Healthcare and Insurance: Everything You Need To Know

Healthcare and Insurance: Everything You Need To Know

Whether you are healthy or not, having the right insurance for you is a must. Nitin Chhoda elaborates the importance of having the right insurance, and how it can help you prepare for future healthcare needs.

healthcare and insuranceThe terms healthcare and insurance have gotten a bit muddled in the minds of most Americans. So much of the public debate around healthcare is focused on health insurance.

But the reason that we need a better system of healthcare and insurance is because people aren’t getting the kind of healthcare they need to stay healthy.

It can be difficult to understand the healthcare practice management system if you never need to know how it works. But then one day you do need to understand, and maybe that’s because you’ve ended up in the hospital and are uninsured or underinsured.

The Truth About Healthcare and Insurance

The truth is that patients these days need better healthcare, and healthcare and insurance is the way that healthcare becomes affordable. If you had millions of dollars in the bank, you might not care about health insurance.

If something happened, if you were in a car accident or got sick with a serious disease like cancer, you could pay for your healthcare, even if that meant spending tens or hundreds of thousands of dollars for the best care. However, if you don’t have unlimited funds to spend on unforeseen expenses, healthcare and insurance is there to cover the big costs.

What is Healthcare?

For a moment, let’s forget about healthcare and insurance altogether. Imagine that every time you got sick and needed to go to the doctor, you would just go and the doctor would charge you a fee for the visit, and you could afford to pay that fee.

You have a bad sore throat that won’t go away, you go to the doctor, suspecting strep throat, and the doctor charges $30 for the visit and gives you a prescription for antibiotics. Then you visit the pharmacy and pay $10 for your medication and you’re all better in a week. You don’t feel like you need a healthcare and insurance.

That is healthcare at it’s most simple approach. Of course, the situation gets more complicated if something serious happens.

You have pain in your back all the time and you visit the doctor. You have to go back a number of times for a number of different tests.

Each time it costs $30, plus the costs of the tests. Then your doctor orders an MRI. In the United States, an MRI costs hundreds of dollars. Healthcare and insurance seemed to be important at this time.

healthcare and insuranceOr if someone has back pain that is making their life difficult and full of pain, they do not have a choice about seeking out healthcare and insurance.

The alternative is to live with awful pain all the time, limiting what they do in fear of making it worse, and possibly taking pain medication which will do further damage in the long term, to the liver, kidneys, and other important organs.

Getting Healthcare and Insurance is Part of Life

So rather than risk that this patient will have to pay for all these medical tests and potentially ending up in surgery, which will cost $50,000 to $100,000, the alternative is to buy healthcare and insurance.

You may choose a high deductible and pay for all those inexpensive visits, but if something truly bad happens, you are financially protected from medical bankruptcy.

Health Care Insurance : The Patient’s Perspective

Health Care Insurance : The Patient’s Perspective

Although patients know the importance of healthcare and insurance, most do not understand their coverage and benefits. Nitin Chhoda explains how patients misunderstand insurance, and why it is important to openly communicate with them in order to avoid financial struggle.

health care insurance patient's perspectiveThe nature of health care insurance of a healthcare practice management in the United States leaves most patients pretty confused about what they need and what they are entitled to.

For example, even patients who have health care insurance may not benefit from their insurance most of the time.

If a deductible is built into the insurance plan, the patient will end up paying for most of their doctor visits every year. The only time they benefit from having insurance is when a serious accident occurs or they are diagnosed with a serious illness.

A Patient’s Perspective

From the patient’s perspective, the health care insurance system is confusing and always more expensive than they expect. A co-pay that is required, perhaps $20 for a visit or 20% of the bill, might come as a surprise to a patient that doesn’t understand their policy.

Even worse is when the patient does not understand the deductible of his/her health care insurance. They may look at their policy, find out that a certain treatment is covered, and not realize that they must pay the entire cost because they haven’t met their deductible limit.

For Clinicians and Medical Practices, Misunderstandings Can Mean Lost Revenue

Let’s consider a patient who does not understand the deductible, but they want to go to a dermatologist to test an unusual mark on their skin. They wonder if it’s skin cancer or just a mole, so they figure out that this kind of test is covered by their health care insurance, as long as they get a referral.

First they go to a general practitioner who is covered by the particular health care insurance company. They pay for that visit, or perhaps just a co-pay, and get their referral.

health care insurance perspectiveBut then they have an appointment with a dermatologist and tests are done to determine what the skin growth is. This is all pretty expensive and the bill comes to $1000.

At first both the dermatologist’s office and the patient believe that the patient must only pay the co-pay of 20%, which is $200 because of his/her health care insurance.

If the patient has a $3000 deductible that they have not reached, a chain of events ensues, which causes expense, wasted time, and stress for the patient and the medical staff.

First, the medical billing staff will bill the health care insurance company for the amount they typically pay, in this case $800. But the claim will be rejected because the deductible has not been met. Then the medical office has to bill the patient that $800 – an amount the patient is not expecting to pay.

A Realization

From the patient’s perspective of health care insurance, this is a terrible realization. From the practice’s perspective, this has been a waste of time and now they do not know if they will be paid for services already rendered. It is quite possible that the patient cannot afford to pay that $800. Even the $200 was probably a bit of a bummer at least.

The truth is that the patient made the right choices in making a health care insurance.

If that skin growth was skin cancer, it should be tested and removed. If they leave it alone, they may get seriously ill and have to undergo much more expensive and intensive treatments. But they are discouraged from taking those first steps because it is so costly.

Health Care for Patients with Modern Technology

Health Care for Patients with Modern Technology

Using modern technology for health care management such as EMR can help many patients foresee their medical expenses. Nitin Chhoda explains how medical EMR can determine the status of the patients’ insurance so that they can prepare and get ahead of their expenses.

health care technologyIn a system of health care practice management where insurance seems to be primarily concerned with the financial bottom line, patients often get caught in a bad place.

Patients are left to shoulder hefty bills because their insurance and benefits don’t cover what they expected them to cover.

Patients are often thrown into medical debt through no fault of their own, losing their jobs, sometimes their homes, and often their ability to get back out there and find work again is hampered or completely destroyed by their health care medical condition.

The Modern Technology

So how can modern technology help to make the patient experience less of a downward spiral? There may be nothing that a private practice health care can do to change the laws, so that insurance companies cannot drop patients for irrelevant technicalities.

However, for health care practice management professionals who want to continue to provide services and help people to get better, there are some ways that technology can improve the way things go for patients.

Preparation Rather Than Reaction

One problem that many patients run into is that they are unprepared for the amount of work it will take to recover, and they are unprepared for the amount of money they have to pay for their health care.

Even for patients with insurance, a serious injury or the diagnosis of a serious medical condition or disease can spell financial ruin due to the high price of medical care in the United States.

As a result, patients are terrified that they will end up at the doctor’s office, hearing bad news. They begin to avoid regular check-ups, even without realizing that they are doing so. In fact, many people actually make their health care worse by avoiding their medical care.

Medical EMRs can make a practice more efficient from within, and for many patients, that becomes a benefit. If health care clinicians can access patient files more quickly, easily, and efficiently, they will spend more time learning about the patient and what they need.

If billers and other staff members have more time to figure out what the patient will owe after the insurance company pays their part, the stress of an unexpected bill will be lifted.

health care patients

Open Communication

Technology can help patients to prepare for what is going to happen as part of their health care treatment or recovery. This empowers them to make the right moves and take the right steps to getting better.

Additionally, with technological advances, it is possible for everyone within the practice to communicate faster and more clearly. If everyone in the health care practice is aware of the needs of patients, patient care improves.

When the staff is in better communication, they will also communicate more effectively with patients. And the more informed your patients are, the better they will understand their role in the process of healing and recovering.

There are ways for clinicians and staff members to make things easier for patients. Many technological options exist today that will help to empower patients and bring better efficiency to everyone involved in the health care of patients.

Health Care Practice Management for Patients to a Better Practice

Health Care Practice Management for Patients to a Better Practice

Nitin Chhoda shares how modern technology such as EMR, and having a good vision about your staffs’ efficiency help you provide better health care for your patients and good management for your practice.

health care practice management patientsIf you ask anyone working in health care practice management, they will probably say that their main goal is to help patients who need medical attention.

The jobs of clinicians, doctors, nurses, and even receptionists revolve around the ability of everyone in the practice to take care of the patients that come through the doors.

And yet, the way that most health care practice management are run does not align with that primary goal.

The Technology of Today

Today, healthcare practice management professionals must put their focus elsewhere; someone has to be watching the income and expenses to make sure that the practice will continue to run.

Most recently, medical EMRs have surfaced as one tool that health care practice management professionals have implemented in an effort to streamline the practice and become more efficient.

Staff members are taught to be focused on time management, and medical billing and coding staff have to constantly fight to improve their rates of accepted medical claims so claims submission is not just a job of futility.

EMR of Health Care Management

Medical EMRs of health care practice management certainly help staff members, who are often set in their ways, to adjust workflows and become more efficient and more effective at their jobs.

But how does this affect the way that patients experience healthcare at your practice? Will improvements in technology really benefit patients? Can health care practice management clinicians care for patients more attentively if they’ve got a tablet computer in front of them rather than a file folder full of paperwork?

The truth is that everyone in the health care practice management, including patients being treated, benefits when the practice runs more smoothly.

Transitioning to new technology is never simple or easy, but once staff members settle into new rhythms, they may find that they are faster and that they feel more confident about their jobs as a result.

Everything Should Be At the Right Time

Of course, it takes time and a lot of very attentive and well-planned health care practice management to get to that point, but in the new economy, this kind of investment may be the only way to survive into the future. Anything that slows down the practice will reduce competitiveness, and the medical community is trending towards switching to medical EMRs.

health care practice managementFor health care practice management where the implementation of a medical EMR seems like too much work and not worthwhile, it may take a little bit of visioning for everyone to get on board.

But imagine a practice that has an integrated medical EMR already installed and functioning properly.

Vision Is the Key

Imagine that the entire staff is already comfortable with the way the program works. Imagine that patients know how much they will pay for each visit, and they even pay up-front because the billing staff knows what their insurance company will pay.

Imagine that health care practice management clinicians have more time with each patient, even though appointments stay the same length, because it is easier and more intuitive for clinicians to review a patient file using the medical EMR.

Everyone benefits, and that includes patients. A confident, happy, and productive health care practice management staff will improve the patient experience. A medical EMR can improve productivity and bring a bit of extra confidence to the staff.

Healthcare Management Defined

Healthcare Management Defined

In this article, Nitin Chhoda defines the healthcare management process and how in past years it had been very complicated.

He will share how electronic medical records can help make the physical therapy management and documentation process easier and simpler to understand.

healthcare managementWhen patients think of healthcare management, they’re referring to their ailments, medications, tests and procedures.

A physical therapist views healthcare management as a total package of client care, practice management, administration, insurers and reimbursements.

Healthcare practice management is a rapidly changing landscape filled with new technology, coding upgrades, innovative treatments and a better understanding of existing conditions.

Healthcare Management

Healthcare management in the 21st century means having the tools, knowledge and methods to provide the best possible care for clients. Therapists must invest in ongoing training, create liaisons with other healthcare providers, market their clinics successfully and educate the public.

It’s an enormous responsibility and one that requires extensive time and effort. The scope of the tasks can seem overwhelming at times, but an EMR facilitates office processes, expedites revenues and enhances the quality of client care.

Healthcare management in the practice setting encompasses working with multiple insurance companies and providers, interacting with patients in a variety of ways in and out of the office, and remaining in compliance with state and federal laws.

It’s a lot to place on anyone’s plate, and smart therapists know that an EMR makes everyday tasks easier, increases productivity and creates a higher level of efficiency throughout the entire practice.

The healthcare management process begins the moment a patient makes an appointment. There are health forms to complete, visits to schedule, and insurance information to verify.

The Process

A client’s insurance eligibility and coverage is an essential part of the healthcare management process. It allows clinicians to provide the best treatments for the client within the boundaries and limitations of their insurance coverage, while ensuring the practice is compensated appropriately.

healthcare management definedIn the electronic age, therapists need the tools to communicate with clients in a variety of ways. In days past, a mailing or a call to a landline will suffice.

Today’s patients live busy, mobile lives and office technology must evolve to reflect those changes.

Superior healthcare management allows therapists to connect conveniently with clients by email, voice mail and text messaging with patient portals. Reminders can be sent about upcoming appointments, balances due, and test results can be posted online for patients to view.

The digital age also allows practice owners to interact with pharmacies, labs, hospitals and other healthcare providers quickly and efficiently. Tests and prescriptions can be ordered using the power of the Internet and consultations with other healthcare professionals is just a click away with an EMR.

The Turnaround

The success of any practice rides on its available cash flow. A great deal of time will be devoted to obtaining and verifying insurance eligibility, ensuring correct coding, and follow ups to ensure funds reach the clinic’s account in a timely manner.

Submitting that information electronically allows claims to reach insurers and clearinghouses almost instantly for a much faster turnaround on reimbursements. A steady cash flow allows clinicians to plan for the future in terms of equipment, training, staffing and expansions.

Today’s patient may have numerous healthcare professionals overseeing their conditions and ailments.

EMRs represent state-of-the-art technology to obtain a clear, concise and complete picture of a client’s medical history that’s updated instantly with an EMR. Therapists can manage their clients’ healthcare more efficiently, without spending valuable time simply waiting for paper records from another facility.

Healthcare management encompasses a wide variety of tasks, from monitoring the efficacy of a patient’s care to ensuring reimbursements reach the clinic in the quickest way possible. Technology provides the means for better patient outcomes and enhanced cash flow. It’s also an environmentally sound solution that will save clinics thousands of dollars each year.

Healthcare Practice Management and Its State (Before, Present and Future)

Healthcare Practice Management and Its State (Before, Present and Future)

Nitin Chhoda shares how the healthcare practice management has evolved from a manual documentation process to an electronic medical records system.

A few more years, and the medical industry will be using a push-button technology that will greatly increase the cash flow of any private practice.

healthcare practice managementHealthcare practice management has changed enormously as technology has evolved throughout the centuries.

A Blast from the Past

Management of a healthcare operation used to involve little more than an exchange of goods for services rendered.

The days of patients bartering a chicken or garden produce for treatments really isn’t that far removed, relatively speaking. Practices were smaller and served a greater geographical area. Patients had few choices in the treatments they received or their provider.

Office management consisted of copious amounts of hand-written records that had to be transcribed and rewritten by the office scribe into a document that could be read by anyone. Records were often lost due to fire, floods and natural disasters, with no way to put them back together into a coherent whole.

The advent of the typewriter improved the overall readability of medical documents, but it was difficult to coordinate care with other healthcare practice management providers. Unless the professional was just across town, it could take weeks or even months for documentation to travel through the postal system, leading to significant delays in treatment.

Cash flow within the practice was unsteady at best. Healthcare providers had to submit reimbursement claims to individual insurers, without the benefit of clearinghouses, and few patients even had insurance.

EMRs Era

healthcare practice management stateToday, EMRs are eliminating the need for paper records with electronic documents. They’re stored in the cloud, can be accessed instantly by multiple medical professionals, and are updated immediately.

Therapists no longer have to endure long waits for reimbursements. Push-button electronic submissions arrive almost instantly and funds are deposited directly into a clinic’s account.

Healthcare practice management can accept one-time and recurring payments online. The clientele of the 21st century is highly mobile, often relocating multiple times to take advantage of employment and educational opportunities.

New healthcare practice management providers can access a patient’s records simply by utilizing the power of the Internet and their EMR, with no interruption or delay in treatment.

The New Technology

Instead of charts, folders and paper records, EMRs of a healthcare practice management can be implemented on laptops and tablets for the ultimate in portability. The systems also allow clinicians to expand into additional therapy-related markets.

Communication is a key aspect of the therapist-patient relationship and patient portals have arisen as the result of technological advances. Clients can schedule appointments, request medication refills, provide insurance information, and view test results, all online. Practices now have multiple ways of interacting with patients via email, texts and voice messages.

Many have speculated about what the future of healthcare practice management holds. While no one knows for sure, it promises to be an interesting journey.

Healthcare providers in all fields could easily find themselves using software programs that assist in the diagnostic and treatment process based on information provided in a patient’s health record.

EMRs in healthcare practice management will continue to evolve and may contain voice recognition capabilities that allow therapists to record their notes and documentation entirely by voice. Technological strides may eliminate the need for certain types of treatments, while opening new vistas in alternative services.

It may be that healthcare delivery will become more uniform across the board. Clients will become more educated about their ailments and conditions, and more time will be expended on preventative measures.

Healthcare practice management professionals in all fields may find themselves engaged in more patient forums to educate clients, while finding new ways to communicate effectively with those they serve. An ever-increasing population in need of services guarantees innovation, with new treatments and means of delivery that will astound even the learned professionals of today.

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