Hcr 202 Medical Insurance

                                                      HCR/202 Medical Insurance

                                                               Brittney Johnson

                                                           University of Phoenix

                                                                JUNE 4th 2017

There’s several different methods of paying medical professionals or health care providers for their services. These professionals accept private health insurance and fee-for-service programs such as Medicare and Medicaid. Fee for service reimbursement is made for the members of the healthcare services to pay within certain parameters under Medicare and Medicaid. Next, the health care provider charges for the services rendered, without prearrangement of fees. Lastly, the provider will submit an insurance claim for payment. Fee for service payment is set up for prior forms of managed care payments, which is known as discounted fee for service managed care. The doctor or team of medical professionals in a practice agrees to provide health care services at a predetermined discount rate from their usual fee for service fees. Upon further reviews, this type of billing is common among dentist. Most insurance policies have a waiting period prior to any services to be rendered. Knowing this some providers will offer a discount to holders of insurances who only pay a portion of care even when the plan takes full effect. This is a reason why patients should first seek in network doctors. A positive effect of discounted fee for service is the flexibility for members to seek out care from both in and out of network providers.. Physicians can see their patients, whenever they need to be seen and there are no waiting periods required (most of the time). Some negative ramifications of discounted fee for service are the deductibles that must be satisfied before co-payments count toward services. In some cases, before there is any covered medical occurrence. Some insurance companies will not reimburse in full for cost of services and members are responsible for 20% to 25% of their medical expenses. All members are responsible to complete their own claims forms and paperwork associated with their medical claims. Which could be disastrous for an already ill patient. In my opinion, fee for service gives the ability to create better incentives for efficiency, cost control and preventive care in health care.