Balance Billing
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Balance Billing
Balance billing, sometimes called surprise billing, is a medical bill from a healthcare provider billing a patient for the difference between the total cost of services being charged and the amount the insurance pays. It is an especially common problem in the United States with providers who are out of network, and therefore not subject to the rates or terms of providers who are in-network. Balance billing has a variable prevalence by market and specialty. Advocates of balance billing argue that it increases the incomes of high-quality healthcare providers, and serves as a measure of their dissatisfaction with insurance company fees. Critics say that balance billing lets providers raise charges through stealth rather than transparent pricing, creates unnecessary administrative costs and patient confusion, and allows providers to simply pass along costs to patients, rather than helping them to secure good value. It is thought to erode political consensus in favor of a one-tier syste ...
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Canada
Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by total area. Its southern and western border with the United States, stretching , is the world's longest binational land border. Canada's capital is Ottawa, and its three largest metropolitan areas are Toronto, Montreal, and Vancouver. Indigenous peoples have continuously inhabited what is now Canada for thousands of years. Beginning in the 16th century, British and French expeditions explored and later settled along the Atlantic coast. As a consequence of various armed conflicts, France ceded nearly all of its colonies in North America in 1763. In 1867, with the union of three British North American colonies through Confederation, Canada was formed as a federal dominion of four provinces. This began an accretion of provinces an ...
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Managed Care
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010. ...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The p ...
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American College Of Emergency Physicians
The American College of Emergency Physicians (ACEP) is a professional organization of emergency medicine physicians in the United States. The organization was founded August 16, 1968, by eight physicians in Lansing, Michigan. ACEP established the American Board of Emergency Medicine (ABEM) in 1976. ACEP publishes the ''Annals of Emergency Medicine and the Journal of the American College of Emergency Physicians Open (JACEP Open).'' See also * American College of Osteopathic Emergency Physicians * American Academy of Emergency Medicine * Academic Emergency Medicine * Society for Academic Emergency Medicine The Society for Academic Emergency Medicine (SAEM) is a professional organization for emergency medicine academicians. It is headquartered in Des Plaines, Illinois. History SAEM was created in 1989 through the merger of two academic groups, the Un ... References External links * {{authority control Medical associations based in the United States Emergency medicine ...
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Air Ambulance
Air medical services is a comprehensive term covering the use of air transportation, aeroplane or helicopter, to move patients to and from healthcare facilities and accident scenes. Personnel provide comprehensive prehospital and emergency and critical care to all types of patients during aeromedical evacuation or rescue operations aboard helicopter and propeller aircraft or jet aircraft. The use of air transport to provide medical evacuation on the battlefield dates to World War I, but its role was expanded dramatically during the Korean and Vietnam wars. Later on, aircraft began to be used for the civilian emergency medical services. Helicopters can bring specialist care to the scene and transport patients to specialist hospitals, especially for major trauma cases. Fixed-wing aircraft are used for long-distance transport. In some remote areas, air medical services deliver non-emergency healthcare such as general practitioner appointments. An example of this is the Royal Flyin ...
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WOAI-TV
WOAI-TV (channel 4) is a television station in San Antonio, Texas, United States, affiliated with NBC and The CW. It is owned by Sinclair Broadcast Group alongside Fox affiliate KABB (channel 29); Sinclair also provides certain services to Kerrville-licensed Dabl affiliate KMYS (channel 35) under joint sales and shared services agreements with Deerfield Media. The stations share studios between Babcock Road and Sovereign Drive (off Loop 410) in northwest San Antonio, while WOAI-TV's transmitter is located in northwest Wilson County (near Elmendorf). History The station first signed on the air on December 11, 1949, as WOAI-TV. It was the first television station in the San Antonio market, owned by Southland Industries along with AM 1200 WOAI. WOAI-TV and WOAI radio are among the few broadcast stations located west of the Mississippi River that have a call sign beginning with "W." In the early days of broadcasting, most Central Time Zone states were in the "W" territory. In 1 ...
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Health Maintenance Organization
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status. Operation HMOs often require members to select a primary care phy ...
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Emergency Department
An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of patients who present without prior appointment; either by their own means or by that of an ambulance. The emergency department is usually found in a hospital or other primary care center. Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention. In some countries, emergency departments have become important entry points for those without other means of access to medical care. The emergency departments of most hospitals operate 24 hours a day, although staffing levels may be varied in an attempt to reflect patient volume. History Accident services were provided by workmen's compensation ...
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Commonwealth Fund
The Commonwealth Fund is a private U.S. foundation whose stated purpose is to "promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, and people of color." It is active in a number of areas related to health care and health policy. It is led by David Blumenthal, M.D. Healthcare rankings Since 2004 it has produced reports comparing healthcare systems in high income countries using survey and administrative data from the Organisation for Economic Co-operation and Development and the World Health Organization which is analyzed under five themes: access to care, the care process, administrative efficiency, equity and health-care outcomes. The United States has been assessed as worst health-care system overall among 11 high-income countries in every report, even though it spends the highest proportion of its gross domestic product on hea ...
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Radiologist
Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiation), but today it includes all imaging modalities, including those that use no electromagnetic radiation (such as ultrasonography and magnetic resonance imaging), as well as others that do, such as computed tomography (CT), fluoroscopy, and nuclear medicine including positron emission tomography (PET). Interventional radiology is the performance of usually minimally invasive medical procedures with the guidance of imaging technologies such as those mentioned above. The modern practice of radiology involves several different healthcare professions working as a team. The radiologist is a medical doctor who has completed the appropriate post-graduate training and interprets medical images, communicates these findings to other physicians by m ...
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Anesthesiologist
Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine. A physician specialized in anesthesiology is called an anesthesiologist, anaesthesiologist, or anaesthetist, depending on the country. In some countries, the terms are synonymous, while in other countries they refer to different positions, and ''anesthetist'' is only used for non-physicians, such as nurse anesthetists. The core element of the specialty is the study and use of anesthesia to safely support a patient's vital functions through the perioperative period. Since the 19th century, anesthesiology has developed from an experimental area with non-specialist practitioners using novel, untested drugs and techniques into what is now a highly refined, safe and effective field of medicine. In some countries anesthesiol ...
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Ambulatory Surgery Center
Outpatient surgery, also known as ambulatory surgery, day surgery, day case surgery, or same-day surgery, is surgery that does not require an overnight hospital stay.The International Association for Ambulatory Surgery (IAAS) would not consider all of these terms synonymous. In a 2003 documen"Ambulatory (day) surgery: suggested international terminology and definitions" the IAAS recommends defining an "outpatient" procedure as one "carried out in the outpatient department of a hospital" and an "ambulatory" procedure as one "excluding an office/surgery or outpatient operation/procedure, where the patient is discharged on the same working day." That is, "ambulatory surgery" occurs in an "ambulatory surgery center." The term “outpatient” arises from the fact that surgery patients may enter and leave the facility on the same day. The advantages of outpatient surgery over inpatient surgery include greater convenience and reduced costs. Outpatient surgery may occur in an inpatient fa ...
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Kaiser Family Foundation
KFF (Kaiser Family Foundation), also known as The Henry J. Kaiser Family Foundation, is an American non-profit organization, headquartered in San Francisco, California. It prefers KFF since its legal name can cause confusion as it is no longer a foundation or a family foundation, and is not associated with Kaiser Permanente. KFF focuses on major health care issues facing the nation, as well as U.S. role in global health policy. KFF states that it is a non-partisan source of facts and analysis, polling and journalism for policymakers, the media, the health care community, and the general public, and its website has been heralded for having the "most up-to-date and accurate information on health policy" and as a "must-read for healthcare devotees." Current activities Policy analysis and polling KFF publishes analysis, polling and journalism about health-care issues, and states that much of its work especially concerns persons with low income or those who are otherwise especially v ...
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