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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.


The Medical Insurance Virus

The Medical Insurance Virus
Author: Michael W. Brown
Publisher: Createspace Independent Publishing Platform
Total Pages: 134
Release: 2017-07-29
Genre:
ISBN: 9781545511350

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Described within the pages of The Medical Insurance Virus is a brief, but cogent, history of healthcare in America as it has evolved into today's healthcare crisis. Through the eyes of the author, a semi-retired physician with 35 years of medical practice experience and who has weathered this metamorphosis, the problem is brought into sharp and personal focus. Additionally, related problems such as medical malpractice are discussed. Finally, the unique solution to this controversial conundrum is definitively detailed. The solution presented herein is the true answer to this frightening problem and it is not currently being discussed. The author hopes to change that! Any adult in America who is concerned about his or her healthcare and that of their loved ones will want to read this book.


Health Insurance

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

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Priceless

Priceless
Author: John C. Goodman
Publisher: Independent Institute
Total Pages: 334
Release: 2024-09-24
Genre: Law
ISBN: 1598133977

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In this long-awaited updated 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. Americans are entangled in a system with perverse incentives that raise costs, reduce quality, and make care less accessible. It's not just patients that need liberation from this labyrinth of confusion—it's doctors, businessmen, and institutions as well. Read this new work and discover: Why no one sees a real price for anything: no patient, no doctor, no employer, no employee How Obamacare's perverse incentives cause insurance companies to seek to attract the healthy and avoid the sick 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 How Medicaid expansion spends new money insuring healthy, single adults, while doing nothing for the developmentally disabled who languish on waiting lists and children who aren't getting the pediatric care they need 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, which compete to meet the needs of the chronically ill 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 crisis. 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 is the one to read.


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.


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.


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.


Curing Our Sick Health Care System

Curing Our Sick Health Care System
Author: Robert Gumbiner
Publisher:
Total Pages: 163
Release: 2006
Genre: Health care reform
ISBN: 9781425933425

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The basic health care system in the United States is not working and must be fixed. The cost of a new, effective system of health care delivery would be instead of rather than in addition to what the US population is now paying for an inadequate, incomplete system. We must put the fiscal responsibility for health care delivery on the medical care sector that makes the decisions on what medications, what procedures and who gets treatment and when, that is, the providers of care, mostly the doctors. By doing this we can correct the more than fifty percent overpayment and misuse of funds currently in vogue. The book deals with the concept of the possibility of eventual coverage of everyone through the Medicare system as the current population ages. It explains the leverage that that single payer universal system such as Medicare, can generate to change the incentives for the providers of care resulting in a reduction of the overall cost. It also sets forth the concept of choice for the patient, the allocation of resources, and the restructuring of the medical education system as well as the recruitment and training of providers. Other problems such as organizational development, provider groups, malpractice, reinsurance through a universal system and other solutions are also dealt with. Today 45 million Americans have no health care coverage, while approximately 50 million are under insured due to high deductibles and co-payments. Many who are eligible for Medicare, federal health care insurance for the aged and Medicaid, federal health care for the poor, may be without coverage due to lack of access to services in the areas that they live. Practical solutions to these problems are addressed. Robert Gumbiner, MD, with more than 40 years experience in the health care field as a practicing physician, a manager and a force in medical management education, derives much of his experience from successfully developing and managing one of the largest managed care companies in the United States for over 30 years. Drawing on this extensive management experience as well as years of studying health care systems around the world, Robert Gumbiner debunks the myths held by opponents to national universal health care and capitated prepayment. His development of the first capitated prepayment plan for Medical in the 60's in California and first contract for prepayment Medicare on the West Coast in the 80's gave credibility to his ideas that succeeded in reducing health care costs. He shows step-by-step how we arrived at our current dysfunctional system and argues persuasively how we have been misled by special interests in the medical/industrial complex into thinking a health care system funded through the government and managed for effective utilization will eliminate choice. In the final analysis the book's major theme is that the cost of a complete comprehensive system is "instead of and not in addition" to what we are currently paying and how to go about instituting such a system. It offers solutions that have been developed by the author throughout his long career in managing health care delivery systems. It is not a theoretical concept but based upon ideas, errors, successes and a logical, practical model.