Week 5 Discussion thread Week 5 Discussion Question What are the reasons for establishing a personal health record? To keep a record of all healthcare that is created by a medical provider.
Generally, these costs make up the insurance, social security, and benefit plans acquired by the
These types of care are covered when deemed medically necessary during a benefit period that begins when a patient is admitted as an inpatient in a hospital or skilled nursing facility and ends when they haven’t received care for 60 consecutive days. Each time a patient receives care during a new benefit period, the beneficiary must pay the inpatient deductible and copayments for all services during that beneficiary period. The duration of the benefit period determines the amount of deductibles and copayments and is due by day 60. The benefit period provides coverage up to 90 days, after which, a beneficiary who still needs care can use their nonrenewable lifetime reserve of up to 60 additional days of inpatient hospital care. After a beneficiary has exhausted all of their care days, whether they use the covered 60 days or have exhausted their additional lifetime reserve, they are responsible for all costs associated with additional care for that benefit
Managed Care plans are also known as prepaid health care plans. Managed healthcare plans strive to deliver high-quality healthcare, while controlling cost. Services and fees are negotiated with healthcare providers and facilities to provide access to otherwise expensive healthcare services to patients. Services under listed within the Managed Care plan monitored continuously to ensure that all services are provided in the most cost effective manner. An HMO or Health Maintenance Organization is an example of a Managed Care Plan.
Some variability differs with the capability of providing out-of-network health providers and the services in which can be provided. By having a broad range of choices that can be provided, will cause a higher the cost for the individual that is paying. Most Medicare patients have received the managed care plans due to promises of a lower copayment amount and often medication benefits. Medicare post-acute spending has grown rapidly with the number of users between 1999 and 2007. The growth in Medicare short-term post-acute service use, in part, reflects short hospital stays and a growing demand for rehabilitation services.
July 30, 1965 Pres. Lyndon B. Johnson signed a bill into law that led to the establishment of Medicare and Medicaid. Medicare is a program that provides health insurance for Americans that are of the age of 65 and older and people that are even younger that have severe disabilities or other health conditions. When Medicare started it consisted of two parts Medicare part
Many people depend upon their vehicles to get them around. Unfortunately, when you combine alcohol and driving, sometimes the result is the loss of driving privileges for a time. The amount of time you actually lose your driving privileges in many cases depends upon the extent of the DWI as well as the number of previous alcohol-related convictions. In some cases, the person will be issued a B-Card, which is a restricted license, before being allowed to return to driving.
Discuss the ethical implications of “medical necessity” in patient care. Ethical Implications of Medical Necessity When it comes to medical necessity can often refers to the determination that is made for the insurance purposes. For example, If the patient has a condition that is chronic or terminal, the treatment could be considered medically necessary whether then the patient can afford the treatment or not. Networked doctors may face ethical dilemmas when recommending treatment or specialist referrals. When it comes to medical necessities it can be controversial, it can be the use of marijuana when there can be others that are more a moral ethical in which it can be in manage care and network providers.
Previously, medical costs were largely paid for by individual patients through out-of-pocket expenses or private insurance premiums. While the Affordable Care
In-State Colleges vs. Out of State Colleges: Where to Commit? Imagine yourself in the position of a high school senior opening up your admission letters in front of your parents to find out whether you got accepted or not to those colleges you sent applications to. You find out that two colleges, that you value equally the same, have admitted you into their respective college system, in which one of the colleges is in-state and the other being out-of-state. It seems as if you were put into a crossroads between the two, each of them having a different journey storyline tied to them, and it is only a matter of time before both of your parents decide to ask you, “Where will you go?” This decision is almost inevitable when you close into your
The Patient Protection and Affordable Care Act was signed law March 23rd 2010 by President Obama. The Affordable Care Act is a health care reform that provides Americans with insurance and makes it more affordable as well as giving the recipient more options for places to go. An example of this would be able to choose between four doctors instead of two. The Affordable Care Act also provides people of a wide age range with better options for health insurance. As a results of the Affordable Care Act many uninsured people are receiving medical attention, young adults can stay on their parents insurance plans longer and Medicare and Medicaid have improved plans.
We live in a world where the communication is the foundation for sharing information between people and debating is a formal way of communicating. Debating on the “Insurance policies obtained through the Affordable Care Act should be replaced by High Deductible Health Plans paired with tax free Health Savings Accounts” was challenging in many ways. My team was on the con side. From the beginning, all members of the team agreed that the Affordable Care Act is a controversial and complicated topic, however, ACA has made a number of positive changes to the health care system and increased access to health care services. In addition, the ACA has a tremendous impact not just on patients, but also on health care providers and workers.
Examples include programs to reduce unnecessary hospital readmissions by coordinating care and services for patients when they leave the hospital. Other provisions provide for the development of Accountable Care Organizations, bundled payments, and medical homes all of which are intended to provider higher-quality, coordinated care for beneficiaries. The Affordable Care Act also covers seniors on preventative services and annual wellness visits. Medicare beneficiaries are eligible to receive many preventive services with no out-of-pocket costs. These include flu shots, tobacco cessation counseling, as well as no-cost screenings for cancer, diabetes, and other chronic diseases.
Healthcare Reimbursement Healthcare is made up of many factors. Among those factors are provider reimbursement and the different types of financial methods used by the patients to acquire healthcare services. Provider reimbursement is important and necessary in order to maintain the continuation of healthcare. Like every organization, including non-profit organizations, require revenue in order to pay their healthcare providers, expenses accrued, and to obtain the supplies needed to aid in rendering services. With that said, this is why there are many financial methods such as third-party payers, government agencies, private health insurance, and patient payments.
This is where one type of plan will explain what is to be expected for users. Explaining the benefits is practically as important as the application itself: for determining the value of the health care may be "service dependent" ("Medicaid", 2015). Another important term that should be well known is clean claims. Clean claims identify the health professional, health facility, home health care provider or durable medical equipment provider that has given service to verify affiliation status. In short, it identifies a lot of the medical information to make it more transparent.
