Evolution of Health Care

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The attached document is not intended as an assignment completion.

A physician's office today is typically automated or in the process of becoming fully automated,
with respect to medical records, scheduling, billing, and even for prescriptions. Patients are often
scheduled automatically, if they are already established and need follow up visits. They are given
printed copies of payments and schedules, before they leave the office. Twenty years ago, the
physician's office relied on paper medical records and office visit notes were hand written in the
progress notes. Patients were given paper bills and called for appointments or had appointments
scheduled by staff prior to leaving. The appointments were hand written in the physician's appointment
book.
Today's physician office usually accepts a multitude of third party payers, with a mix of
Medicaid, Medicare, Worker's Compensation, HMO, PPO, and self pay patients. Offices may also
contract with manufacturing facilities that provide health services to employees on a daily basis.
Physician offices may accept capitated (monthly fees) from some payers, and reimbursed on a fee for
service basis from other payers. Physician offices often rely on other programs, like cash and carry
medication programs or dietary consulting, to generate additional income that covers administrative
and other costs (Riethmiller, nd). Cash and carry programs offer patients low cost medications that
may be slightly lower than co-payments in pharmacies. They purchase the medications at a very low
cost from generic brand suppliers, then increase the cost to make a profit. Nutrition consulting may
include dietary modification advice and weight loss programs that charge a competitive fee.
The physician's office would not provide such services twenty years ago. Physicians would rely
on payment from a few select insurance companies and possibly from Medicare, for revenue. Billing
of insurance companies and Medicare consisted of filling out lengthy paper forms and sending them to
the appropriate office for reimbursement. If forms were filled out improperly or one error was found on
a claim form, the payment was denied.
Today's medical billing software includes many safeguards that find and alert users of errors,
before they are electronically transmitted to insurance companies. There are many safeguards
incorporated into automated patient records. Alerts for prescribing conflicts and medication
interactions are common. They prevent medication ...