Taming the Cost of Health Care – How the Health Insurance Industry Fights High Costs

For many families, finding affordable health insurance is a task akin to the search for the Holy Grail. Depending on where in the country you live, a family health insurance plan can cost as much as $800-$1000 per month. Even when you split that cost between employee and employer, that’s a major chunk of nearly anyone’s monthly budget. And while it’s popular to swear under your breath at the greed of the health insurance industry, a look at the cost of medical care is an eye-opening shock for many people. The expenses associated with a broken arm, for instance, can easily mount into several thousands of dollars.The Health Industry has a stake in keeping people healthy.The high cost of health insurance is the direct result of the high cost of medical care. It’s a simple matter of economics. The more it costs to take care of each subscriber, the more the insurance companies have to charge all their subscribers. This cost/expense ratio is what has made most insurance companies embrace the idea of providing preventive care to their subscribers. It’s a simple matter of business sense – healthy people don’t cost the insurance companies a lot of money.Accidents may be the first type of medical need that springs to mind when people consider buying health insurance, the major insurance companies all agree that accidents aren’t the major cost drain on medical resources. That place is reserved for chronic illnesses like diabetes, heart disease, cancer and high blood pressure. Because of this, it makes good business sense for major players in the insurance industry to encourage their subscribers to adopt preventive health strategies. That pays off in special benefits for health conscious consumers. Preventive Health Benefits Help Keep Costs LowAmong the benefits that have become commonplace for major health insurance providers are routine physicals, medical screenings for all subscribers, discounts on health club and gym memberships, payment of dues for weight loss groups and lowered subscription fees for non-smokers.Some health insurance companies and HMO’s go even further in their preventive efforts. Because of the high risk of serious injury or fatality for infants in automobile accidents, Fallon Community Health Plan of Massachusetts has for years teamed with local organizations to provide free infant car seats to families with newborns. In the same spirit of prevention, many HMOs offer free stress management and stress reduction workshops to all subscribers because stress has been identified as a leading risk factor in nearly every major illness. Seeking a CureThe quest for affordable health care has also prompted health insurers and HMOs to help fun research and health initiatives all over the country. The industry underwrites millions of dollars of medical research annually in an effort to lower the costs of health care. Their dollars fund grants to enroll low income and other hard to insure populations, and to offer eye, dental and health care to inner city and poor rural populations. They estimate that routine preventive eye and dental care, as well as routine medical screenings and physicals can identify illnesses at early stages and prevent conditions and costs from escalating out of reach. Get the Most from Your Health InsuranceYou pay for it – you should certainly get the most possible benefit from your health plan. Here are some suggestions for ways that you can make your insurance plan work for you:
Join a gym.
Check the benefits that your HMO or health insurer offers. Chances are good that one of them is a discount good on membership at a local gym or health club. Get fit – it saves THEM money… but it saves YOUR life.

Lose weight.
Take advantage of nutritional counseling and memberships in weight loss support groups to get down to your ideal weight. Added bonus? Many insurance plans offer a lower tier cost for subscribers who are at healthy weights.

Quit smoking.
Non-smokers are another group that often enjoy lower insurance premiums. Many HMOs and health providers offer free smoking cessation programs to help you get smoke free and healthy.

Attend medical screenings and health fairs.
Many insurance providers sponsor ‘wellness fairs’ where you can have your blood pressure tested, get free medical screenings and learn about alternative medical techniques like massage therapy, acupuncture and yoga. Take advantage of special events to learn more and get healthy.
It may be popular to demonize the insurance industry, but today more than ever, these companies have a stake in keeping you healthy. Find out what your inusrance company has to offer you by visiting their web site, or calling customer service.

Importance of Medical Coding for Insurance

With health and diseases becoming a major issue these days around the world, it has become A LOT more important to have more and more coders involved in the medical field for insurance. But what is medical coding? A medical coder, clinical coding officer, or diagnostic coder are professionals involved in the health care sector who analyze clinical documents and using proper classification systems, assign standard codes to them. They provide medical coding guidelines and suggestions to help regulate the ways doctors, nurses, and other medical staff provide care for their patients. There are three main types of medical coding:

1) ICD (International Classification of Diseases): These are codes used for describing the cause of illness, injury, or death.

2) CPT (Current Procedural Terminology): These deal with anesthesia, surgery, pathology, radiology, measurement procedures, and new technological changes in the medical field.

3) HCPCS Healthcare Common Procedure Coding System): These include outpatient hospital care, medical aid, and Medicare.

Let us look at some points as to why coding is necessary for the medical field.

DATA SYSTEMS
When the coding is paired with the data systems of the hospitals, a powerful tool is made. By doing so, a large number of data from various hospitals, clinics, and other sources are stored, accessed, and used from one large online data system. This implementation helps in the transfer of any patient’s data from any hospital to another for any medical purpose. This information helps doctors to be more connected and make wiser decisions, especially in cases involving the life and death situation of the patient.

PATIENT CARE

Coding is very much required for reimbursements, which include submitting medical claims with insurance companies and bills between insurers and patients. The transfer of information for bill related purposes requires medical records, patient’s medical needs, lab results, pathology records (if any), and any other related documents. Appropriate payment is possible only when the required diagnostic codes are put in place, which also means to verify in case the medical claim is denied by the insurance company.

REGULATIONS

Medical billing and coding fall under the rules and guidelines of many countries and states. Coders in this field are also responsible for protecting the privacy of the patients and their families. They are supposed to take safeguards to preserve the confidential details concerning the patient and his/her medical background in a safe place. Electronic medical records fall under the International Classification of Diseases (ICD-10) codes issued by the World Health Organization (WHO).

Medical coding analysts are in the front line in healthcare data analytics. They work in many types of healthcare setups and not necessarily in hospitals and clinics. Their valuable service is very functional for research and development in the medical field.

Medical coders are in high demand, with an average growth rate of 20% over 10 years. The training imparted to become a medical coder can be offline and online. Many institutes provide Online Medical Coding Training globally that are reasonably priced and provide proper teaching. Medical training may seem hard, but with many jobs being created in this field, this is the first option chosen by many coders who wish to work in the medical field. Of course, with the ongoing pandemic, it is best to have Medical coding training online.

How to Start Or Join a DirectMatches Network

Like most of the other neat services on DirectMatches that link back to your profile, Networks also do the same. It will link as both networks you mange and networks that you are a member of.So, how do you start and join networks?From you main page, you can access networks from the top menu bar. When you click on it and bring it up, you will have the option to create a new network or to join a network.Here’s an excerpt from the web site that explains the importance of networks and why you should create or join them.”Networks let existing organizations and communities use DirectMatches technology to connect their members with each other.When you create a new Network, you become the manager! Networks give you the ability to:* Manage and build your own private networking organization using DirectMatches technology.
* Approve and control who joins your private network.
* Maintain your own private forum.
* Maintain your own private group mail, including mass mailing your network.
* Post private events and functions.
* Keep your team informed with special announcements.
* Add sub-managers to manage groups within your network
* Market your own Network home page and Website URL.Networks give existing organizations more value by increasing their ability to communicate, be visible and help network with each other.”This is just another great way to build a list of people with common interests, promote your opportunity, join with others who are in your same opportunity, and offer advice to others that benefit both you and them.You have the option to search networks to find ones that best suit you. You can either enter in search terms or click through the pages 10 at a time. When you click on a network that you want to join, you will find a brief synopsis about the network, who created and moderates it, their picture (if they have one), most recent topics, special announcements, the option to join the network, and most importantly the option to invite a friend to join DirectMatches via that network.You will set up these same functions if you create and moderate a network. But, think of it this way, if you create one and the topic really grabs the interest of others, people will join your network. You can also go back out in the community on DirectMatches and promote your network by sending an email to your downline or sending out a group email. The possibilities are endless.Another neat function of the networks is that you can see who the members are and add them to your personal contact list, find out which forums they are attached to if any, see what events are taking place with that network or add your own events, manage network memberships, and allow or limit private networking features.Most of all, have fun with it.