DM Medical Billings incorporated in October 1997, and has been providing EMS and medical transportation billing for over nineteen years. When DM Medical Billings was established, it was decided to focus our billing efforts solely in the EMS and Medical Transportation industry. This has proven extremely successful for us. By specializing in one industry, we can say, with certainty, that we are more experienced and more knowledgeable in emergency medical billing, than your average third party billing agency. Dina Mueller is the sole principal of DM Medical Billings.…
It is our intention to provide you the best healthcare care possible. At Central North Alabama Health Services you can receive care from an internal medicine or family practitioner. Our physicians focus on primary care, general health assessments and consultation for complex medical issues. We believe in a patient-centered approach to healthcare, collaborating with patients, families and specialists.…
n this article, we will examine three analytical techniques for increasing your commercial payer contracts’ reimbursements: 1) Use weighted averages to calculate your reimbursements, 2) Avoid the infamous “Lesser of” Billed Charges or Contracted Rate problem and 3) Focus on your most important codes. When negotiating payer contracts, it is key to do your own data analysis of your contracts to effectively increase your reimbursements.…
There are different options patient to make payment during check-in. Most time the will have a sign in the office saying VISA, MASTERCARD, AMERICAN EXPRESS, not physician will accept DISCOVERY and personal checks. FSA (Flexible Spending Account) is also another form of payment. FSA is a health flexible account that is normally a part of the benefits package. FSA is pre-taxed dollars for anyone in your family.…
Physician Manipulation of Reimbursement Rules for Patients Between a Rock and a Hard Place Matthew Wynia, Deborah Cummins, Jonathan Van Geest, Ira Wilson American Medical Association Synopsis and Summary A study was done to determine at what rate physicians manipulate the rules of reimbursement in order for patients to receive services for which they may not otherwise be granted under utilization review rules though the physician may find the service necessary. The 1998 study was a random study that contained a national sample of 1124 physicians who were surveyed through mailings and the response rate was 64%. Three areas of concentration were involved that asked if the physician’s (1) exaggerated the severity…
TRICARE Standard Standard TRICARE is the basic health care. It provides healthcare for soldiers and their family who do have TRICARE prime. “If you visit a non-network provider, you're using the Standard option. If you visit a network provider, you're using the Extra option. Referrals not required, but you may need prior authorization from your regional contractor for some services.”…
Due to my Veterans Disability rating, I am required to attend scheduled medical appointments at the Veteran’s Administration Health Clinic . Sometimes I am unable to reschedule appointments because of the vast amount of veterans seeking medical attention such as myself. When possible, I try to schedule my appointments around school related obligations, mostly, these are routine appointments. There are those appointments that are specific that are administered by specialists, those are rarely or if ever flexible. However, occasionally I do not have the luxury of scheduling at my convenience and when that occurs I do so .…
Doctors feel that what they charge is fair. Doctors do not take into consideration the patients financial status and how this can affect a family. “When the doctors work in the hospital, not for the hospital, which is often the case, they’re not obliged to join the same networks as the hospital,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. “And patients generally have no say in selecting those doctors” (Alberico,…
Introduction Private health care is known in Canada as care that is funded by private sources or by the patient themselves (DeCoster and Brownell 301). There are many different perspectives on whether or not Canada should privatize their health care system. In a situation like this, it must be taken into account what is best in the country’s eyes, and not the perspective of an individual or a single community (Uplekar 898). Quality health care is a concern for many people.…
Each employee is assigned to a primary care doctor for when they need medical attention. If the employee has a problem that is out of the physician’s area of expertise then that person is referred to another HMO physician. In the event the employee needs immediate medical attention or medicine, they are referred to hospitals and pharmacist within their HMO. There are various types of HMOs but first lets address group-model HMO.…
For example, a physical or general health check, you’re probably only allowed one a year, I mean you could get ten done, but the HMO will only cover one of those visits. One of the important elements of HMOs is selecting a primary care provider, this person will determine all your needs and be able to refer you if you need any special treatment done. HMOs most of the time are generally less costly, but then again there is a tradeoff between price and…
They only submit the claim to the providence and they pay them back. By having one single administration that manages the pay out to the doctors, it immensely eliminates the administrative cost. Unfortunately, the United States does not have this…
You can only be treated by hospitals that accept your plan and you need to have a referral to be seen by a specialist. PPO (Preferred Provider Organization). A PPO is more adjustable. You can choose any doctor you want and are not limited to a specific network. If the provider you choose happens to take part in your plan the cost will be lower than if the provider is outside the network.…
Discuss the difference between Level 1: CPT Codes and Level II: HCPCS National Codes and give an example of each. Level 1: CPT Codes are codes used for medical procedures, these consist of five digits. “Current Procedural Terminology (CPT), is a code set maintained by the American Medical Association (AMA)”, it is designed to describe medical, surgical, and diagnostic services accurately. It is used as a form of uniform communication across the medical field. The CPT Codes are not particularly private, as AMA has the sole copyright to the codes, so you have to “pay a license fee if you want to compare the Relative Value Unit (RVU) values to the CPT codes”.…
Opportunity cost is defined as what must be given up in order to do or obtain something; the highest-valued alternative that must be foregone; for example, the opportunity cost of taking the final exam may be missing out on a trip to Bermuda (Getzen, 2013). The New Oxford American Dictionary defines it as "the loss of potential gain from other alternatives when one alternative is chosen. " Opportunity cost is a key concept in economics, and has been described as expressing "the basic relationship between scarcity and choice (Buchanan, 2008). Opportunity costs play a role in decision-making to ensure that scarce resources are utilized efficiently. Opportunity cost is not only monetary or financial but can be associated with loss of time, experiences…