Medicare elucidation with a summary of its parts A, B, C & D

Medicare is the national health insurance program, by the government for medical and health related services. These services are provided to the specific group of people. Medicare is administered by the Centers for Medicare and Medicaid Services (CMS), a division of the U.S. Department of Health and Human Services. Since 1965, Medicare guarantees access to health insurance for Americans ages 65 and older and younger people with disabilities as well as people with end stage renal disease.

Medicare is providing services in four major parts. These parts are categorized according to the specific services in different sections of healthcare industry. These parts are known as A, B, C & D. Lets discuss each of them:
Part A: Hospital Insurance

• Helps cover inpatient hospitals care

• Helps cover skilled nursing facility, hospice, and other medical services

Part B: Medical Insurance

Part B includes other medical services & supplies that are not covered by Part A. It also helps the doctor to cater the medical bills from outpatient visits & care.

• Helps cover doctors' and other health care providers' services, outpatient care, durable medical equipment, and home health care

• Helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse

Part C: Medicare Advantage

Part C covers the element of choice. This plan allows you to select to receive healthcare services through a provider organization. This works incredibly to reduce your costs of receiving medical services. To enroll in Part C, you must have both parts A & B.

• Offers health plan options run by Medicare-approved private insurance companies

• Medicare Advantage Plans are a way to get the benefits and services covered under Part A & B

• Most Medicare Advantage Plans cover Medicare prescription drug coverage (Part D)

• Some Medicare Advantage Plans may include extra benefits for an extra cost

Part D: Prescription Drug Coverage

This part of Medicare is voluntary & provides outpatient prescription drug coverage. Part D is only available through private insurance companies that have contracted with government.

• Helps cover the cost of prescription drugs
• May help lower your prescription drug costs and help protect against higher costs in the future
• Run by Medicare-approved private insurance companies

Policies driven by Medicare help the private health insurance companies to utilize Medicare benefits & privileges. There are many Medicare plans like HMOs (Health maintenance Organization) or PPOs (Preferred Provider Organization). In general the benefits cover:

• Payment  for Doctor Bills
• Handling hospitalization charges/costs
• Prescription Drugs
• Settlement of other related medical services & products.

The meaningful use program by Medicare brings supplementary benefits in addition to the federal government financial incentives. It allows providers and practices enhance their services by reducing errors and quick access to information.

Meaningful Use with its Meaningful Results

Meaningful Use (MU) defines the use of certified Electronic health record (EHR) to improve quality care, reduce health disparities, and achieve better clinical outcomes within a healthcare organization. After the implementation of meaningful use, significant changes are done to transform a better healthcare system and following major changes will be seen:

    1.  Developed Quality, Safety, and Efficiency

    2.  Patient Commitment

    3.  Care Coordination between Clinics and Hospitals

    4.  Improved Public Health and Preventive Medicine

    5.  Complete Privacy and Security Protection

Physicians, after adopting electronic health records in a meaningful way, may have been awarded from the Centers for Medicare & Medicaid Services. More than 55,000 physicians received bonuses for meaningful use of EHRs in 2011 or 2012. Doctors or hospitals found ineligible for an EHR incentive after an audit would be asked to return the bonus payment.

Adoption of meaningful use program is now a fundamental requirement for the physicians, since two and half years is the rough time span left to implement Electronic Health Record (EHR) systems without facing any financial penalties. Practices should take serious notice on these deadlines and physicians need to focus all the essential elements necessary to meet the criteria of Meaningful Use (MU) bonuses.

For the ongoing success of EHR Incentive Programs, many billing companies have designed webinars and profound coaches that will walk physicians through solutions surrounding EHR issues and MU criteria. Each webinar with its training is interactive and featured. Identifying the key elements to achieve MU bonuses is the core objective. It will also provide an overview of related initiatives, incentives and penalties and how they will impact physician practices.

They Laughed When I Said I'd use EHR-- But When I Employ the LEVEL system in new Medical Practices, They Begged Me for My Secret!

A recent study by Pamela Lewis Dolan, revealed that a number of physicians have been doubled since 2008 who adopted electronic health records. Although EHR service is overwhelming, this source can be a reason of communication breakdown between patients and physicians. An internist and medical director of informatics at the Reliant Medical Group in Worcester, Larry Garber, MD, said that, “When physicians who are used to carrying paper charts start using tablets or desktop computers in the exam room, it’s going to be disruptive,”. This disruption “can absolutely make or break the relationship between doctor and patient,” he said.

Study said that numerous medical schools have realized the impact of bad communication affecting patient satisfaction and outcomes. Introduction of LEVEL system is a unique contribution to avoid unintended consequences based on bad communication.

Exam Room Setup: Many practices are implementing EHRs in spaces meant for paper-based practices said Glen Stream, MD, president of the American Academy of Family Physicians and chief medical information officer of the Rockwood Clinic. This undergoes with a new setup that has the physician’s back to the patient when he or she uses the computer, “which is absolutely the wrong message you want to send to the patients,” Dr. Stream said. Implementation of a basic triangle design that puts the physician, patient and computer screen at each of the three corners, allowing the doctor to look at both patient and computer screen without shifting his or her body is another method. In this way patients feel they are being looked at even when the physician is looking at the computer screen, Dr. Garber said.

Work-flow Design: Vincent WinklerPrins, MD, a family physician and associate professor of family medicine at Georgetown University School of Medicine in Washington said that computer terminal should never be the first place the physician goes when entering the room. The doctor should go to the patient first, greet him/her and establish an agenda for the visit. After that is done, the doctor should have some kind of transitional line explaining what he or she is about to do in the EHR, such as, “OK, let me jot down a few notes.”

Employ the LEVEL system: Designed by Kaiser Permanente to help physicians use an EHR in the exam room, LEVEL stands for:

L: Let the patient look on. This goes back to the triangle setup that allows the physician to easily share things on the computer screen with patients.

E: Eye contact. Dr. Garber treats every patient encounter as he would have a conversation with a friend or family member.

V: Value the computer. If the physician praises the benefits of the computer, the patient will appreciate its presence. Using such statements like “With my EHR, I can look that up” or “I can send your prescription straight to the pharmacy,” will help patients think their care is more advanced because of the computer, Dr. Garber said. Sharing visuals on the screen, such as a chart mapping historical cholesterol levels and positive framing by Dr. Stream are beneficial for the patients.

E: Explain what you’re doing. Dr. Braddock said it’s important for doctors to be transparent about everything they do. Share everything and be very clear with their work, in addition easy statements will make patients more comfortable.

L: Log off. Logging off in front of the patients, in the exam room makes them confident that the next patient won’t walk in with their information still on the screen, Dr. Garber said.

Dr. Braddock said that medical practices should look to one another for tips and guidance on how to handle this training and in this same regard, Reliant Medical Group adopted the LEVEL system from Kaiser. A YouTube video created by Dr. Garber explains the LEVEL process with “good doctor” and “bad doctor” examples. Communication is a foremost thing to bring a revolutionary change.  It reduces the uncertainty in opinions and practices. Dr. WinklerPrins said that every physician has to deal with how to work with an EHR in the exam room, and EHRs are here to stay, so every practice has to figure out how to work with them effectively. 

Technological Era hits the Medical and Billing Company by introducing Web-Based Electronic Health Records (EHRs)

One of the magnificent changes in the medical and billing company would be Electronic Health Record (EHR) invention. EHR is internationally recognized and well considered by many physicians and healthcare providers across USA.

Electronic Health Record is a unique solution to patients’ problems, medications, their medical history and other related reports. Web-Based EHR is easily accessible from anywhere, any computer or mobile device, like iPhone, iPad and latest mobile phones, where there is no hardware required as well.

Its users can easily access the complete information with enhanced technology and protected safety measurements. Web-Based EHR can be a defined sensation for many physicians, since there are no restrictions and limitations on the number of patients, users or medical records. These are certain advantages which stimulate majority doctors’ workflow and they also recommend Web-Based EHRs.

It won’t be wrong to say that Web-Based EHR is a big evolution in medical and billing services. Gain the benefit of accessing Web based EHR fully online with complete safety and medical solutions.

White House proudly acclaimed Bloomfield's Cigna Corp. for its care-centric efforts

Cigna is a prominent name among health insurance companies. It is a recognized entity in providing administrative services, to approximately 80 percent of its clients, said Internet search. Cigna endures key footprints in the Phoenix, Arizona with the collaboration of a full-service staff-model HMO with satellite clinics throughout the state too. Bloomfield's Cigna Corp. care-centric efforts for all Americans were immensely prized. It is contributing to serve millions of people with advance health concerns, welfare and sense of safety. Cigna core competencies involve:

1. Health care concerns with improved strategies and services
2. Advanced well-being programs
3. Proven health records
4.  Targeting the needs of customers, clients and partners

Cigna is one of the nine organizations that U.S. Surgeon General Regina Benjamin accepted for care-centric efforts to reduce health care disparities during a roundtable at the White House, recently. The event was done by the Department of Health and Human Services, the White House Business Council and the National Business Group on Health. Cigna's M.D. namely Christina Stasiuk accepted the Surgeon General's Medallion on behalf of Cigna and its Health Disparities Council, including council co-chair Peggy Payne and council lead Brooke Tomblin, said Internet search.

Health disparities result from multiple factors, including, communications barriers, poverty, cultural beliefs, environmental threats, medical bias, inadequate access to health care, individual and behavioral factors and even educational inequalities. This big achievement encouraged Cigna to continue their efforts more vigorously. Award was given in the credit of winning exceptional achievements that upgraded the public health service. In future, Cigna will work to remove cultural, linguistic and other barriers, connecting people to meaningful health information and studying new ways to engage people in health improvement, reflecting true commitment with diversity and enclosure.[1]

[1]http://newsroom.cigna.com/NewsReleases/cigna-honored-at-white-house-for-efforts-to-reduce-health-care-disparities.htm

                                               

Benefits of Health care law – A Medical Revolution

Health care law is formed to provide medical facilities to those who deserve. The health care law is successively working to promote wellness programs and strategies. No cost is involved by the patient and to support community health centers.

There are even some essential healthcare benefits for women under Obamacare. The benefits includes contraceptives, breast-feeding supplies and screenings for gestational diabetes, sexually transmitted infections and domestic violence, as well as routine check-ups for breast and pelvic exams, Pap tests and prenatal care. Recent survey found that estimated 47 million women are indulged with healthcare plans with other benefits & privileges. Before the implementation of healthcare law, many women were unaware and discouraged to get basic preventive services.

Now majority insurance companies are said to practice clear terms and conditions to describe their healthcare plans in beginning of 2012. Expectedly in 2013, states will initiate online marketplaces, where you will be able to compare the perks of healthcare plans equally. And in 2014, all healthcare plans will provide at least a minimum package of services, known as “essential health benefits”. We must predominantly focus on the below listed benefits: 

• Patient services
• Emergency services
• Maternity and newborn care
• Mental health and disorder services
• Prescription drugs
• Rehabilitative services
• Wellness programs and chronic disease management

Under the law, every state is under a certain check or observation. Healthcare law aims to govern a complete set of medical benefits and costs. Such benefits also retain the confidence of women avail medical service like free screening, pregnancy-related benefits and other supporting operations. Regardless, majority agree that to ensure quality of result, latest healthcare practices should be entertained.

Obama Care

Electronic Health Record: For Efficient and Error-free Practice Management

To provide better and more efficient medical care, doctors need to have access to information about their patients. A provider can better treat the patient if he or she has access to the patient’s medical history, demographics, lab results, clinical reports and other relevant data. Real-time access to all this information prevents errors and results in accurate diagnosis, better treatment and improved patient outcomes.

The question is how a provider could get all this information at a single centralized place. The answer is Electronic Health Records (EHR). EHR is a comprehensive healthcare system that provides a complete solution for a medical practice. It helps practices improve their services and double their revenues. Moreover, practices that make meaningful use of EHR also become eligible to earn a meaningful use bonus from Medicare or Medicaid. With the e-prescription feature, the EHR allows the provider to send prescriptions directly to the drug store. Similarly, the lab connectivity feature allows the provider to access lab results and reports directly on his or her computer system. With quick access to a patient’s data, a provider can accurately diagnose the disease and treat the patient in a better way.

One of the convincing features of EHR is that it handles all the data electronically, thereby reducing errors. It ensures smooth, efficient and error-free operations. Once the data about the patient is stored in the EHR, the doctor can always retrieve that patient’s medical data even if the patient is not present or is unconscious. This is really helpful in emergency situations when providers have to take prompt action for an unconscious patient.

Electronic Health Records (EHR)

Get Paid Faster up to $44000 with EHR Incentive Program

Electronic Health Record allows practices and providers to maintain an electronic record of patient’s information. The capabilities of EHR extend far beyond just maintaining electronic records. EHR features such as e-prescription, lab connectivity, drug interactions, automatic alerts, online patient engagement, etc. are making significant contribution in transforming healthcare industry. 

These programs have promised to reward providers and practices on demonstrating meaningful use of EHR. Medicare promises to give $44,000 and Medicaid promises to give $63,750 to the providers who will demonstrate meaningful use of EHR. Ensure your participation in EHR incentive program to earn meaningful use bonus. Following is the eligibility criteria for providers to participate in EHR incentive programs:

Eligible professionals under the Medicare EHR Incentive Program include	Eligible professionals under the Medicaid EHR Incentive Program include
Doctor of medicine or osteopathy	Physicians (primarily doctors of medicine and doctors of osteopathy)
Doctor of dental surgery or dental medicine	Nurse practitioner
Doctor of podiatry	Certified nurse-midwife
Doctor of optometry	Dentist
Chiropractor	Physician assistant who furnishes services in a Federally Qualified Health Center of Rural Health Clinic that is led by a physician assistant

Source: https://www.cms.gov/Regulations-and Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRIncentivePrograms/

Flow-chart of EHR

OB/GYN EHR: Another Remarkable Achievement

Science and technological developments have changed the process of examining a patient. The arrival of the OB/GYN EHR has made enormous differences to the efficiency of OB/GYN practices. To gain the full incentive, practitioners should participate in the Medicare incentive program.  Obstetrics is the medical practice for pregnant women and Gynaecology is the medical practice of diagnosing problems with the female reproductive system. An OB/ GYN's job is to screen for certain diseases including cancers of the breasts, cervix, uterus, and vagina and surrounding area. 

Another important part of an OB/GYN's job is to diagnose and treat female reproductive health issues that include sexually transmitted diseases, menstrual issues, diseases of the breasts, uterus, fallopian tubes, and ovaries, as well as fertility problems, and premenstrual syndrome and menopause related issues. Like other practices, OB/GYNs are supposed to have EHR as mandated by the U.S. government that “every physician should move to Electronic Health Records by 2015”. Therefore it is essential for OB/GYNs to switch to EHR software offered by many companies across the U.S. EHRs for OB/GYNs assist OB/GYN Practitioners in improving the quality of care being provided as well as assist the OB/GYN in building solid relationships with patients. OB/GYN EHR Features generally includes:

• Gynecological History
• Obstetric History
• Antenatal Visit History
• STD Studies
• Non Stress Tests
• RH Antibodies
• Breast Exam
• Pelvic Exam
• Ultrasound
• Mammogram
• X Rays

Along with the above features, OB/GYNs can also have the benefits of customized OB/GYN templates that feature easy-to-use and easy to document pictures for documenting HPIs, causes and treatments. Breast and pelvic exam templates are specialized and modified so physicians can best meet the needs of their patients. Practitioners can also have specialized diagnosis and treatment templates. The customized templates, HPIs and associated treatments of OB/GYN EHR make it possible for every OB/GYN to be documenting charts and submitting claims with efficiency. 

OB/GYN EHR