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Solved! Curing Your Medical Insurance Problems

Solved! Curing Your Medical Insurance Problems
Author: Adria Goldman Gross Fipc
Publisher: Outskirts Press
Total Pages: 130
Release: 2015-10-24
Genre: Business & Economics
ISBN: 9781478760566

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Consumer protection advocate Ralph Nader praised Solved! Curing Your Medical Insurance Problems: "Who hasn't been bewildered and outraged by lengthy, inscrutable medical bills and the tricky ways of the health insurers? ....Learn what to watch out for in this volume by authors who know the inside ways of sellers who try to take you to the cleaners." Some say, "You get what you pay for." If only this were true! Too often, consumers find themselves paying much more than they expected, getting much less than they bargained for. Medical care is no exception. In their book, the authors show readers how to spot over-charges by providers, under-reimbursements by insurers, and inappropriate denials by insurers and government employees. Furthermore, they presented steps to take to prevent being victimized by "the system." And what is the system? In America, it is a hybrid of private healthcare providers, massive insurance companies, and governments at the state and national levels. Unlike Britain with its single-payer National Health System, this public-private mixed-breed creates the need for patient advocate professionals, who take up the cudgels on behalf of the medically disadvantaged and the financially strapped.


Multi-Payer Medicine Nightmare Made in the USA

Multi-Payer Medicine Nightmare Made in the USA
Author: Fipc Adria Goldman Gross
Publisher: Outskirts Press
Total Pages: 132
Release: 2015-09-08
Genre: Law
ISBN: 9781478760559

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"You get what you pay for." If only this were true! Too often, consumers find themselves paying much more than they expected, getting much less than they bargained for. Medical care is no exception. In the U.S. edition of this book - Solved! Curing Your Medical Insurance Problems - the authors showed American readers how to spot over-charges by providers, under-reimbursements by insurers, and inappropriate denials by insurers and government employees. Furthermore, they presented steps to take to prevent being victimized by "the system." And what is the system? In America, it is a hybrid of private healthcare providers, massive insurance companies, and governments at the state and national levels. Unlike Britain with its single-payer National Health System, this public-private mixed-breed creates the need for patient advocate professionals, who take up the cudgels on behalf of the medically disadvantaged and the financially strapped. The material presented here may serve as an object lesson for those countries that would create or maintain mixed public-private financing and management of medical care.


Health Insurance

Health Insurance
Author: Sy Banner
Publisher:
Total Pages: 148
Release: 1993
Genre:
ISBN:

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Lives at Risk

Lives at Risk
Author: John C. Goodman
Publisher: Rowman & Littlefield
Total Pages: 278
Release: 2004
Genre: Health care reform
ISBN: 9780742541528

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Lives at Risk identifies 20 myths about health care as delivered in countries that have national health insurance. These myths have gained the status of fact in both the United States and abroad, even though the evidence shows a far different reality. The authors also explore the political and economic climate of the health care system and offer alternatives to the current health care public policies.


Care Without Coverage

Care Without Coverage
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 213
Release: 2002-06-20
Genre: Medical
ISBN: 0309083435

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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.


An American Sickness

An American Sickness
Author: Elisabeth Rosenthal
Publisher: Penguin
Total Pages: 434
Release: 2017-04-11
Genre: Medical
ISBN: 0698407180

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A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.


Curing Medicare

Curing Medicare
Author: Andy Lazris
Publisher: Cornell University Press
Total Pages: 263
Release: 2016-05-19
Genre: Medical
ISBN: 1501703870

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Andy Lazris, MD, is a practicing primary care physician who experiences the effects of Medicare policy on a daily basis. As a result, he believes that the way we care for our elderly has taken a wrong turn and that Medicare is complicit in creating the very problems it seeks to solve. Aging is not a disease to be cured; it is a life stage to be lived. Lazris argues that aggressive treatments cannot change that fact but only get in the way and decrease quality of life. Unfortunately, Medicare's payment structure and rules deprive the elderly of the chance to pursue less aggressive care, which often yields the most humane and effective results. Medicare encourages and will pay more readily for hospitalization than for palliative and home care. It encourages and pays for high-tech assaults on disease rather than for the primary care that can make a real difference in the lives of the elderly. Lazris offers straightforward solutions to ensure Medicare’s solvency through sensible cost-effective plans that do not restrict patient choice or negate the doctor-patient relationship. Using both data and personal stories, he shows how Medicare needs to change in structure and purpose as the population ages, the physician pool becomes more specialized, and new medical technology becomes available. Curing Medicare demonstrates which medical interventions (medicines, tests, procedures) work and which can be harmful in many common conditions in the elderly; the harms and benefits of hospitalization; the current culture of long-term care; and how Medicare often promotes care that is ineffective, expensive, and contrary to what many elderly patients and their families really want.


Priceless

Priceless
Author: John C. Goodman
Publisher:
Total Pages: 0
Release: 2024-09-03
Genre: Business & Economics
ISBN: 9781598133950

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In this long-awaited second edition of his groundbreaking work, Priceless: Curing the Healthcare Crisis, renowned healthcare economist John Goodman ("father" of Health Savings Accounts) analyzes America's ongoing healthcare fiasco--including, for this edition, the extra damage Obamacare has inflicted on America's healthcare system. Goodman then provides what many critics of our healthcare system neglect: solutions. And not a moment too soon. Entangled in even more perverse incentives that raise costs, reduce quality, and make care less accessible, Americans are sicker and poorer than ever. But it's not just patients that need liberation from this labyrinth of confusion--it's doctors, businessmen, and institutions as well. The truth is, no one benefits in our current system. Which means the time for change was yesterday. Read this new work and discover: How the absence of real prices for health insurance and medical care doesn't solve but creates problems--especially under Obamacare The perverse Obamacare incentives that cause insurance companies to avoid insuring patients with real health problems--and fail to encourage them to treatment even when they are insured Why having a preexisting condition is actually WORSE under Obamacare than it was before--despite rosy political promises to the contrary Why emergency-room traffic and long waits for care have actually increased under Obamacare The alarming shortcomings of Medicaid (and how it's managed, thanks to Obamacare, to expand anyways) How the market for medical care COULD be as efficient and consumer-friendly as the market for cell phone repair...and what it would take to make that happen How to create centers of medical excellence designed to actually treat Americans (not exclude them, as is the current practice) And much, much more... Thoroughly researched, clearly written, and decidedly humane in its concern for the health of all Americans, John Goodman has written the healthcare book to read to understand today's healthcare mess. His proposed solutions are bold, crucial, and most importantly, caring. Healthcare is complex. But this book isn't. It's clear, it's satisfying, and it's refreshingly human. If you read even one book about healthcare policy in America, this--once again--is the one to read.


Insurance Handbook for the Medical Office

Insurance Handbook for the Medical Office
Author: Marilyn Takahashi Fordney
Publisher: Saunders
Total Pages: 674
Release: 2010
Genre: Medical
ISBN: 9781437701289

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Keep current with all the latest changes with this complete resource! Trusted by medical insurance instructors and billers for more than 30 years, Insurance Handbook for the Medical Office helps you excel at all aspects of insurance billing for a full range of today's health care plans. In full color, this edition includes all the new regulations, such as the latest information on HIPAA, diagnostic coding, procedural coding, bill collection strategies, and Medicare. Meticulously reviewed by a panel of industry experts. Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist's role in filing clean claims, solving problems, and collecting overdue payments. Key terms are bolded at first mention, explained within the context of the discussion, and defined in the glossary. Key points summarize important chapter content. Block-by-block explanations and examples demonstrate the correct way to complete the CMS-1500 claim form. Completed sample insurance forms apply concepts to real life. Unique payer icons clarify CMS claim form completion. Form icons and Computer icons ease the transition from paper to electronic filing. Special HIPAA Alerts ensure compliance with governmental privacy regulations. Guidelines for the filing and submission of electronic claims include the do's and don'ts for the electronic environment. Service to Patient features discuss ways to provide quality service to the patient as well as to your co-workers. A documentation chapter covers the principles of documentation and shows how proper documentation can prevent penalties and refund requests, and help you prove compliance in the case of an audit or review. An Evolve website includes supplemental Medisoft activities, self-assessment quizzes, updates of content, and web links for further research and study. A workbook contains learning tips, review exercises, cases, and critical thinking activities for hands-on experience with real-world cases. (Available separately.) Updated learning objectives correlate directly to the text, making it easier to study and to measure your progress. New CMS-1500 form filler software on Evolve provides additional exercises for hands-on practice.