Private Pay Health Care Private Pay is the basis upon which the healthcare financing system began. Patients paid physicians a fee-for-service. In its purest sense, the Private Pay model includes only the physician and patient in the exchange of compensation for medical care provided. Over the years as healthcare financing arrangements have changed, entities paying a fee-for-service includes all payers-public and private. Recently, the healthcare industry has referred to physician practices that do not accept health insurance as cash-only practices or Private Pay offices.
Private Pay vastly reduces the traditional overhead expenses by not having to bill and abide by contractual requirements of third party payers. Further, collection rates may be higher with fewer bad debt expenses.
Physicians in a pure Private Pay practice may want to continue to see patients with private insurance who are willing to pay cash and submit their own claims. Before charging privately insured patients on a cash basis, the physician should determine that there are no contractual or legal restrictions on doing so. This will necessitate a review of existing contracts and state insurance regulations. Certain states protect enrollee’s in particular private insurance plans from being billed for any sums beyond what the insurance company pays, except for co-pays and deductibles.
Opponents of a completely Private Pay practice model would argue that it violates the professional principle of ensuring equal access for all. Individuals with insurance may not be able to afford seeing a physician who does not participate with their health plan due to the added financial responsibilities. Thus, the Private Pay practice is limiting its level of patients’ access to care based on one’s financial means.
There are already millions of Americans who cannot afford private health insurance and have Medicaid coverage. Others self-insure due to their financial resources being such that they can pay out-of-pocket for their medical expenses.
Physicians who wish to move to a pure Private Pay practice and still take Medicare patients must privately contract with such patients. If still accepting Medicare, it is advisable to follow the Medicare fee schedule as to avoid causing any red flags to be raised. The rules related to treating Medicaid patients on a Private Pay basis will vary from state to state. It is advisable to contact the state Medicaid agency for their terms on charging patients directly.
An act of performing surgery may be called a surgical procedure, operation, or simply surgery. In this context, the verb operates means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The patient or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who performs operations on patients. In rare cases, surgeons may operate on themselves. Persons described as surgeons are commonly physicians, but the term is also applied to podiatrists, dentists and veterinarians. A surgery can last from minutes to hours, but is typically not an ongoing or periodic type of treatment. The term surgery can also refer to the place where surgery is performed, or simply the office of a physician, dentist, or veterinarian.
At a hospital, modern surgery is often done in an operating theater using surgical instruments, an operating table for the patient, and other equipment. The environment and procedures used in surgery are governed by the principles of aseptic technique: the strict separation of sterile free of microorganisms things from unsterile or contaminated things. All surgical instruments must be sterilized, and an instrument must be replaced or re-sterilized if it becomes contaminated i.e. handled in an unsterile manner, or allowed to touch an unsterile surface. Operating room staff must wear sterile attire scrubs, a scrub cap, a sterile surgical gown, sterile latex or non-latex polymer gloves and a surgical mask, and they must scrub hands and arms with an approved disinfectant agent before each procedure.
Prior to surgery, the patient is given a medical examination, certain pre-operative tests, and their physical status is rated according to the AS A physical status classification system. If these results are satisfactory, the patient signs a consent form and is given a surgical clearance. If the procedure is expected to result in significant blood loss, an autologous blood donation may be made some weeks prior to surgery. If the surgery involves the digestive system, the patient may be instructed to perform bowel prep by drinking a solution of polyethylene glycol the night before the procedure. Patients are also instructed to abstain from food or drink to minimize the effect of stomach contents on pre-operative medications and reduce the risk of aspiration if the patient vomits during or after the procedure.
In the pre-operative holding area, the patient changes out of his or her street clothes and is asked to confirm the details of his or her surgery. A set of vital signs are recorded, a peripheral IV line is placed, and pre-operative medications are given. When the patient enters the operating room, the skin surface to be operated on, called the operating field, is cleaned and prepared by applying an antiseptic such as chlorhexidine gluconate or povidone-iodine to reduce the possibility of infection. If hair is present at the surgical site, it is clipped off prior to prep application. The patient is assisted by an anesthesiologist or resident to make a specific surgical position, sterile drapes are used to cover all of the patient's body except for the head and the surgical site or at least a wide area surrounding the operating field. The drapes are clipped to a pair of poles near the head of the bed to form an ether screen, which separates the anesthetist/anesthesiologist's working area from the surgical site.
Anesthesia is administered to prevent pain from incision, tissue manipulation and suturing. Based on the procedure, anesthesia may be provided locally or as general anesthesia. Spinal anesthesia may be used when the surgical site is too large or deep for a local block, but general anesthesia may not be desirable. With local and spinal anesthesia, the surgical site is anesthetized, but the patient can remain conscious or minimally sedated. In contrast, general anesthesia renders the patient unconscious and paralyzed during surgery. The patient is intubated and is placed on a mechanical ventilator, and anesthesia is produced by a combination of injected and inhaled agents.
An incision is made to access the surgical site. Blood vessels may be clamped to prevent bleeding, and retractors may be used to expose the site or keep the incision open. The approach to the surgical site may involve several layers of incision and dissection, as in abdominal surgery, where the incision must traverse skin, subcutaneous tissue, three layers of muscle and then peritoneum. In certain cases, bone may be cut to further access the interior of the body; for example, cutting the skull for brain surgery or cutting the sternum for thoracic surgery to open up the rib cage. passagesmalibu
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