The Positives and Negatives of Healthcare Providers

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We as U.S. citizens are lucky to live in a country that has so many wonderful offerings, especially when it comes to the health care system. Currently, things are even better for the younger adults because they are covered under their parents health insurance until the age of 26. This may seem to cost more money and everything, but many people do not understand that when these young people get out of college, it is not easy to just find a job and acquire all the benefits and health care in which they all need, at least should have. But with all these programs comes costs, and in the end it is sadly all about the money.

Since the enactment of the Health Maintenance Organization Act of 1973, there has been a sufficient growth in managed care within the United States. Also, despite the mandate to control costs by managed care professionals, the U.S. healthcare expenditures has continued to overstep the overall national income, rising to about 2.4 percentage points faster than the annual GDP since back in 1970. Although these healthcare programs are an utter need, nothing is free and simply they want their money. The use of payment compliance and contract compliance is popular in these fields, because without the reassurance that they will get their money, a person will not receive the care. Revenue recovery is hard for these medical companies to get, so payment compliance is a must.

One of the most characteristic forms of managed care is the use of a panel or network of healthcare providers to offer care to its enrollees, but they will require payment compliance. Having said that, there is provider networks out there than can be used to reduce costs by negotiating favorable fees, selecting cost effective providers, and creating financial incentives for more efficient practices. So, these sets of designated doctors and health care facilities will require payment reviews, but they are a provider network and this hallmark of the managed healthcare system is there so you can receive the care you need no matter what cost.

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