With a PPO you have a free choice of your health care provider. PPO members are not required to seek care from PPO physicians. There are also some disadvantages: Less coverage for treatment provided by non-PPO physicians. More paperwork and expenses than HMOs. As a PPO member, you may have to fill out paperwork in order to be reimbursed for your medical treatment.
HIPAA does not require a practice to purchase a computer-based system as it applies only to electronic medical transactions. HIPAA requires that all patients be able access their own medical records, correct errors or omissions, and be informed how personal information is shared used. Other provisions involve notification of privacy procedures to the patient. HIPAA provisions that have led in many cases to extensive overhauling with regard to medical records and billing systems” (April 2013). The HIPPA law was passed in 1996 to protect the privacy of the client.
Difference and Similarities among the major types of health plans 01/04/2012 The two major types of insurances in the United States are the indemnity and managed. Indemnity insurance patients can choose health care providers and hospitals. Referrals to specialists are not required. Patients pay deductible and insurance will pay the major part of the bill if the expenses will be considered “reasonable and customary”. Preventive care services are not covered.
There is nothing that says judges, individuals, or companies can ignore a law once its made because their beliefs don't follow under that law. Some people may believe in human sacrifice but that doesn't make it any less then murder. In The Judge John Kane case it was said that they were merely trying to follow through with their First Amendment right of freedom of religion. Although freedom of religion means they have the freedom to have it within the boundaries of the law. Health insurance is not a part of the religion therefore they must follow the Obama mandate.
This results in pitting ethnic group against ethnic group, union organizations against companies and non-union workers, legal residents against illegal immigrants, and so on. Average Americans should not be divided into an assortment of various groups and sub groups. The Case for Universal Healthcare 8 We should be united in the common cause of securing what is in the best interest of all, this being the first priority. President Barack Obama has addressed Congress concerning his plan for “Stability & Security for All Americans.” The Obama Plan ensures that all Americans have secure and stable health insurance. For those with health insurance, Obama promises (“The Obama Plan”, 2009): o Ends discrimination against people with pre-existing conditions.
I have discussed the advantage of the consumer driven health plans. I talked about the advantage and disadvantage of the reforming health care. I believe that the advantages overweight the disadvantages of health care reform. It will allow the uninsured to have health insurance coverage and mandates coverage for all
What makes health care different? In the healthcare system, federal and state regulation can be used to accomplish several important goals (Harris, 2011, p. 62). These include, to protect the public health by preventing and controlling communicable disease and protecting the public against bioterrorism, to promote the quality of healthcare services provided by facilities and individual practitioners, to reduce healthcare costs and promote access to care, and to protect consumers in the market for health insurance and other types of coverage (Harris, 2011, p. 62). While I would agree that it should be operated under more of a free enterprise system it is items such as these that make it important for the government involved. Healthcare is very different from other free enterprise systems as there are many licensures that are required by various professionals and facilities, and some choose self-regulation via accreditation facilities.
The current alternative to the fee-for-services is the capitation arrangement. The physicians believe that the pay-for-performance is controlling how that he or she conducts the practice, but it will eliminate many expensive and unnecessary procedures (Shi & Singh, 2012).The pay-for-performance in the United States healthcare industry comes after the capitation and managed care and if managed correctly will become an asset and if not it will become a major blunder. The goal of pay-for-performance is to change patient behavior and doctors and hospitals with a rewards systems or punishment. A pay-for-performance bonus for doctors can be an increase for the general fee-for-service hospitals can receive an extra in the form of the diagnosis group-based payment (Shi & Singh,
Obamacare forces people to have health insurance, so it caused those who do not agree with it to make the choice to not get any type of health insurance. For those who did obtain health insurance, it makes it difficult for health care facilities to accept new patients with pre-existing health conditions because there are many insurance companies who do pay for health care for pre-existing health conditions. This can cause problems for health care facilities to obtain payment for services from the insurance companies. Other political forces that may also influence the development of the clinic are the state’s budget that could be distributed among the healthcare industry and where the money is being used, what clinical staff positions are going to be funded, and which programs will be implemented and which ones will be terminated. Many facilities determine what services they are going to be providing by where their facility is located.