Financial Responsibility – What Patient’s Should Know When Visiting Their Care Provider

Financial Responsibility – What Patient’s Should Know When Visiting Their Care Provider

Stethoscope wrapped around hundred dollar bills

Cost of Wellness

Coby Tyner has submitted another excellent essay on exploring ways to improve the patient experience at the physicians office. This time he focuses on the financial responsibility aspect of patient care. Dr. Joe Galati

I have learned a lot over the years as a healthcare administrator.  And while I am not a billing expert, I do consider myself a good consumer of healthcare.

There are times that I field concerns from patients regarding bills they receive.  The concerns can range anywhere from the amount of the bill itself, to why the proper insurance was not used in the submission of the original claim (and all points in between).

Now it’s true, mistakes can and do happen in the billing and collecting process.  Every practice and every third party biller seeks opportunities to improve with internal processes and to minimize human errors.  To complicate issues, insurance companies can often confuse patients on covered services and what’s actually required prior to receiving those services.

But there’s still hope for patients…   Often times, patients can be better informed consumers of healthcare.  When it comes to selecting an insurance plan that works for them and their family, covered services, and the amounts they will be required to pay (as defined by their insurance plans), they should be fully informed before the process even starts.

So let’s get down to the nitty gritty of the matter.  Questions the patient should ask could include:  What insurance plan fits the needs of my family?  How much is the co-pay for office visits?  How much is the deductible?  Why should I choose a PPO plan over an HMO plan (or vice versa)?  When do I need a referral?  Is a pre-authorization required for procedures?  Who could I talk to if I have a questions about a bill?

The takeaway from all of this is straightforward:  If patients want to avoid unexpected and undesirable surprises, they should consider researching what will be required when they visit their care provider’s office – this can be done through researching the plan and asking questions to the insurance carrier they’ve chosen.  The plan the patient chooses will directly drive the amounts they will be expected to pay.  Also, they should actively work with their care provider’s office staff to get a clear picture on financial obligations for the practice itself (such as Co-Pays, Procedure Costs, Deductible Amounts, etc).  I’d suggest working closely with the person that verifies benefits in their care provider’s office or reaching out to the practice administrator to point them in the right direction.

As a patient advocate, I want each and every patient to have a great experience when they visit their care provider; especially at Liver Specialists of Texas.  Billing is an important part of the overall experience and I encourage all patients to be better consumers of healthcare – it starts with first knowing the expectations from the beginning.

 

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Coby Tyner Discusses the Patient Experience: Making it a Good One

Coby Tyner Discusses the Patient Experience: Making it a Good One

Coby Tyner is the Practice Administrator with Liver Specialists of Texas

Coby Tyner is the Practice Administrator with Liver Specialists of Texas, in Houston, Texas

Coby Tyner, MBA, CMPE, is the Practice Administrator for Liver Specialists of Texas. In his guest blog entry, he discusses his thoughts on the patient experience we all strive for, and hope to deliver for our patients.

It occurred to me that healthcare is changing more than most people actually realize. With Meaningful Use requirements, the Affordable Care Act, changes with CMS policies, Insurance Benefit Coordination and much more, it doesn’t surprise me that many medical practices struggle with communicating changes with many of their patients.

One way to address questions, avoid confusion, and make the patient feel like someone is actively listening is for medical practices to focus on the patient experience. The Beyrl Institute defines the patient experience as “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.” Maybe this definition sounds a bit fancy but it makes sense right? So, what does that definition really mean? Simply put, every time a physician, advance practice provider or a member of the staff has ANY interaction with a patient, it should be memorable to the patient in a positive and informative way. The goal at the end of the day is to have the patient reflect positively about their experience while being cared for by all members of the medical team.

So, where does the experience start? The answer is at the beginning when the patient first calls the office or makes contact. Areas in which to focus could include, is the phone answered with a “smiling voice?” Are staff members nice and friendly and do they answer questions about the appointment, insurance requirements, and location of the office (remember, this should all be done with a smiling voice)? When the patient comes to the office, are they greeted with a smile and are staff members prepared to provide excellent service? Does the staff ensure the patient is coordinated quickly and avoid long waiting times in the lobby? Are the care providers actively listening and ready to provide quality care – all without making the patient feel rushed or discounting the patients concerns as relevant? Are billing and collection efforts done in a timely fashion and are patients able to get quick responses to their questions about a bill? Are prescription orders coordinated and filled timely? And the list goes on and on.

Bottom line, with every question previously asked, there is a direct opportunity for the member of the medical staff to impact what the patient is thinking and if the patient will remember the experience as positive. So remember, from how soon a patient can be seen to coordinating billing questions and all points in-between, focusing on the patient experience can be used to answer questions, develop long term relationships and give patients peace of mind – all while making them feel right at home. And that should be the goal of every medical practice… Just my 2 dollars.

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Fatty Liver Disease: Latest Update on What You Need to Know

Fatty liver disease is everywhere. Dr. Galati outlines a basic review of the information you need to know about fatty liver disease, and the treatment options available to you.

For a consultation if you have fatty liver disease, contact his office at 713-794-0700, or visit the practice website. For a second opinion, please fill out these forms and return to Liver Specialists of Texas.

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31 Days of Wellness: The App I Love for Exercise

31 Days of Wellness: The App I Love for Exercise

Seven minutes. Repeat…seven minutes.

Learn more here.

This app for your smart phone has been around for a few years and it is terrific. Download it-for free-and start using it. You break out in a sweat pretty quickly, and it gets your heart rate up. Tone up, and lose weight.

7-min Workout

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31 Days of Wellness: It’s the Bacteria, Stupid!

Over the past 10 years, there has been an explosion of research indicating that the bacteria in our guts, the microbiota as it is called, is ground zero for wellness. Having the right number and type of bacteria leads to wellness, while having too much of the bad ones leads to a host of problems and diseases, including obesity, depression, fatigue, diabetes, and even cancer.

So how do we make this bacterial playground in your guts better?

The answer comes down to our diet for starters (and the message for today’s installment). It has been shown that a diet rich in vegetable, fruits, and dietary fiber support the grown of the “good” bacteria, and lessen the “bad” bacteria. Conversely, a diet high in processed foods, and thus deficient in these naturally occurring foods, fosters the bad guys to flourish, and thus put you at risk for disease. Processed foods come in a box, can, or bad, have the majority of nutrients stripped away, and have an almost never-ending shelf life. If your food does not rot on the counter-top, don’t eat it. (thanks to Michael Pollan)

Additional Helpful Links
Dr. Galati’s Great American Produce Giveaway
Build a better microbiome
Dr. Galati’s guide to dietary fiberDr. Weil-Love your microbiota
Human food project
Dr. Galati cooks fresh vegetables
Gut bacteria and health and disease

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31 Day of Wellness: No Excuse Not to Exercise

31 Day of Wellness: No Excuse Not to Exercise

Buy sheer chance, I stumbled across this book while looking for last minute Christmas presents. Seven Minutes to Fitness is a great book everybody should have, especially those interested in health, wellness, and exercise.  The easy to perform exercises, not requiring any additional gym equipment, makes this a very useful tool for all of us.

A common lament I hear from patients is that they just don’t have the time to exercise.  This is a load of bunk, considering the wasted time people  spend playing mindless games on their computers and handheld devices, sitting in front of worthless television programming, or simply doing nothing.  If you don’t have seven minutes in a day to dedicate to your well-being, things are pretty sad and we are doomed.

Pick up a copy, or two, of this book and make full use of it. The seven minutes you invest in exercise will have a pay off in the years to come.

Exercise Daily

Exercise Daily

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31 Days of Wellness: Don’t Eat Food Packaged in a Box

31 Days of Wellness: Don’t Eat Food Packaged in a Box

My last rant about food-for now.

It’s criminal to feed your kids this food. Period. If you are serious about the health and the well-being of them, don’t even go down the isle that has this man-made food on the shelf. Take the time to buy real food, and take 10 minutes a day to make a real lunch for them. Here is the nutritional profile on Lunchables.

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31 Days of Wellness: Don’t Be Fooled By Food Labels

31 Days of Wellness: Don’t Be Fooled By Food Labels

Food makers try to trick all of us daily. Take a look at the picture below.

Patato chips are patato chips regardless how you disguise them.  If you see “sea salt” or “olive oil” you may be duped into thinking it’s healthy. Listen up-it’s not. All sorts of food products try this same tactic. If it seems to good to be true, it likely is.

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31 Days of Wellness: Reduce the Number of Pills You Take

31 Days of Wellness: Reduce the Number of Pills You Take

Wellness come in a lot of different flavors. Please give thought to the number of medicines you are on (or someone else you know). Wellness should not be measured by how many pills you take. It’s a national epidemic I see everyday where adults take so many medicines that they have no idea what they are, or how they work. This leads to medication errors, overdoses, drug-drug interactions, and an overall sense that modern medicine is simply prescribing a bunch of medicines without taking a closer look at what is actually wrong with the person.

It is the patient’s responsibility to understand what each medicine is for, how long they need to be on it, potential side effects, and how to measure success. Your silence here will lead to many, many problems.

Below is a recent picture I took of a typical “patient drug stash”. You can make up your own mind if this is good or not.

Here are a few tips to consider:

  1. Always have a list of all your medicines, and which doctor prescribed it for you.
  2. Understand what each drug is used for.
  3. Talk with your doctor about the expected result of the drug, and how you will be monitored if it is working or not.
  4. Have a general idea of the potential side effects each medicine has.
  5. Make sure you know both the generic and brand name of the drugs. This prevents taking duplicate doses of the same drug.
  6. Use the same pharmacy for all of your prescriptions.
  7. Get to know the pharmacists at your pharmacy as an ongoing resource of information and education about your medicines and conditions.
  8. If you are seen by multiple physicians, update and share your medication list with each office. Your specialists need to know what your primary care doctor is prescribing you. This will again prevent duplications, and lower the risk of drug interactions and complications.
  9. Discard expired medicines or medicines you no longer need.

For 2016, make it a goal to reduce the number of medicines you take.

Let me know what you think. Share this with those closest to you!

Dr. Joe Galati

We take too many medicines

We take too many medicines

 

 

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31 Days of Wellness: Cancer Death Rate is Down 23%

Today, we discuss the latest reduction in cancer death rates – down more than 23%. Reduction in smoking is the largest contributor to this improvement, followed by breast cancer screening, colon cancer screening with colonoscopy, and weight loss through MORE FRUITS AND VEGETABLES! How novel? Enjoy the video and make sure everyone is aware of the cancer screening guidelines.

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