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.

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. 

In this new era of Online Healthcare, majority doctors and consumers prefer Practice Management

Practice management software is wisely preferred, since it is convenient, cost effective and gainful. Due to its usefulness, it is highly preferred by the doctors and patients. Using this software, it not only covers a phenomenal flow in the procedural work, but also helps the doctors to take financial decisions. 

A recent survey by Katharina Scharruhn concluded that, “treating medical practice management as a business involves the following: the front end, which is about making the money, and the back end, which is about keeping the money.”

Practice management solution helps us to gain our patients’ satisfaction with integrated workflows and accelerating revenue cycle. Access any billing information from any Internet-ready computer and a number of mobile platforms. This research continues with the agreement that U.S. health citizens are part of practice management solution to deal with their day-to-day operations. Not wrong to say that it’s a multi-pronged strategy to low down the cost curve in American health care!

Practice Management Software

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.

Internet simplifies a Doctor-Patient Relationship

Information technology era has come up with many dynamic changes. It effectively settles the doctor-patient relationship too. Users generally prefer Internet to seek online health information instead of asking friends and going through reference books, offline sources or even health news reports. Internet is one of the primary concerns that provide all the information about health and related issues. Majority patients go with online searches to handle their medical problems not because they mistrust their doctors, as now they believe that personal control over their illness can be figured out very easily.

Patients will never suffer from any problem, while setting their medical appointments with the doctors. Personal Health records (PHR) is one of the unique contributions that provides patients an online access to get their past and current health information directly from their doctor’s website. With PHR, patients get information about their personal assessments, medications, general allergies, immunizations and procedures too.

PHR is completely free and reliable. Patients can get their personal online portal from which they can record, track and even save their important health related information at one secure online place. With the improved workflow and efficiency of a practice, free technical support is also provided where needed. Patients can easily manage their personal health records like demographic information, appointment history, health records, lab tested results, payment reports, outstanding balances and claim history, available 24/7 from any Internet-ready computer. Level of trust between a doctor and a patient gets more compact since online information-seeking is higher among the patients who get all the information from Internet.

Doctors play a dynamic role in supporting online health challenges. They need to be attentive and alert to provide the same degree of reassurance, their patients expects from them. Direct communication through the patient-doctor communication module and viewing direct comments from the personal providers strengthen a Doctor-patient relationship. Moreover, majority patients feel much comfortable to get any sort of online information from their doctors. This has also developed trust and confidence among the patients, who prefer online health solutions.

PHR allows online scheduling, from which patients can simply schedule their own appointments directly through the practice’s website. An ideal PHR holds an incredible ability, since it can easily get and assess the information from a patient's lab results or monitoring devices; store a patient's remarks about the physical and social environment and link with a doctor’s electronic health record (EHR). PHRs can also make health care more reasonable by urging avoidance and wellness, and by reforming better care delivery.

Personal Health Record (PHR)