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Video instructions and help with filling out and completing patient claim form

Instructions and Help about patient claim form

Welcome to the judge Maps for the week in this week's tip I'm going to show you how to disallow a charge from showing up on a claim form so you don't bill it to the insurance company we'll start by going to our patient list by clicking on patients up here at the top and then we'll choose Robin Williams to work with so I'm going to simply click his name and click on Ledger I'm gonna post a few items from his treatment plan by going to my options menu and clicking post from treatment plan and we'll go ahead and select the items that we want to post for today's treatment we'll say the crown on number 4 and the buildup on number 4 and let's say it was a CEREC crown so we seeded it today - and then I'm gonna click post selected items and now on the ledger you can see our seat our crown and our post and core build-up for tooth number 4 in many situations the insurance company is gonna pay you based on the date you prepped the crown not necessarily the day you seat crown although there are a few companies that do want the seat date and that is the date that they pay you off of in this situation we're billing to MetLife for our dental insurance and for the most part they want the prep date not the seat date the seat itself does not have any money attached to it so that item I want to exclude from my claim form I'm simply going to double click on that item and mark it as I do not bill insurance item and save my changes now that we've disallowed that on a claim form I'm going to go ahead and create my claim we'll click OK to go ahead and view the claim since two claims were created I actually need to now go to my claims list so I can choose which claim I want to view so we have to Robin Williams claims I'll double click on it to open it up and view the claim and this is for a reason so that's not the claim we were looking for I'll double click on this second one and here's our claim for tooth number 4 for only a buildup and a crown so you can see that the seat did not show up on this claim form which is what we were after if this seating of a crown is a code that you never want to build out to an insurance company and have show up on your clean form we can manage that once and for all just like products for example you wouldn't necessarily build the insurance company for an oral-b or a Sonicare toothbrush that you sold so in order to manage that I'm going to our list and our service code list I'm going to pull up

FAQ

How can Canada afford free healthcare for every Canadian?
Thanks for your question. First of all, Canada does not have completely “free healthcare,” (we “pay” indirectly through our income taxes, of course, among other sources) nor do we have “socialized healthcare” like the U.K. Our universal healthcare is more like a nationwide group insurance policy that benefits from huge economies of scale and the efficient use of resources that follows from a more planned, centralized approach, and our doctors are not employed by the government. They have their private practices or are employed by hospitals, and bill the government per service.Our healthcare is as mentioned partly subsidized by income taxes, and then each province or territory has other means of funding their own system. For example, in Ontario, most alcohol sales are controlled by the Liquor Control Board of Ontario, and their revenue is one of the chief sources of funding for our provincial system (amounting to $2+ billion as of 2017–18).Each province or territory then receives a transfer payment from the federal government. The provinces have a certain degree of freedom to deliver the services that best suit their needs, but there are limits to this. To receive their federal transfer payment they must adhere to the five core principles set out in the Canada Health Act. These are: Public administration, universality, portability, comprehensiveness, accessibility.Canada’s taxes per capita are comparable to U.S. tax rates, by the way, not significantly higher.Costs of drugs are considerably lower, because the provincial governments negotiate directly with drug companies (economies of scale). A nationwide prescription drug plan is planned to roll out in 2022.Canadian hospitals are not public, but 95% are non-profit organizations and are bound by strict budgets.Canadians are guaranteed free care for medically necessary procedures and tests and surgical dentistry. This means that care not deemed necessary by each province may be charged for or involve co-pay.Regular dental care outside of a hospital setting is generally not covered, except for the very young and for seniors, people have private insurance or insurance through work for dental care. (My personal opinion is that the lack of coverage for dental care is a significant flaw in the system, and should be addressed. However, when I needed urgent wisdom tooth surgery twenty years ago, my surgery took place in hospital, under general anesthetic, and therefore the costs were completely covered.)Medications mostly involve a small co-pay, but a doctor can also admit a patient to hospital, in which case the drugs are free. Each province has its own program for medications and list of drugs covered. These programs are usually geared to your income after tax. For example, there are usually different programs for Seniors (65+), people on social welfare, diabetics, those needing expensive drugs (e.g. HIV-related illnesses or palliative care) and even over-the-counter meds if your doctor states they are necessary. Co-pay is often only $2 per prescription. Where there is an exact equivalent generic version of a drug, this is provided as they are normally a lot cheaper. However, if you have had adverse reactions to generics, they will prthe brand name versions.Also let’s address the topic of wait times, often given as a reason that Canada’s system is “broken.”Our system is not broken. One of the ways we keep costs down and are fiscally conservative is by limiting supply of elective and non-essential procedures. Sure Americans might get a hip replacement or MRI scan a bit faster, but with the result that their health care costs are much higher. (Americans also ration healthcare: with high fees. Unfortunately, this amounts to limiting demand, but health care isn’t something you can decide not to have— if you need heart surgery you need heart surgery. No one in Canada will ever go bankrupt because of medical bills, because there essentially aren’t any.)We could reduce wait times if that was our primary goal. It’s not.So the answer is: Through efficient use of taxes, by covering only medically necessary procedures and drugs, by rationing supply of non-necessary procedures, by negotiating drug prices at the provincial level and by not running on a for-profit basis, but on a strict budget.No system is perfect, but I’m grateful for my country’s system. I have always received excellent care and can’t imagine living without this. It’s part of the Canadian identity, really.
As a doctor or nurse, have you ever struggled to keep a straight face, or outright LOL'd as a patient described how they were injured in an unusual manner?
I think that I may have answered this question a few years ago.It concerned a gentleman who had just been to the bathroom, and had forgotten to zip up his fly!The individual was walking down his stairs, and when he got to the last couple of steps, he tripped and fell. Unfortunately, his vacuum cleaner was still running, and was upside down, and his fall positioned him in such a way that his penis, very unfortunately, disappeared into the vacuum cleaner and was badly macerated.The history was provided for me by a totally straightfaced patient, with his desperately worried and concerned partner sitting at the bottom of his bed, such that one would have thought, by the unfortunate individual’s demeanour, that this was a routine injury that occurred every day!It feels like last week, although it must’ve been about 35 years ago! The junior urological surgeon, red-faced, embarrassed and clearly totally at a loss to know what needed doing, was seriously considering performing an amputation, as the damage appeared to be far too great for preservation of the organ. In fact, fundamentally, on careful observation, it looked a great deal worse than it actually was.As an anaesthesiologist, I felt the patient needed a more senior opinion, and I suggested that the consulting, consultant in the United Kingdom, a Mr. Clarke, was called in at 2 o’clock in the morning, for an opinion.On the one hand, he wasn’t particularly pleased at being in the hospital at that time, but on the other hand, he felt that the situation was almost certainly recoverable, and he spent most of the next two hours doing his best to appear totally professional, and determined to maintain complete clinically appropriate discipline under very trying circumstances!He was able to perform a very impressive, complex, neat and tidy plastic surgical repair to the rather battered and sad looking organ, and he left a silastic implant where the urethra should have been, in order to keep it patent and open.In fact, the rather clever, difficult and tricky procedure, was worthy of its own patent, although to the best of my knowledge, this was never explored!He then fashioned a suprapubic catheter, by inserting a wide bore needle through the abdominal wall into the bladder, such that it drained into a large Winchester bottle.This meant that the urine could exit freely from the bladder, although the urethra was completely blocked off by a device that was calculated to keep it open, and vaguely circular in an attempt to prevent future obstruction and scarring.The patient was very fortunate, and despite not having the very best visibly optimal and attractive result, he was able to avoid having a total amputation of his penis, including a totally functional result!When everything had healed, all sutures removed, the suprapubic catheter extracted and the Silastic implant gently teased out, all appeared to function normally, as far as the casual observer could determine.Two weeks later, the surgeon assured me that the organ had achieved 100% normal function!Many of my friends and colleagues did not initially believe me when I explained the events of that night, so I was very pleased to have taken a before and after Polaroid photograph of what had occurred!To this day, I do not have the patient’s permission for publication, so the images are probably best kept at the bottom of a large drawer, to avoid damage by sunlight, not to mention litigation!Steve
Why are patient forms at hospitals such a pain to fill out?
Usually there is a one or maybe a two-page form. I don't think they are that difficult to fill out. They copy my insurance card and that's it. Generally they include a brief list of history questions and current symptom questions. If it is a current doctor, only the current symptom questions. As I am not the one with the medical degree, I hope they use those answers to put two and two together in case my sore throat, indigestion, headache or fever is part of a bigger picture of something more seriously wrong. The HIPAA form is long to read, but you only need to do that once (although you'll be expected to sign the release each time you see a new doctor or visit a new clinic or hospital).
Why do patients have to fill out forms when visiting a doctor? Why isn't there a "Facebook connect" for patient history/information?
There are many (many) reasons - so I'll list a few of the ones that I can think of off-hand.Here in the U.S. - we have a multi-party system: Provider-Payer-Patient (unlike other countries that have either a single payer - or universal coverage - or both). Given all the competing interests - at various times - incentives are often mis-aligned around the sharing of actual patient dataThose mis-aligned incentives have not, historically, focused on patient-centered solutions.  That's starting to change - but slowly - and only fairly recently.Small practices are the proverbial "last mile" in healthcare - so many are still paper basedThere are still tens/hundreds of thousands of small practices (1-9 docs) - and a lot of healthcare is still delivered through the small practice demographicThere are many types of specialties - and practice types - and they have different needs around patient data (an optometrist's needs are different from a dentist - which is different from a cardiologist)Both sides of the equation - doctors and patients - are very mobile (we move, change employers - doctors move, change practices) - and there is no "centralized" data store with each persons digitized health information.As we move and age - and unless we have a chronic condition - our health data can become relatively obsolete - fairly quickly (lab results from a year ago are of limited use today)Most of us (in terms of the population as a whole) are only infrequent users of the healthcare system more broadly (cold, flu, stomach, UTI etc....). In other words, we're pretty healthy, so issues around healthcare (and it's use) is a lower priorityThere is a significant loss of productivity when a practice moves from paper to electronic health records (thus the government "stimulus" funding - which is working - but still a long way to go)The penalties for PHI data breach under HIPAA are significant - so there has been a reluctance/fear to rely on electronic data.  This is also why the vast majority of data breaches are paper-based (typically USPS)This is why solutions like Google Health - and Revolution Health before them - failed - and closed completely (as in please remove your data - the service will no longer be available)All of which are contributing factors to why the U.S. Healthcare System looks like this:===============Chart Source: Mary Meeker - USA, Inc. (2011) - link here:http://www.kpcb.com/insights/usa...
How can I claim the VAT amount for items purchased in the UK? Do I need to fill out any online forms or formalities to claim?
Easy to follow instructions can be found here Tax on shopping and servicesThe process works like this.Get a VAT 407 form from the retailer - they might ask for proof that you’re eligible, for example your passport.Show the goods, the completed form and your receipts to customs at the point when you leave the EU (this might not be in the UK).Customs will approve your form if everything is in order. You then take the approved form to get paid.The best place to get the form is from a retailer on the airport when leaving.