Seven weeks seem to travel by fast when you are blogging about a topic that you are genuinely passionate about. Healthcare was that mist of passion for me!
I have taken this blogging exercise and experience from English 112 and have truly grown from it, as
a person and writer. It is beneficial to open your mind to opposing views in order to see the glass half full, rather than half empty. As well as positively accepting the criticism from others in order to correct mistakes that we all make as writers, in order to perfect our writing skill and style.
Over the semester, I covered a variety of topics that are relevant to healthcare but often overlooked. Certainly, in the current news the "Affordable Care Act" has dominated the focus in healthcare. While that is significant important, there are growing concerns in other areas of healthcare.
In brief, topics that I covered were: the Affordable Healthcare Act (policy and conspiracy), health insurance fraud, supplementary health insurance plans, the Health Insurance Portability and Accountability Act (H.I.P.A.A.)
The connection I had with my blog grew personal working in the healthcare field. I found myself blogging about issues that I observed affecting citizens. Passion grew from my personal connection in the healthcare field. I found myself interviewing my coworkers and having open discussions with coworkers and patients from time to time in order to decide on topics for my weekly posts.
But like they say, "all good things must come to an end..."
With the semester coming to a close, I will not be continuing my blog, "The Healthcare Post." Between balancing family, school and work, it's hard for me to personally manage my time to continue this blog. Whelp!, it was fun while it lasted!
HIPAA, a common phrase and well known term among healthcare and legal professionals. HIPAA stands for, Health Insurance Portability and Accountability Act. This was an act passed by Congress in 1996 and signed by past President Bill Clinton.
"HIPAA does the following:
Provides the ability to transfer and continue health insurance coverage for millions of American workers and their families when they change or lose their jobs; Reduces health care fraud and abuse; Mandates industry-wide standards for health care information on electronic billing and other processes; and Requires the protection and confidential handling of protected health information" ("Health Insurance Portability and Accountability Act")
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HIPAA, is an important aspect in regards to healthcare. The act protects the privacy of patients. A
disclosure must be signed by a patient before any information is given to anyone on the patients behalf. Each year the office that I work at prints out a HIPAA privacy form, in which we require patients to update their chart with the updated form. Patients are asked to list in the comments section the name of any individuals, if any, who we can release their information to. This includes discussing lab results and having a designated proxy to pick up and sign for their prescriptions.
When handling patients information it is important to be careful, it is vital and confidential information. Protecting their information is not limited to verbal protection. It also includes the handling of the patients medical chart. A medical chart is legal documentation and should be secured and treated as such. This means, that there should be frequent checks where the patients name and date of birth are checked to make sure paper work is filed into the proper chart.
Sometimes we fail to realize the importance of "acts" that are passed in order to benefit the public.
Work Cited:
"Health Insurance Portability and Accountability Act." California Department of Healthcare Services. DHCS. Web. 21 Nov 2013. <http://www.dhcs.ca.gov/formsandpubs/laws/hipaa/pages/1.00WhatisHIPAA.asp&xgt;.
As I prepare to gather information for my analysis paper of my blog, "The Healthcare Post", I narrowed the sources down to the most direct and significant sources. This includes creditable sources, such as: The New York Times, The Washington Post, and a personal Healthcare Professional personal interview. It is significantly important to include a variety of sources, in order to eliminate a bias opinion.
I will include direct quotes from Government Officials and healthcare professionals in order to positively persuade my audience that America needs a healthcare reform. It is essential to provide the audience with reliable and creditable information. I believe that based on my selection of sources I can effectively reach my audience and highlight the importance of the presence healthcare issue in America.
With efforts to simplify the healthcare act, today President Obama made an announcement on Capitol Hill this morning that citizens can keep their old health insurance plan, which would not have been permitted with the original Affordable Healthcare Act. The extension is still yet only temporary and will only extend keeping your old health insurance policy for "one" year.
President Obama stated at the press conference, "I completely get how upsetting this can be for a lot of Americans, particularly after assurances they heard from me that if they had a plan that they liked the could keep it," said Mr. Obama, who repeatedly took personal responsibility for the health care rollout, which has thrown Democrats on the defensive. "And to those Americans, I hear you loud and clear. I said that I would do everything we can to fix this problem. And today I'm offering an idea that will help do it." (Parker)
Full Press Conference 11/14/15:
President Obama is trying to restore faith in the Affordable Healthcare Act, in order to persuade citizens of the benefits. I am afraid that extending the options for patients to keep their current healthcare plan for one year is not good enough. Whether we face the facts or not, a year is going to come and go soon as we blink our eyes.
I still firmly believe that citizens should have the right to chose. America is a Democracy and we should not dictate healthcare options. The Affordable Healthcare Act is beneficial for those who are currently un-insured and seeking insurance. Along with those citizens who are looking for a more cost efficient healthcare plan. Thus, the Affordable Healthcare Act should be available for those who chose to receive the benefit.
A quick fix of extending the time citizens have to keep their current healthcare plan does not eliminate citizens concerns. This decision that was made by President Obama is only buying time for the President to re-think issues and faults in the Affordable Healthcare Act. In a year, will we face this same issue?
Work Cited:
Parker, Ashley. "A Contrite Obama Unveils a Health Fix. "The New York Times. N.p., 14 Nov 2013. Web. 14 Nov 2013. <http://www.nytimes.com/2013/11/15/us/politics/obama-to-offer-health-care-fix-to-keep-plan-democrat-says.html?_r=0&adxnnlx=1384476572-zujFvKN3tEFtJttUhuRpIA>.
It is essential for elderly patients with medicare to obtain a supplementary health insurance plan. Medicare covers 80% of the medical costs, and the patient is responsible for the remanding 20%. Twenty percent may not seem like a big amount but it truly is once medical bills start piling up for patients.
Keep in mind that elderly patients are more likely to be hospitalized because of their high risks and medical conditions. Hospital bills along side transportation costs (Ambulance services) can really put a dent in a patients pocket. The majority of patients that are on medicare only have one source of income, social security. "What's Medicare supplement (Medigap) insurance?"
“A
Medicare supplement (Medigap) insurance, sold by private companies, can help
pay some of the health care costs that Original Medicare doesn't cover, like
copayments, coinsurance, and deductibles.
Some
Medigap policies also offer coverage for services that Original Medicare
doesn't cover, like medical care when you
travel outside the U.S. If you have Original Medicare and you buy a
Medigap policy, Medicare will pay its share of the Medicare-approved amount for
covered health care costs. Then your Medigap policy pays its share.
A Medigap
policy is different from a Medicare
Advantage Plan. Those plans are ways to get Medicare benefits ,
while a Medigap policy only supplements your Original Medicare benefits.” ("Official U.S. Government Site for Medicare)
With a supplementary health insurance plan, that plan would cover the 20% that medicare will not cover. The majority of all major health insurance companies offer a medigap plan which is classified as a supplementary plan. Some of the options for a supplementary plan are: BlueCross Blueshield, Cigna, Aetna, Compass Rose, Golden Rule, AARP, Humana, and etc. A lot of patients even keep their previous insurance that was offered through their job when they were employed, making medicare their primary and the other a secondary.
Many of the patients at the physician office that I work at, have medicare as a primary and tricare as a secondary. For those patients who just have medicare, we do not collect a co-pay since we do not know before hand how much the total visit will cost. Our billing Administrator files the claims to medicare and the patient is then billed the remaining balance. This method also results in a collection of debt for patients who are unable to pay in full their account balances.
We often see that older patients make attempts to make payment arrangements by paying something on their accounts but we rarely see patients without debt.
We encourage all patients with medicare to obtain a supplementary health insurance plan in order to save the patient costly services that medicare will simply not cover 100%.
Works Cited:
"What's medicare supplement (medigap) insurance?." The Official U.S. Government Site for Medicare. N.p.. Web. 7 Nov 2013. <http://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html>.
Working in the Medical Field has taught me the importance behind verifying information. In healthcare it is imperative to verify a members identity as well as medical benefits, to ensure that the physician and/or office gets reimbursed for services rendered.
On a daily basis I encounter patients that would like to be seen by a physician but they can not provide the office with a valid photo id. It is essential that we verify the patients identity before their visit in order to confirm that the individual insured is correct as well as verifying a correct billing address for claim purposes. If a patient is unable to provide a id, our office has the right to deny services and refer them to an outside facility, such as a local hospital.
Since the downfall in the economy there has been high volumes of insurance fraud reported. Cases
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have been documented where patients allow other "un-insured" individuals use their medical insurance card to receive services, for a small "fee." Thus, greater measures have to be taken in order to control this growing issue.
Responsibly falls back on the facility and/or office front desk staff and billing staff to insure accuracy in billing claims, in order to submit accurate patient information.
I interviewed, Jade Shaw, a Clerical Administrator at MHCA (abbreviated for privacy) on measures being taken at the medical facility in which she is employed.
Interview Questions: 1. What forms of identification are required at MHCA for new patients? - "Here at MHCA we require that all new patients present the front desk with a valid photo id along with their insurance card during check in."
2. What types of identification are acceptable? -"We accept drivers licenses, state issued identification cards and passports. Rather anything with a picture id, where we can match the patients name and the name on the insurance card with the patient along with being able to verify their face by photo."
3. What if a patient is unable to present a form of id to your office? -"We advise them to reschedule when they have proper documentation to verify their identity or either refer them to a local hospital, in an emergency situation."
4. How does your office keep record of the patients id and insurance card? -"In the previous years our office would make a xerox copy and file it in the patients medical chart. Now, with advances in technology our office now has the resources to scan electronically the patients id and insurance card. This makes it easier for verify a patients information during check in."
5. Would you say that the measures being taken are reducing account of insurance fraud? -"I would have to say that our office has not had any incidents of insurance fraud because of our pre-cautious measures that we are taking in efforts to prevent it. Not saying that it could never happen, but we keep an open eye in order to prevent errors."
(Interview Concluded)
In brief, insurance fraud is an issue that needs to be addressed and monitored closely. Consequences could result in physicians loosing their licenses as well as employees loosing their job. It is a chain of command that verifying a patients identification goes through and someone should catch the errors. Beginning with the front desk, as it works it way through to the physician.
Imagine the physician coding the wrong diagnose and procedure code for a patient because of a case of insurance fraud. Once the physician codes patients fee ticket and that trickles through to the billing department who then files it to the insurance company, the insurance company verifies the diagnosis and procedure codes. Insurance companies may even request for a physicians clinical notes on the patient from a specific period of time in order to verify that the claim was billed correctly before the insurance company agrees to pay for a procedure.
Working in healthcare requires attention to detail. You are handling sensitive patient information. There is no room for error!
Would you say that problems citizens are having accessing the healthcare.gov website are a conspiracy?
Since the launch of the website on October 1st, 2013 the technical issues which halt citizens from successfully completing their application for healthcare are still present, nearly a month later. It amazes me that this highly anticipated debut of the the websites opening was not prepared for.
At a recent press conference, Marilyn Tavenner, Administrator of the Centers for Medicare and Medicaid Service stated, "I want to apologize to you that the website has not worked as well as it should." (Alonso-Zaldivar)
I completely understand that there are high traffic volumes on the website, due to citizens trying to access the database to join the American bandwagon for healthcare. Yet, is this issue so supreme that our "oh, so powerful" American Government can't solve it?
Could Republicans have sabotaged President Obama's, www.healthcare.gov?
In the mornings during my commute to work, I tune into 89.3 NPR. A heavy discussion that surfaces every morning is about the effectiveness of the healthcare.gov website. Republicans have made attacking statements towards President Obama's healthcare agenda.
Obama's healthcare legislation passed through all checks and balances, and was approved by the Supreme Court, and although the bill was made a Law, Republicans were consistently trying to stop the legislation that was already in place. The Affordable Care Act is a law, and despite this fact, republicans attempted to bully the law out of legislation. As a result of the battle to reverse The Affordable Care Act, the Government was shut down. this shows that there is no avail or preference for the american people in the eyes of republicans. This also shows that there is nothing that the republicans wouldn't do in order to have things in their favor.
I believe that the conservative party has ties in the implication and construction of the healthcare.gov website. The United States is a world class leader in intelligence and technology. Although technology is not always 100% reliable, the technical advances that the United States has can make a task such as implementing and contracting a website that allows access to healthcare services for United States citizens a very minuscule task.
A government contracting company, CGI warned the Center for Medicare and Medicaid services of potential issues and risks with the operation of the website.
"The firm, which was responsible for both contracting key elements of the sites and helping interweave them, cautioned that "hub services are intermittently unavailable" and the time allotted for testing was "not adequate to complete full functional, system, and integration testing activities." They rated problems as "nearly certainty" and "highly likely" and rated the impact as "significant" or "severe." (Eilperin)
If the battle to implement new healthcare reform was so brute as to have our government shut down, isn't it ironic that after the battle was lost for the conservative party they now fight for a new cause. Republicans are in a uproar because citizens can't access healthcare.gov, a site that Republicans had our government shutdown in effort to stop.
I am convinced that Republicans knew all along that the new healthcare reform would be beneficial to citizens. Thus, they are continuing to make it seem like the Democratic party do not have citizens best interest in mind and that the entire healthcare act is flawed.
Works Cited:
Alonso-Zaldivar, Ricardo.
"Medicare chief apologizes for 'Obamacare' website woes." Los
Angeles
Daily News. N.p., 29 Oct 2013. Web. 31 Oct 2013.
<http://www.dailynews.com/government-and-politics/20131029/medicare-chief-apologizes-for-obamacare-website-woes>.
Eilperin, Juliet. "CGI warned of HealthCare.gov problems a
month before launch, documents show."
Post Politics. The Washington Post, 29 Oct
2013. Web. 31 Oct. 2013.
Over the semester, I covered a variety of topics that are relevant to healthcare but often overlooked. Certainly, in the current news the "Affordable Care Act" has dominated the focus in healthcare. While that is significant important, there are growing concerns in other areas of healthcare.
