Managed care can cause delays in approvals, testing, diagnosis = lawsuits
What’s the difference between an “authorization” and a “pre-authorization?
An authorization is special patient permission to share certain PHI
A pre-authorization is a request sent to managed care insurance for the purpose of gaining their agreement to pay for certain services, testing, drugs, etc. If they “approve” they will pay; if they do not approve, they will not pay.
What’s the difference between a consent and an informed consent?
Consent is permission from a patient to share routine health care information with insurance companies, other people involved in their care
Informed consent is when a provider ‘informs’ patient of risks, benefits, alternatives to treatment, and then the patient gives (usually written) consent for the treatment as described
Some reasons for the rise in health care costs today include:
Increased cost of a medical education
Increased lawsuits cause increase in medical malpractice insurance
Longer life expectancy = more people with chronic health issues = increased costs
Increased technology = increased specialization = higher cost for personnel