Doctor patient-insurance 040213

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Doctor patient-insurance 040213

  1. 1. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY
  2. 2. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY
  3. 3. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY MANAGING MY HEALTH • Medical History • Visits • Lab Results • Medications • Immunizations HEALTH & WELLNESS CONDITION MANAGEMENT EMERGENCY SERVICES HEALTH & WELLNESS • Immunization • Screening tests • Physical/Dental/Vision checkup • Diet / Exercise program • Mental health CONDITION MANAGEMENT • Illness: treatment + follow-up • Chronic disease: medication + measurement • Pregnancy: treatment + follow-up • Elective surgery: treatment + follow-up • Mental health: treatment + follow-up EMERGENCY SERVICES • Accident response • Ambulance • Emergency room
  4. 4. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY MANAGING MY HEALTH • Medical History • Visits • Lab Results • Medications • Immunizations HEALTH & WELLNESS CONDITION MANAGEMENT EMERGENCY SERVICES HEALTH & WELLNESS • Immunization • Screening tests • Physical/Dental/Vision checkup • Diet / Exercise program • Mental health CONDITION MANAGEMENT • Illness: treatment + follow-up • Chronic disease: medication + measurement • Pregnancy: treatment + follow-up • Elective surgery: treatment + follow-up • Mental health: treatment + follow-up EMERGENCY SERVICES • Accident response • Ambulance • Emergency room PATIENT ADVOCACY GROUPS • Research • Support • Policy • Cure PERSONAL BIOMETRICS • Family & Friends • Websites • Mobile Apps HEALTH INFORMATION • Books & Magazines • Websites • Mobile Apps PHARMACEUTICAL MEDICAL DEVICES MEDICAL PRODUCTS & SERVICES COMPANIES • Medical Devices • Drug Treatment • Lab Testing • Medical Imaging Health & Human Services State Health Laws Food & Drug Administration
  5. 5. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY MANAGING MY HEALTH • Medical History • Visits • Lab Results • Medications • Immunizations HEALTH & WELLNESS CONDITION MANAGEMENT EMERGENCY SERVICES HEALTH & WELLNESS • Immunization • Screening tests • Physical/Dental/Vision checkup • Diet / Exercise program • Mental health CONDITION MANAGEMENT • Illness: treatment + follow-up • Chronic disease: medication + measurement • Pregnancy: treatment + follow-up • Elective surgery: treatment + follow-up • Mental health: treatment + follow-up EMERGENCY SERVICES • Accident response • Ambulance • Emergency room PATIENT ADVOCACY GROUPS • Research • Support • Policy • Cure PERSONAL BIOMETRICS • Family & Friends • Websites • Mobile Apps HEALTH INFORMATION • Books & Magazines • Websites • Mobile Apps PHARMACEUTICAL MEDICAL DEVICES MEDICAL PRODUCTS & SERVICES COMPANIES • Medical Devices • Drug Treatment • Lab Testing • Medical Imaging Health & Human Services State Health Laws Food & Drug Administration MANAGING MY INSURANCE • Payments • Deductable • Max Out of Pocket • Reimbursements • FSA MEDICARE MEDICAID EMPLOYER BENEFITS MANAGEMENT BENEFITS PACKAGE • Health • Disability • Life • FSA
  6. 6. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY MANAGING MY HEALTH • Medical History • Visits • Lab Results • Medications • Immunizations HEALTH & WELLNESS CONDITION MANAGEMENT EMERGENCY SERVICES HEALTH & WELLNESS • Immunization • Screening tests • Physical/Dental/Vision checkup • Diet / Exercise program • Mental health CONDITION MANAGEMENT • Illness: treatment + follow-up • Chronic disease: medication + measurement • Pregnancy: treatment + follow-up • Elective surgery: treatment + follow-up • Mental health: treatment + follow-up EMERGENCY SERVICES • Accident response • Ambulance • Emergency room PATIENT ADVOCACY GROUPS • Research • Support • Policy • Cure PERSONAL BIOMETRICS • Family & Friends • Websites • Mobile Apps HEALTH INFORMATION • Books & Magazines • Websites • Mobile Apps PHARMACEUTICAL MEDICAL DEVICES MEDICAL PRODUCTS & SERVICES COMPANIES • Medical Devices • Drug Treatment • Lab Testing • Medical Imaging Health & Human Services State Health Laws Food & Drug Administration MANAGING MY INSURANCE • Payments • Deductable • Max Out of Pocket • Reimbursements • FSA MEDICARE MEDICAID EMPLOYER BENEFITS MANAGEMENT BENEFITS PACKAGE • Health • Disability • Life • FSA TREATING PATIENTS PHARMACY STAGES OF CARE • Determine Diagnosis • Determine Care Plan • Activate Care Plan • Maintain Care Plan • Refer-Follow Patient
  7. 7. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY MANAGING MY HEALTH • Medical History • Visits • Lab Results • Medications • Immunizations HEALTH & WELLNESS CONDITION MANAGEMENT EMERGENCY SERVICES HEALTH & WELLNESS • Immunization • Screening tests • Physical/Dental/Vision checkup • Diet / Exercise program • Mental health CONDITION MANAGEMENT • Illness: treatment + follow-up • Chronic disease: medication + measurement • Pregnancy: treatment + follow-up • Elective surgery: treatment + follow-up • Mental health: treatment + follow-up EMERGENCY SERVICES • Accident response • Ambulance • Emergency room PATIENT ADVOCACY GROUPS • Research • Support • Policy • Cure PERSONAL BIOMETRICS • Family & Friends • Websites • Mobile Apps HEALTH INFORMATION • Books & Magazines • Websites • Mobile Apps PHARMACEUTICAL MEDICAL DEVICES MEDICAL PRODUCTS & SERVICES COMPANIES • Medical Devices • Drug Treatment • Lab Testing • Medical Imaging Health & Human Services State Health Laws Food & Drug Administration MANAGING MY INSURANCE • Payments • Deductable • Max Out of Pocket • Reimbursements • FSA MEDICARE MEDICAID EMPLOYER BENEFITS MANAGEMENT BENEFITS PACKAGE • Health • Disability • Life • FSA TREATING PATIENTS PHARMACY STAGES OF CARE • Determine Diagnosis • Determine Care Plan • Activate Care Plan • Maintain Care Plan • Refer-Follow Patient PLACES TO PRACTICE CLINICAL OUT-PATIENT HOSPITAL IN-PATIENT LAB IMAGING • Clinical Staff • Admin Staff • Clinical Staff • Admin Staff SERVICE PRESENTED TO PAYER • Patient’s Insurance Contract • Diagnostic Code / Billing Code • Right to Bill / Referral DIAGNOSTIC SERVICES
  8. 8. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY MANAGING MY HEALTH • Medical History • Visits • Lab Results • Medications • Immunizations HEALTH & WELLNESS CONDITION MANAGEMENT EMERGENCY SERVICES HEALTH & WELLNESS • Immunization • Screening tests • Physical/Dental/Vision checkup • Diet / Exercise program • Mental health CONDITION MANAGEMENT • Illness: treatment + follow-up • Chronic disease: medication + measurement • Pregnancy: treatment + follow-up • Elective surgery: treatment + follow-up • Mental health: treatment + follow-up EMERGENCY SERVICES • Accident response • Ambulance • Emergency room PATIENT ADVOCACY GROUPS • Research • Support • Policy • Cure PERSONAL BIOMETRICS • Family & Friends • Websites • Mobile Apps HEALTH INFORMATION • Books & Magazines • Websites • Mobile Apps PHARMACEUTICAL MEDICAL DEVICES MEDICAL PRODUCTS & SERVICES COMPANIES • Medical Devices • Drug Treatment • Lab Testing • Medical Imaging Health & Human Services State Health Laws Food & Drug Administration MANAGING MY INSURANCE • Payments • Deductable • Max Out of Pocket • Reimbursements • FSA MEDICARE MEDICAID EMPLOYER BENEFITS MANAGEMENT BENEFITS PACKAGE • Health • Disability • Life • FSA TREATING PATIENTS PHARMACY STAGES OF CARE • Determine Diagnosis • Determine Care Plan • Activate Care Plan • Maintain Care Plan • Refer-Follow Patient PLACES TO PRACTICE CLINICAL OUT-PATIENT HOSPITAL IN-PATIENT LAB IMAGING • Clinical Staff • Admin Staff • Clinical Staff • Admin Staff SERVICE PRESENTED TO PAYER • Patient’s Insurance Contract • Diagnostic Code / Billing Code • Right to Bill / Referral DIAGNOSTIC SERVICES METHODS TO PRACTICE PROF/SPECIALTY SOCIETIES ACADEMIC MEDICAL CTRS MEDICAL RESEARCH • Clinical Trials • Published Research • Conferences
  9. 9. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY MANAGING MY HEALTH • Medical History • Visits • Lab Results • Medications • Immunizations HEALTH & WELLNESS CONDITION MANAGEMENT EMERGENCY SERVICES HEALTH & WELLNESS • Immunization • Screening tests • Physical/Dental/Vision checkup • Diet / Exercise program • Mental health CONDITION MANAGEMENT • Illness: treatment + follow-up • Chronic disease: medication + measurement • Pregnancy: treatment + follow-up • Elective surgery: treatment + follow-up • Mental health: treatment + follow-up EMERGENCY SERVICES • Accident response • Ambulance • Emergency room PATIENT ADVOCACY GROUPS • Research • Support • Policy • Cure PERSONAL BIOMETRICS • Family & Friends • Websites • Mobile Apps HEALTH INFORMATION • Books & Magazines • Websites • Mobile Apps PHARMACEUTICAL MEDICAL DEVICES MEDICAL PRODUCTS & SERVICES COMPANIES • Medical Devices • Drug Treatment • Lab Testing • Medical Imaging Health & Human Services State Health Laws Food & Drug Administration MANAGING MY INSURANCE • Payments • Deductable • Max Out of Pocket • Reimbursements • FSA MEDICARE MEDICAID EMPLOYER BENEFITS MANAGEMENT BENEFITS PACKAGE • Health • Disability • Life • FSA TREATING PATIENTS PHARMACY STAGES OF CARE • Determine Diagnosis • Determine Care Plan • Activate Care Plan • Maintain Care Plan • Refer-Follow Patient PLACES TO PRACTICE CLINICAL OUT-PATIENT HOSPITAL IN-PATIENT LAB IMAGING • Clinical Staff • Admin Staff • Clinical Staff • Admin Staff SERVICE PRESENTED TO PAYER • Patient’s Insurance Contract • Diagnostic Code / Billing Code • Right to Bill / Referral DIAGNOSTIC SERVICES METHODS TO PRACTICE PROF/SPECIALTY SOCIETIES ACADEMIC MEDICAL CTRS MEDICAL RESEARCH • Clinical Trials • Published Research • Conferences CLAIMS PORTAL PAYMENT PORTAL BENEFITS PORTAL SELF-MONITORING APPLICATIONS BEHAVIOR-CHANGE APPLICATIONS PATIENT MANAGEMENT • Lab / Imaging • Medication • Medical History • Schedule PRACTICE MANAGEMENT • Diagnosis Code • Billing Code • Time In/Out • Supplies POINT OF CARE • Clincial decision support
  10. 10. PATIENT DOCTOR INSURER PATIENT-DOCTOR-INSURER HEALTHCARE ECOLOGY MANAGING MY HEALTH • Medical History • Visits • Lab Results • Medications • Immunizations HEALTH & WELLNESS CONDITION MANAGEMENT EMERGENCY SERVICES HEALTH & WELLNESS • Immunization • Screening tests • Physical/Dental/Vision checkup • Diet / Exercise program • Mental health CONDITION MANAGEMENT • Illness: treatment + follow-up • Chronic disease: medication + measurement • Pregnancy: treatment + follow-up • Elective surgery: treatment + follow-up • Mental health: treatment + follow-up EMERGENCY SERVICES • Accident response • Ambulance • Emergency room PATIENT ADVOCACY GROUPS • Research • Support • Policy • Cure PERSONAL BIOMETRICS • Family & Friends • Websites • Mobile Apps HEALTH INFORMATION • Books & Magazines • Websites • Mobile Apps PHARMACEUTICAL MEDICAL DEVICES MEDICAL PRODUCTS & SERVICES COMPANIES • Medical Devices • Drug Treatment • Lab Testing • Medical Imaging Health & Human Services State Health Laws Food & Drug Administration MANAGING MY INSURANCE • Payments • Deductable • Max Out of Pocket • Reimbursements • FSA MEDICARE MEDICAID EMPLOYER BENEFITS MANAGEMENT BENEFITS PACKAGE • Health • Disability • Life • FSA TREATING PATIENTS PHARMACY STAGES OF CARE • Determine Diagnosis • Determine Care Plan • Activate Care Plan • Maintain Care Plan • Refer-Follow Patient PLACES TO PRACTICE CLINICAL OUT-PATIENT HOSPITAL IN-PATIENT LAB IMAGING • Clinical Staff • Admin Staff • Clinical Staff • Admin Staff SERVICE PRESENTED TO PAYER • Patient’s Insurance Contract • Diagnostic Code / Billing Code • Right to Bill / Referral DIAGNOSTIC SERVICES METHODS TO PRACTICE PROF/SPECIALTY SOCIETIES ACADEMIC MEDICAL CTRS MEDICAL RESEARCH • Clinical Trials • Published Research • Conferences CLAIMS PORTAL PAYMENT PORTAL BENEFITS PORTAL SELF-MONITORING APPLICATIONS BEHAVIOR-CHANGE APPLICATIONS PATIENT MANAGEMENT • Lab / Imaging • Medication • Medical History • Schedule PRACTICE MANAGEMENT • Diagnosis Code • Billing Code • Time In/Out • Supplies POINT OF CARE • Clincial decision support Electronic Health Records CMS Claims Insurance Claims All Payer Claims Personnel Records Benefits Claims Payments Clinical Data Quality Data Personnel Health Records Biometrics Genome Records Medical Text

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