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Healthcare Consumerism

Healthcare Consumerism. Mount Vernon Nazarene University – October 2012. Common Insurance Terms. Deductible Coinsurance Maximum Out of Pocket Procedure Code Diagnosis Code Network Discount Pre-Certification. How a Claim Gets Paid. Future of Health Plans.

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Healthcare Consumerism

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  1. Healthcare Consumerism Mount Vernon Nazarene University – October 2012

  2. Common Insurance Terms Deductible Coinsurance Maximum Out of Pocket Procedure Code Diagnosis Code Network Discount Pre-Certification

  3. How a Claim Gets Paid

  4. Future of Health Plans

  5. Factors Influencing Healthcare Costs Technology Advances – MRIs $1890 vs. Chest X-ray $175 Prescription Drugs – Generic vs. Brand Increased Patient Demand – 30% of healthcare treatments viewed as unnecessary Government Regulations & Coverage Mandates – HIPAA, PPACA Increased Financial Pressure on Doctors & Hospitals – malpractice insurance, consolidation Lifestyle Choices – 50% of all healthcare costs stem from preventable lifestyle choices

  6. Factors Influencing Healthcare Costs Direct-to-Consumer Marketing TV Commercials Magazine Ads Billboards Increased number of chronic conditions Increased availability and access to care

  7. Consumer Tools Discounted Prescription Medications Wal-Mart - $4/$10 Kroger - $4/$10 K-Mart - $5/$10 with Pharmacy Prescription Savings Club Membership Meijer - Costco – no membership required Websites to Compare Prices www.healthcarebluebook.com www.fairhealthconsumer.org www.rxaminer.com Online Drug Stores www.drugsource.com Physician & Hospital Quality www.healthgrades.com www.hospitalcompare.hhs.gov www.umr.com Consumer Reports Health

  8. Consumer Tips Get the Most of Doctor Visits – www.choosingwisely.com Ask for prescription samples from your physician for short-term medications Ask your physician for copay assistance prescription cards for long-term medications Review medical bills Stay in-network Utilize generics Shop around

  9. Additional Tips Prescription Drug costs can change daily and vary widely from store to store Generic drugs are not cheaper than brand name drugs the first six months on the market You can negotiate your provider bills Antibiotics and Prenatal vitamins are FREE at Meijer

  10. Questions

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