Cobra Healthcare Coverage Vs Individual And/or Family Medical Assurance

While C.O.B.R.A. Insurance might be a lifesaver for some individuals, individuals often take the C.O.B.R.A. option when they shouldn’t. If compared to private medical care assurance, COBRA can be pricey, it can be over too early and it can put someone else in control of your policy.

COBRA is often too pricey

COBRA is s short-term solution

C.O.B.R.A. is under someone else’s control

C.O.B.R.A. is often too costly

The COBRA law gives you the right to be covered by a group insurance policy. One of the biggest misconceptions individuals have about healthcare Insurance is that group insurance policies are less expensive than individual and/or family health care insurance policies that you can purchase on your own. While this is sometimes true, it isn’t usually. In many states, health care coverage costs more when bought through an employer.

This is because of the cost of governmental mandates that apply to group health care insurance policies that don’t apply to private medical care insurance policies. A company offering a group assurance policy may have to offer a policy to anyone regardless of their medicalcare history. coverage companies cannot drop an insured person from their family and/or individual health Insurance plan simply because their health has gotten worse after their policy’s effective date, but they won’t take new people with pre-existing conditions. This can mean that the insurance company’s costs are much higher for their group coverage policies than for their family or individual healthcare assurance policies.

You may be offered the group insurance plan that you had before your employment concluded or if your company has made changes in the policies they offer to their current employees, it may be a different healthcare policy.

C.O.B.R.A. is s short-term solution

In most scenarios, COBRA may be kept for a maximum of 18 months, although in certain scenarios, this time period can be extended to 36 months. This may mean that your coverage may end when you need it the most. A good family and/or individual health assurance policy may cover you until you reach the age of 65.

You may be healthy enough to qualify for a long-term health Insurance plan at the time when your job ends but not 18 months later. If you or someone in your family contract an illness or have trauma that prevents you from buying a policy at the end of your COBRA eligibility

COBRA is under someone else’s control

When you mail in your COBRA payments, you send them to your former company. Although this happens rarely, sometimes companies will take your money and never pay the insurance company.

If your company changes the plans that are offered to their current employees, they may also change the plans available to those eligible for health care Insurance because they have taken the COBRA option. This may mean that your policy may not cover you as well as it used to. You might suddenly be in the position of having an expensive plan that no longer covers you well.

Scenarios where C.O.B.R.A. is better than individual medicalcare insurance:

When C.O.B.R.A. is much less pricey than a private assurance policy

A family or individual medical care coverage plan isn’t available to you

You’re assured a medical assurance plan before your COBRA eligibility ends.

There are situations where COBRA is a better option than a family and/or individual medical care coverage plan. If you are not able to purchase a healthcare policy on your own at a reasonable rate and you find that your COBRA option isn’t too pricey C.O.B.R.A. may be your best options. This of course is also true if you cannotpurchase a C.O.B.R.A. plan because of a preexisting medical condition. Another situation when COBRA can be a good option is when you will be eligible for Medicare or some other medicalcare policy before your C.O.B.R.A. eligibility will end.

Ways To Tell The Difference Between A Nurse And Medical Assistant

Technology is considerably advancing – computers, phones, laptops, cars and of course even the medical technology. Just when the technology is expanding, so is the human population. In connection to this, research shows that these two factors have a great impact to people. Technology had made the lives of many people easy and comfortable resulting to unhealthy lifestyle making them prone to disease. In the same way, the advanced medical technology served as life sustainer to the people. Hence, more people are needed in order to support with the growing medical needs of people.

To counter the exigency in health care, hospitals and clinics are hiring medical assistants. But medical assisting must not be confused with nursing. Even if they fall under health care, they have its differences.

Instruction
Nurse is a degree. In order to be a nurse, one must need to finish the 4-year curriculum and needs to pass the board exams before getting a job. While medical assistant does not need any official education and its training would only take six months to one year to finish. Also, medical assistants are not compelled to take the authentication unlike nurses who needs to be registered before applying for a job.

Duties
Nurse takes vital signs, take notes to medical records while Medical Assistants most of the time do clerical or managerial works. However, depending on the demand, both can do bookkeeping and managerial duties. Although MA can also take vital signs and other clinical works, they are not highly educated for administering and caring for patient’s medical requirements and performing bedside care. Besides, if a nurse has a bachelor degree, he or she is allowed to give medications not like medical assistant who needs the supervision of a doctor before he or she can give medication.

Work Place
Nurse can work in nursing homes, home health care or in any other healthcare amenities and centers while medical assistant cannot because these healthcare conveniences do not have doctors. Medical assistants as requisite by the law, should only work in an environment where doctors or any other medical practitioner is present. Furthermore, MA are allowed to do ancillary in-house tests under the direct supervision of medical doctor or a registered healthcare practitioner.

Supervision
Medical assistant often take orders and instructions from doctors or other medical practitioners including nurses. While a nurse works under the guardianship of the doctors or other medical practitioners.

Given those differences, both of them should act in accordance with a healthcare facility’s Health Insurance Portability and Accountability Act or HIPAA, Occupational Safety and Health Administration or OSHA, Clinical Laboratory Improvement Amendments or CLIA and Joint Commission on Accreditation of Healthcare Organization or JCAHO. Both must be efficient and productive at all times.

In conclusion, nurses are licensed to practice the profession. Their work is to treat patients. Also, they are accountable for educating patients about health-care. While medical assistants are those people who do not only clinical responsibilities but administrative responsibilities as well. They are the ones who guarantee that the hospitals or the clinics are working smoothly.

Whether medical assistant or nurse, they both are serviceable in the healthcare industry. These healthcare assistants are important in keeping up in meeting the needs of people when it comes to healthcare.

Medical Billing Services: Good Ones Fight Rising Healthcare Costs

Everyone hears about the fact that much of the cost of healthcare is driven by the expense of processing and adjudicating claims. What is often not mentioned is what is truly at the root of these expenses – payers that are attempting to withhold from physicians the money they are due. I mentioned in a previous article (Outsource Medical Billing Must Have: Comparison to Allowables) how ClaimCare Medical Billing Services constantly sees payers systematically underpaying claims. We also see claims that have been properly submitted and for which we have proof the claim was accepted simply “lost” by payers and the claims have to be resubmitted (sometimes multiple times) in order to secure payment. I know from experience with many practices that this “lost” claim phenomena is rampant across payers and practices. Now, here is a shocking fact – over 50% of claims that payers “lose” or are underpaid are never pursued by physicians (and therefore the payers never have to pay the money they owe to the physician or facility). This means that payers have a powerful economic incentive to play games and make the medical billing process complicated. Here is another shocking fact – it costs the average insurance company about $25 each time a representative has to get on the phone and discuss a lost or underpaid claim with a medical billing specialist. A final key fact is that most payers “grade” each provider. The lower a provider’s grade (i.e., a D versus an A) the more likely the payers are to lose or under pay the provider’s claims. Why? Because these providers have no track record of catching these problems and pursuing them.

So, how do all of these facts tie into my title about Medical Billing Services fighting the rising cost of healthcare? If each and every underpaid or lost claim is pursued (which is what Medical Billing Services should do because they have the scale to have groups of people that do nothing but follow-up on such claims) then eventually payers will lose all economic incentive to play games and make the billing process complicated and expensive. Imagine if every physician pursued every claim until it was paid in full. The payers would see their cost to adjudicate the claims rise and they would see their payments to providers rise because the lost/under paid claim games would no longer prevent providers from ultimately being paid. This combination would lead to each physician ultimately being paid quickly and without fuss because the insurance companies would lose significant money by playing games ($25 per extra phone call generated by the games) and they would gain nothing since payments would only be delayed, not avoided.

There is lots of talk about the dream system where claim adjudication happens in real time and physicians immediately receive their reimbursements. Such a system will never happen until the economic incentive payers have to maintain a difficult, complicated and veiled system are removed. This is what medical billing companies (and medical practices with internal billing) can do by doggedly pursuing each claim and insuring that every one of their clients is rated an “A” by all of their payers.