When Should You Use 3rd Party Medical Insurance Claims Requests In Your Practice?

When one thinks of healthcare in the U.S. today, there are three key components to consider. They are the patient, the provider, and the one who pays the bill. It is no secret that the health insurance industry, both government and private insurance carriers, pays for most of the health care for U.S. citizens. About 70% of all the payments to hospitals, doctors, labs, diagnostic centers, rehab facilities, and other certified providers are made by insurance payers. The patients pay the other 30% or so out of their own pockets. What happens when your medical insurance claims are not paid timely?

Medicare and Medicaid are taxpayer-funded and are highly regulated, as are the private payers. However, almost all private health care insurance companies are "for profit." This means that they must take in more than they pay out in insurance claims to providers, and the amount of positive cash flow must be enough to pay all overhead costs, employee salaries, variable expenses, and stockholders, plus a required amount of cash in reserve as required by various federal and state laws. Even Medicare and Medicaid are required to simulate that model, or at least not lose money, which means all payers (both government and private) have strict rules regarding reimbursements, or payouts for legitimate claims. To patients and providers, these regulations may often appear arbitrary and unfair, which is why there are state and federal agencies to monitor and police the insurance industry.

But who acts on behalf of the medical providers? The legislation of the past five years, including the HITECH Act and the Affordable Healthcare Act (Obamacare) has added to the financial burden. The providers, as the recipients of the payment for healthcare services, are feeling the crunch of lower reimbursement from payers, and higher accounts receivable from patient balances.

The Affordable Care Act Effect: How the Affordable Care Act Affects Medical Practices

The practice of medicine is highly revered in the U.S., and yet no other industry or career path has as much regulation or such widespread and public potential of litigation for malpractice. The days of the venerable country doctor are over, yet the public still holds that perception, while the reality is more controlled by Federal agencies, insurance companies, Congress, drug companies, attorneys, and technology.

Today, more than 65% of the new physicians bypass private practice when they begin their practice of medicine. Largely due to the costs of starting a practice (much of which is due to the heavy regulation and litigation potential) these new doctors would rather be employees of hospitals and have someone else take all or most of the risk. Just a few of the laws that have contributed to this transition are The Health Insurance Portability and Accountability Act (HIPAA) passed in 1996; the Balanced Budget Act of 1997; the HITECH Act 2009, and of course the Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare.

The Affordable Care Act Effects On Private Practice

Besides the movement away from entrepreneurship, this transition can have an impact of the quality of care if only from the standpoint of the potential for changing the highly regarded "physician-patient interaction" standard the public has long treasured. There is another trend that is just emerging. More of the existing doctors are choosing to become hospital employees rather than struggle with the unprecedented challenges which medical practices face in accounts receivables management and cash flow. Again, these challenges are the result of the regulations of Medicare, Medicaid, commercial insurance, and the many acts mentioned earlier.

The latest act, Obamacare, is still unfolding. Only a small portion of its regulatory structure has been implemented. The act was intended to help citizens pay for healthcare by forcing regulations onto insurance companies and private citizens, but the impact of this, as well as the other acts, always falls on the medical provider, usually in the form of reduced reimbursement. Obamacare promises to impact the financing model of healthcare in ways still unknown, but potentially feared by most physicians. However the known provisions of the legislation are already having an effect. The continued pressure to reduce Medicare reimbursements are a known part of the act. Lesser known provisions, such as the pressure to move the healthcare financing model to ACOs (Accountable Care Organizations), and the incentives to force medical providers to purchase and use EMRs (electronic medical records) systems, have caused nothing less than frenzy in the private medical community.

What Is Aromatherapy and How Can It Help in Alleviating Stress?

The internet is abuzz with the growing popularity of alternative therapies for a large number of ailments and diseases. Aromatherapy too is a traditional alternative medicinal practice that is aimed at improving the emotional and spiritual being of a person.

The basis of Aromatherapy is to cure using essential oils and certain aromatic herb, which has a profound influence on a person's emotional being, cognitive functions, and even physical health.

Science practitioners deem Aromatherapy to be more of a placebo-based treatment method and hence the effectiveness of Aromatherapy in actual treatment is relatively low. However, strong evidences lend support to the efficacy and benefits of using this traditional healing method to heal a good number of ailments, especially in terms of reducing and curbing stress.

A lot of doctors and therapists adopt the practice of Aromatherapy with their clinical treatment. Dentists keep scented candles in their offices to help the patients get rid of anxiety and feel a sense of calm prior to their appointment. In a lot of offices of psychiatrists and clinicians, essential candles are specifically placed to calm down anxious and nervous patients.

Aromatherapy of course is considered as more of an additional aid to modern medicine, but even in isolation Aromatherapy works as a significant therapy for certain ailments.