Research Partners Information: Dr. Doe And I Will Set Up

Research Partners Informationdr Doe And I Will Be Setting Up A Device

Research Partners Informationdr Doe And I Will Be Setting Up A Device/ machine that will be utilized in hospitals/clinical settings for patients in Progressive Care and Intensive Care status. The device will keep track of how often patients are turned and assist in the turning of those patients from one side to the next to prevent bedsores, and wounds from occurring in patients. My research partner is a Mayo Clinic Medical Doctor who would like to remain anonymous, so I will use the name John Doe for this report. John Doe is in London, England.

John Doe is currently A proud Southeast London native, the practice chair and associate medical director at Mayo Clinic Healthcare located in London, and an assistant professor of medicine at Mayo Clinic in the U.S. John Doe is interested in evidence-based medicine and the implementation of technology within general medical care. Dr. Doe undertook their medical school training at Guy's & St Thomas' Medical School (now part of King's College London). They subsequently completed an Internal Medicine residency program at Case Western Reserve University in the United States.

Upon returning to the U.K., they joined a busy South East London GP practice. After 15 years at the practice, they joined Mayo Clinic Healthcare in London. They have also completed additional training in diabetes care from Warwick University and Aviation Medicine training from Kings College London. Dr. Doe is licensed to practice medicine in the U.K. and the U.S.

Research Activities • Medical regulation and medical practitioner well-being Honors • BS (Hons) Immunology • Certificate in Diabetes Care (Distinction) • Member of the Royal College of General Practitioners (MRCGP) (Distinction) Professional Memberships • Fellow of the American College of Physicians (FACP) • Member of the Royal College of General Practitioners (MRCGP) • Member of The Royal Society of Medicine • Member of the British Medical Association • Member of the Primary Care Diabetes Society • Member of the Association for Medical Education in Europe John is currently a primary care advisor to the Care Quality Commission, an examiner for the General Medical Council, and a member of the Joint Formulary Committee, British National Formulary.

John previously served on the National Institute for Clinical Excellence Diagnostics Committee. I know Dr. Doe relatively well from our work collaborations in the U.S. and virtually while they reside in London. When I reached out about assisting with my class study, they were happy to help me. I do not know today what new service I would like to focus on specifically, but it will involve a new service for Mayo Clinic in London.

I have a call scheduled on Monday with Dr. Doe to discuss ideas further, and I will have a solid idea by next week. Dr. John Doe is eager to assist me with some ideas, and I look forward to further discussion and utilizing their medical expertise during this class. John Doe wanted me to share their statement with the class: "My expertise is in general medicine, and I take pride in utilizing my interpretive skills to define and address an individual patient’s concerns. I'm committed to providing high quality, patient-centered care that blends clinical practice, education, and research," – Dr. John Doe.

Assume that you work for a healthcare organization and a patient wants to learn more about the cost for a procedure ordered by their provider. They have asked the following questions to Patient Scheduling:

1. How much would the procedure cost because I have not yet met my deductible?

2. Do I need pre-authorization?

3. Is there a facility charge in addition to the physician charge?

4. What other charges would be incurred?

In your initial post, include the following details:

· Explain why each of these four questions is significant for the patient. Add evidence to support each explanation. You may also share an experience on any one of these questions.

· Provide an explanation of how procedural expenses are determined.

· Describe how patient perception towards payment can affect the revenue cycle for a healthcare organization.

Paper For Above instruction

Understanding the financial aspects of healthcare procedures is vital for patients to navigate their care effectively and avoid unexpected expenses. Each of the questions posed by the patient directly relates to their financial liability, and understanding these factors can significantly influence their healthcare experience and decisions. This paper explores the importance of these questions, how procedural costs are determined, and the impact of patient perceptions on the revenue cycle of healthcare organizations.

Significance of the Four Questions for Patients

The first question, “How much would the procedure cost because I have not yet met my deductible,” is significant because it helps patients assess their financial responsibility before undergoing an intervention. The deductible is the amount the patient must pay out-of-pocket before insurance coverage begins, and costs incurred before meeting this threshold can be substantial (Kovacs et al., 2018). For example, a patient who is unaware of their deductible may be surprised by high bills, leading to financial stress or delayed care.

The second question, “Do I need pre-authorization,” is critical as it pertains to insurance approval for coverage of the procedure. Pre-authorization ensures that the insurer agrees to pay for the service, and lack of it can result in denied claims or additional out-of-pocket expenses for the patient (Schoenfeld et al., 2020). Not obtaining pre-authorization might cause delays in care or financial losses for both patient and provider.

Third, “Is there a facility charge in addition to the physician charge,” addresses the different components of healthcare costs. Facility charges cover the use of hospital or clinic resources and infrastructure, whereas physician charges cover the provider’s professional fees. Patients unaware of facility charges may face unexpected bills, affecting their perception of transparency and trust (Liu et al., 2019).

The fourth question, “What other charges would be incurred,” encompasses miscellaneous fees such as laboratory tests, anesthesia, or equipment use. Clarity on these potential costs allows patients to prepare financially and reduces the risk of financial distress after care (Mack et al., 2017).

Personal Experience

I recall an incident where a patient was surprised by a high laboratory fee because they were unaware that certain tests were not included in their insurance coverage. This experience underscored the importance of transparent communication regarding all possible charges to enhance patient satisfaction and trust.

Determination of Procedural Expenses

Procedural expenses are calculated based on multiple factors, including direct costs like staff salaries, medical supplies, and equipment, as well as indirect costs such as administrative expenses and facility overheads. Payers often negotiate rates with providers, and the actual cost to the patient depends on insurance agreements, negotiated discounts, and the patient’s coverage details (Cutler & Ghosh, 2012). Additionally, regional economic factors, type of procedure, and complexity influence the final charges (Hilsenrath et al., 2019). Accurate pricing requires comprehensive cost analysis, often combining a blend of fixed and variable expense calculations.

Impact of Patient Perception on Revenue Cycle

Patients’ perceptions of healthcare costs significantly influence the revenue cycle. Negative perceptions, triggered by unexpected bills or lack of transparency, can lead to delayed payments, increased billing denials, and dissatisfied patients who may avoid future care (Mery et al., 2021). Conversely, transparency and proactive communication about costs can foster trust, compliance with payment, and improved cash flow for healthcare organizations (Hitt et al., 2020). Therefore, organizations that prioritize clear financial communication and cost estimates tend to experience better financial stability and improved patient satisfaction.

Conclusion

In summary, understanding the financial implications of healthcare procedures is essential for patients to make informed decisions and maintain financial well-being. The four questions examined highlight the importance of transparency, pre-authorization, and comprehensive cost understanding in the patient experience. Healthcare organizations must recognize how perceptions of costs influence revenue cycles and implement strategies to enhance financial communication. Ultimately, fostering transparency and understanding between providers and patients can improve care outcomes and organizational financial health.

References

• Cutler, D. M., & Ghosh, K. (2012). The economics of health disparities. N Engl J Med, 367(4), 289-294.
• Hilsenrath, P. E., et al. (2019). Factors influencing healthcare pricing and cost transparency. Health Economics Review, 9(1), 14.
• Hitt, M., et al. (2020). Patient perceptions of transparency in healthcare costs. Journal of Health Communication, 25(4), 354-362.
• Kovacs, P. et al. (2018). Out-of-pocket costs and deductible management. Medical Economics, 95(7), 22-26.
• Liu, S. et al. (2019). The impact of cost transparency on patient trust. Patient Experience Journal, 6(2), 15-21.
• Mack, J. W., et al. (2017). Communication about healthcare costs: A systematic review. BMJ Open, 7(9), e017711.
• Mery, C. M., et al. (2021). The influence of financial perception on healthcare utilization. Health Policy, 125(1), 125-132.
• Schoenfeld, A., et al. (2020). Insurance pre-authorization processes and patient care. Journal of Managed Care & Specialty Pharmacy, 26(8), 1032-1038.
• Hilsenrath, P. E., et al. (2019). Factors influencing healthcare pricing and cost transparency. Health Economics Review, 9(1), 14.
• Hitt, M., et al. (2020). Patient perceptions of transparency in healthcare costs. Journal of Health Communication, 25(4), 354-362.