Emergency

Emergency. Dictionary.com defines it this way: “a sudden, urgent, usually unexpected occurrence or occasion requiring immediate action. “

In my healthcare experience lifetime, perhaps nothing has changed more than the role of the hospital emergency room. In my youth the hospital had two roles: caring for very ill or post-surgery patients needing nursing care until they could be released home, and attending to accidents (think someone getting their hand injured by machinery or being in an auto accident).

As a variety of things have changed in our healthcare system over the years, there are some common beliefs about emergency rooms that we should take a closer look at. read more

Your Decisions Matter… Or Do They?

Healthcare Directives and Planning

The call came late on a Thursday. The husband of a long married couple had suffered a stroke 2 weeks earlier. He had lost the ability to swallow and the doctor at the hospital had urged surgery to place a feeding tube directly to his stomach before transferring him to a skilled nursing facility, where it was expected he would remain for the rest of his life.

By his wife’s report, she didn’t feel she had been given an option; the doctor simply told them this was the next step in his care so he could be discharged from the hospital. Now in the skilled nursing facility she had time to see the situation more clearly and realized this wasn’t what her husband had told her he wanted if he was in this situation. read more

When the Bill is Just Wrong

Health care bills have mistakes, sometimes lots of them.

The figure most often quoted is that up to 80% of medical bills have errors. I’ve looked for the original source of that statement without success, but I did find one medical bill review company, Medical Billing Advocates of America, who noted that in their practice 3 out of every 4 bills they review have errors. (Caveat: Theoretically only people who think they have a billing issue would be submitting their bills for review, so this may create a falsely high rate.)

Still, you probably look over your restaurant bill and ask the waiter about charges you see that don’t look right before you pay it, right? The same applies for medical bills – and even though you may not fully understand everything that was ordered for you, asking about what’s on the bill you don’t recognize before you pay it is just smart. read more

In or Out, Round About – Navigating Out of Network Providers

Stethoscope and hundreds of American dollars

Health insurance is complicated and healthcare costs a lot. If you’re not up for a complicated read, here’s the short version: Don’t use out of network providers if you can avoid it. If you think healthcare is expensive, out of network healthcare is very expensive! But if you want to dig a bit deeper, read on.

 

Maybe your doctor has recommended you see a certain specialist who’s not in your insurance network. Maybe you’re in an accident and the closest hospital isn’t in your insurance network. What then? read more

It costs how much??

Health care costs scrabble

Anymore, it seems for most of us every medical bill has a surprise when we first open the envelope!

How does a provider (doctor, hospital, laboratory, imaging center) decide how much healthcare costs? It’s a pretty closely guarded secret, and it’s not uniform across providers. But suffice it to say, it definitely requires some serious accounting that is largely invisible to consumers. Coined the “chargemaster” by Time author Stephen Brill, providers establish a base price for each and every service they provide. This is the price that they bill insurers and patients without insurance for services. It includes their overhead costs (staff, facilities, billing), and is essentially the base price for services. Understandably it’s higher for hospitals who have more significant overhead costs and lower for office based providers. Consider this “retail” pricing. read more

I’ll have some palliative care, please.

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Huh? Although medical care has certainly become incredibly specialized, whenever I’ve suggested that a client consider asking for a palliative care consult, the first response is “What’s that?” or a close second “I’m not dying, why would I want that??”

In our current environment in many cases palliative care and hospice are often provided as one service, and not the continuum of services from which palliative care as a stand alone is beginning to emerge.

The Association for the Advancement of Palliative Care defines it this way: “Palliative care, and the medical sub-specialty of palliative medicine, is specialized medical care for people living with serious illness. It focuses on providing relief from the symptoms and stress of a serious illness—whatever the diagnosis. The goal is to improve quality of life for both the patient and the family.” read more