The Role of a Healthcare Management Agency
Healthcare is the medical practice involving the care of patients suffering from debilitating diseases, injuries, or illnesses. Healthcare includes the entire field of health management that encompasses prevention, diagnosis, treatments, rehabilitation, or cure of the ailment, disease, disability, and other medical and mental disabilities in humans. Healthcare is delivered by healthcare practitioners and other allied healthcare fields. Healthcare organizations provide healthcare facilities and services to meet the needs of healthcare providers, patients, and society. The activities of healthcare include preventive healthcare, primary healthcare, and health maintenance, acute healthcare, disability and aging healthcare, hospital medicine, physician care, pediatrics, and nursing care.
A primary care doctor generally refers a patient to a specialist for further evaluation and treatment. The primary care physician may see other doctors or refer the patient to another provider. In some cases, primary care physicians perform other procedures such as ordering tests or laboratory tests or acquiring physical exams or X-rays. The primary care physician may also participate in any professional association or group therapy program approved by the state.
In the United States, the term “health insurance plan” refers to a group of health insurance providers that offer a contract to cover expenses for services provided by a primary care physician and his or her staff. The contract may cover some or all of the physician’s office visits, laboratory tests, prescriptions, etc. The primary care physician is covered under a health insurance plan, while his or her staff are not. The health insurance plan reimburses the primary care physician and his or her staff for services provided to a patient. This reimbursement system is often used to encourage healthcare providers to provide more extensive health care to their patients. However, if a patient uses more than the agreed upon number of healthcare providers, he or she may be denied reimbursement.
Hospitals are an important part of the healthcare system in the United States. Many hospitals, nursing homes, rehabilitation centers, and outpatient treatment centers provide medical care to patients who cannot stay at a hospital for whatever reason. Long-term illnesses and surgeries are very expensive. As such, the cost of providing these high level medical care services has come down while the quality of care has not deteriorated over the years. As a result, many patients who would otherwise have had to undergo more expensive hospital stays can receive timely care at less costly hospitals or nursing homes.
Assisted-living facilities are similar to hospitals and nursing homes in many ways. Many of them offer medical care to senior citizens and allow them to stay in their own homes instead of being placed in a hospital or nursing home. Although they may function somewhat like healthcare providers, assisted living facility does not provide healthcare providers or prescription drugs. Medicare and Medicaid, two federal programs designed to assist seniors with healthcare costs, provide financing for assisted living facilities. Because these two federal programs typically do not cover non-medical healthcare services, it is wise to verify that a facility provides such services before deciding whether to enroll.
For people who need healthcare but do not qualify for one of the above options, healthcare providers can be seen and referred to through an agency. Healthcare agencies are professional organizations that connect patients to healthcare providers who accept their pay. This allows the patient to work closely with the healthcare provider to ensure that healthcare service is obtained. If one is unable to find a healthcare facility that meets all of their healthcare needs, an agency can help with finding a provider who will. A healthcare management agency may refer the patient to appropriate healthcare facilities.