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    Dual Insurance System: Public and Private

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    I wanted to see if I could get help answering these questions below.


    What are the challenges and benefits to health care professionals providing care in a dual insurance system: public and private?

    What do health care professionals need to remember when caring for patients in managed care organizations?

    How does being old (65 years old or older) or being poor affect oneâ??s ability to access health care?

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    Solution Preview

    There are many benefits to health care providers, in a dual insurance system. The most
    common benefit is the ability to serve a greater number of patients, which helps increase
    revenue. It can also help providers increase the level of continuity in care, when patients move
    from private to public sources. An example might be a retiree who is no longer eligible for
    employer benefits and who now relies on Medicare or some other public source. As long as
    the provider accepts the public source, the patient can continue using the provider he or she is
    familiar with. Patients with current dual coverage may be more likely to seek medical care
    when they need it, rather than putting it off. This makes follow up much easier and providers
    can more easily treat illnesses in the early stages, rather than it later stages.

    Challenges for health care providers are in developing automated systems for patient
    records and billing, that will satisfy the requirements of both public and private health care
    insurers. Some insurers may require a format that is different from others. In addition, some
    insurers may require authorization for procedures that others do not. This can be confusing
    to patients, when they move from one insurer to another. Health care providers are left with
    the responsibility of explaining this to patients in ...

    Solution Summary

    This solution public and private insurance systems.