Medical Outsourcing
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Medical Outsourcing
Medical outsourcing is a business process used by organizations like hospitals, nursing homes, and healthcare provider practices to obtain physician, nursing, healthcare technician, or other services in a managed services model. Physicians Outsourcing of emergency department physicians, as well as radiologists and anesthesiologists in operating rooms, grew rapidly in the United States in the 2000s due a combination of several economic forces, and medical staffing companies developed niche expertise in various medical specialties. Since 2008 a number of Swedish hospitals have used teleradiology services to outsource their emergency night-time radiology to Australia where daytime staff cover Swedish nighttime patients. Physician outsourcing has led to an increase in the number of people who received catastrophically large medical bills due to the outsourced physicians billing at out of network rates. A doctor in Tampa Bay claimed in 2015 that an emergency department she was staffin ...
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Healthcare Provider
A health care provider is an individual health professional or a health facility organization licensed to provide health care medical diagnosis, diagnosis and therapy, treatment services including medication, surgery and medical devices. Health care providers often receive payments for their services rendered from health insurance providers. In the United States, the United States Department of Health and Human Services, Department of Health and Human Services defines a health care provider as any "person or organization who furnishes, bills, or is paid for health care in the normal course of business." Individual providers In the United States, the law defines a healthcare provider as a "doctor of medicine or osteopathy who is authorized to practice medicine or surgery" by the state, or anyone else designated by the United States Secretary of Labor as being able to provide health care services. In general, this is seen to include: * Physician, a professional who practices medi ...
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Healthcare Technician
A healthcare technician is an allied health professional who provides direct care to patients with or without the supervision of registered nurses. Healthcare technician's primary position is to assist medical staff complete tasks around their assigned unit or clinic's and accommodate patient needs. Healthcare technicians are typically found in specialty clinics, intensive care, emergency departments, or laboratory collection facilities. Technicians will perform basic cardiology reports such as, electrocardiograms and will have basic understanding of bodily function. The technician is an integral member of the unit-based healthcare team, they contribute to the continuity of care by decreasing fragmentation through decentralization of selected diagnostic and therapeutic treatment modalities. Role description Healthcare technicians provide two levels of care, direct and indirect. Often, technicians are trained and qualified to complete specialty tasks and this varies depending on cl ...
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Managed Services
Managed services is the practice of outsourcing the responsibility for maintaining, and anticipating need for, a range of processes and functions, ostensibly for the purpose of improved operations and reduced budgetary expenditures through the reduction of directly-employed staff. It is an alternative to the break/fix or on-demand outsourcing model where the service provider performs on-demand services and bills the customer only for the work done. Under this subscription model, the client or customer is the entity that owns or has direct oversight of the organization or system being managed, whereas the managed services provider (MSP) is the service provider delivering the managed services. The client and the MSP are bound by a contractual, service-level agreement that states the performance and quality metrics of their relationship. Advantages and challenges Adopting managed services is intended to be an efficient way to stay up-to-date on technology, have access to skills ...
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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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Teleradiology
Teleradiology is the transmission of radiological patient images, such as x-rays, CTs, and MRIs, from one location to another for the purposes of sharing studies with other radiologists and physicians. Teleradiology is a growth technology given that imaging procedures are growing approximately 15% annually against an increase of only 2% in the radiologist population. Teleradiology allows radiologists to provide services without actually having to be at the location of the patient. This is particularly important when a sub-specialist such as an MRI radiologist, neuroradiologist, pediatric radiologist, or musculoskeletal radiologist is needed, since these professionals are generally only located in large metropolitan areas working during daytime hours. Teleradiology allows for trained specialists to be available 24/7. Teleradiology utilizes standard network technologies such as the internet, telephone lines, wide area network, local area network (LAN) and the latest high tech be ...
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Medical Billing
Medical billing is a payment practice within the United States healthcare system. The process involves a healthcare provider obtaining insurance information from a patient and filing, following up on and appealing claims with health insurance companies in order to receive payment for services rendered, such as testing, treatments, and procedures. The same process is used for most insurance companies, whether they are private companies or government sponsored programs. Medical coding reports what the diagnosis and treatment were and prices are applied accordingly. Medical billers are encouraged, but not required by law, to become certified by taking an exam such as the CMRS Exam, RHIA Exam, CPB Exam and others. Certification schools are intended to provide a theoretical grounding for students entering the medical billing field. Some community colleges in the United States offer certificates, or even associate degrees, in the field. Those seeking advancement may be cross-trained i ...
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Health Insurance In The United States
Health insurance in the United States is any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage. In addition to medical expense insurance, "health insurance" may also refer to insurance covering disability or l ...
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Envision Healthcare
Envision Healthcare is an American healthcare company and national hospital-based physician group. History In December 2016, Envison and AMSURG merged, and shortly thereafter the company's stock replaced Legg Mason in the S&P 500 index. In 2017, the company's subsidiary EmCare, came under scrutiny due to healthcare consumers being shocked by high medical bills from Envision's out-of-network healthcare providers. In August 2017, Envision sold its ambulance unit, American Medical Response, for $2.4 billion to KKR, which combined it with a similar company it already owned. In 2017, the company reported a net loss of $232.5 million on revenue of $7.8 billion. In June 2018, KKR announced that it was acquiring the rest of Envision for $9.9 billion, including the assumption or repayment of debt. In February 2020, Envision Healthcare appointed James Rechtin as CEO. In April 2020, they were considering bankruptcy. In October 2020, it was announced that Cigna and Envision had renewe ...
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Nursing Agency
A Nursing Agency (also known as Home Health Agency or Home Care Agency) is a service provider agency which provides nurses and usually health care assistants (such as Certified Nursing Assistants) to people who need the services of home healthcare professionals. Nurses are normally engaged by the agency on temporary contracts and make themselves available for hire by hospitals, nursing homes, eldercare centers, and other providers of care for help during busy periods or to cover for staff absences. Some nurses may be seconded to private clients who choose to receive their nursing care within their own homes. Nature of work As with other staffing agencies, a large amount of capital is necessary to operate, since nurses must be paid by the registry as often as they work, but the hospital or other institution utilizing the services of the registry might not pay the registry until several months after the work has been done. Profit margins for this type of business go between 4% and ...
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Nursing Shortage
A nursing shortage occurs when the demand for nursing professionals, such as Registered Nurses (RNs), exceeds the supply locallywithin a health care facilitynationally or globally. It can be measured, for instance, when the nurse-to-patient ratio, the nurse-to-population ratio, the number of job openings necessitates a higher number of nurses than currently available, or the current number of nurses is above a certain age where retirement becomes an option and plays a factor in staffing making the work force in a higher need of nurses. The nursing shortage is global according to 2022 World Health Organization fact sheet. A nursing shortage is not necessarily due to a lack of trained nurses. In some cases, perceived shortages occur simultaneously with increased admission rates of students into nursing schools. Potential factors include lack of adequate staffing ratios in hospitals and other health care facilities, lack of placement programs for newly trained nurses, inabilit ...
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Medical Tourism
Medical tourism refers to people traveling abroad to obtain medical treatment. In the past, this usually referred to those who traveled from less-developed countries to major medical centers in highly developed countries for treatment unavailable at home. However, in recent years it may equally refer to those from developed countries who travel to developing countries for lower-priced medical treatments. The motivation may be also for medical services unavailable or non-licensed in the home country: There are differences between the medical agencies (FDA, EMA etc.) world-wide which decide whether a drug is approved in their country or not. Even within Europe, although therapy protocols might be approved by the European Medical Agency (EMA), several countries have their own review organizations in order to evaluate whether the same therapy protocol would be "cost-effective", so that patients face differences in the therapy protocols, particularly in the access of these drugs, which mi ...
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