affect the healthcare industry. The application of business to the healthcare industry enables healthcare professionals to carry a broader viewpoint on the mechanics and functioning of the healthcare industry. Rather than just using my core science classes and internships to develop my point of view and learn about the healthcare industry, through the certificate program, I aim to broaden my scope of study and learn about the systems that affect the structure and functions of healthcare. Interning at private and public practices, learning about insurance billing systems, I saw how the U.S healthcare…
The status of healthcare in the United States was a goal of President Obama, in which Obama sought to correct. Prior to 2009, health insurance was not a luxury all Americans could afford. Various countries including France, Canada, and Germany all currently provide universal healthcare to its citizens. The Affordable Healthcare Act was introduced into Congress, and became law in 2010. An analysis of the underlying need for universal healthcare, case studies in Germany, and the future of healthcare in the United States, reveals the motivation of the Obama Administration.…
The young couple , Jon and Maria , are running behind on the house bills for paying for medical bills because of their 10 year old son having a leg injury . Bills started to pile up left and right , collecting dust and have “urgent” on top of them in large font . On Sunday evening , they go a knock on the door from the sheriff . “You are being evicted because of failure to pay the rent” the sheriff said. “ NO PLEASE !!!…
This would cause emergency rooms not to be as busy because patients wouldn’t have to use the emergency for non-emergency visits. With many uninsured individuals using emergency rooms as their primary care doctors because they are unable to financially afford going to the doctor’s without it being a burden. Emergency rooms are known for not collecting the whole cost of treatment up front which indelibly harms them by not receiving payment at all by some of those uninsured. There are those individuals that make payments for the treatment they received but the cost could put the family in a financial crisis. Sooner or later, those who are not covered by insurance could possibly be denied treatment due to these reasons.…
This case study demonstrates the use of the four different cost allocation methods: the Direct method, Step-down method, Double Apportionment method, and Reciprocal method. In the Direct method, all overhead costs are allocated to the patient services departments directly. The Direct method is the easiest and cheapest in application, however is the weakest. The Step-down method, unlike the Direct method, recognizes some of the overhead services provided by each supporting department to one another.…