It takes an awful lot to take care of a medical office. The rent, supplies and all of the maintenance from years of use. I am thrifty or cheap and it probably disgusted people when the front office was put in the position of ordering everything. It was all said and done for a lot less than what most physicians would have spent. Laugh if you want but you probably said" She has never lived on her own via apartment, house or some sort of rental arrangement." Yes you are correct, I found a more thriftier deal by living at home, at least for now. This is what oppression does. Physicians have a more glamorous view on life, so they will purchase things that remind them of their own homes and what not. Really, when you are a front desk medical worker you want the patients to see the physician and then well, if their visit is over there is no point in staying around the medical office. You can get a cheaper cup of coffee from a bodega. People who work in medical offices may not want a patient who is on the healthier spectrum to get overly comfortable. There is a huge difference in having to upkeep a healthy body as opposed to a very sickly one. If you think in terms of what would you want patients to do with themselves, you are perhaps suggesting that there is a lot more to life than just having one by seeing every physician and hospital in the tri-state area. Ok, so you may not like what I suggested. In that instance you can probably realize that I have taken my own advice and got a hobby or a few of them and as a result if you need someone to chat with I may not be the best person to do so because being healthy or in that focus of optimizing the body to exist that way is more important to me. It takes money to be sick. How so? Medications, doctors and hospital visits, and the other things that require you to have care at all times. Becoming healthy is doing what is needed to replenish the body for survival. There are no exorbitant costs for physicians or hospitals and you don't need to take meds or even supplements that are very expensive. A physicians office should not be a standing room experience, and the sick do need care. Sometimes medical office furnishings are done to incite well visit mentality even if it is on the cheap.
There is nothing more aggravating than having to write out a prescription. Nope, I was wrong there are several more things that are considered aggravating but I will not discuss all of those in detail today. Why would writing out a prescription be aggravating? Because, a hospital may or at least for payment reasons want the prescription to state what procedure is being done in a certain way. Medical linguistics can complicate things somewhat if and when a prescription is being written by novice hand or lament terms. Or, of course when only one part of a procedure can be pre-certified then a new prescription must be written to indicate the actual procedure being done. I hate prescriptions among other things. Gosh, I was really born this way. The written prescriptions that subsequently get scanned into the EMR, sometimes have medical linguistic issues with them. But then, that is where the EMR's prescription orders should be used as they include the CPT code for billing reasons and why using the EMR prescriptions would be more useful. Then all the hospital and the physicians office has to agree upon is the CPT code that will be used for the procedure. My only problem with using an EMR prescription is that when a patient needs lab work, the EMR will not allow a physician to print more than one lab test on a prescription. This is rather silly because if a physician orders several lab tests and a patient cannot find the prescription for it then, well I guess that particular test will not be done. There has to be a way for a physician to create an EMR prescription so that they can add on more than one lab test on the prescription along with the diagnosis. There should be a blank prescription form under the orders section of an EMR so that a physician can select it and be able to add a test by it's CPT and or type in a requested test and then just select a diagnosis for which a patient can use as a prescription to take to a lab or hospital. The blank prescription selection for EMR is great to use when a physician may want to give a patient a script for something and he or she for the sake a time may want to write it out. It may be easier during the visit just to select blank prescription in the EMR and type out what is needed for the patient, this way the patient has everything the need to finally leave as their visit is over, aside from their next appointment. The entire medical office seems to become where the patient has their appointment, between the intake of information, the actual visit, and everything else and of course the prescriptions, and the medications. One day and probably when I retire from this misery there will finally be an entire physician's visit that will occur in the exam room of the physician and not the whole office. I must say this job has done everything but...
When working in a medical office there are many websites that have to be used or accessed in order to obtain something. By this I am not talking about referrals or pre-authorizations. Years ago most of the payments from health insurers were issued by check. This was the only way as it was the horse and buggy standard. It also became a process because you had to put the check amounts on a deposit slip so that it could be cashed at the bank. You had to make sure the checks were not lost and over time the remittance attached to them created a lot of paperwork that piled up over the years. Eventually payment by electronic funds transfer or automatic clearing house meant that payments from insurers went directly to the providers or physician's company bank account. This became a wonderful idea because the medical office no longer had to sort and gather checks from all over the place to be deposited. In some instances this is done online as the front desk medical office workers scramble from one website to another to obtain EFT OR ACH payments from the various health insurance companies. There has to be a simpler way to obtain any and all EFT or ACH information by using (at least for the most part) one website. How can this be done? I'm so glad you asked that. For example: Electrolink is an electronic access clearinghouse that allows other clearinghouses and electronic funds transfer or healthcare reimbursement companies to link themselves under one website so that all payment information can be obtained from the various health insurers. Let's say you are already receiving payment from insurers like Big Blue, Who Cares, Netna and a few others. Under the Electrolink website you can select Big Blue, Who Cares and Netna and the website and or clearinghouse/healthcare reimbursement company you are using to obtain payment information from each health insurance company. When you sign-up for Electrolink you provide all of the usual provider information and the bank info for EFT and ACH processing. Electrolink will ask if you want to link Big Blue, Who Cares or Netna's clearinghouse or reimbursement company to their website. You will select yes and allow the link to take place and be able to access such permissions as necessary in order to be able to access payment information. As you add different insurance companies and their clearinghouses/healthcare reimbursement companies you will only have to long in once to Electrolink and then select the different insurance companies you need to access, when obtaining payment information. Electrolink can also send email notifications once new payments arrive. Please note: Electrolink is not designed to replace or take the place of any clearinghouse or reimbursement company, it is created so that there exists a website that can be used by most health insurance companies to access payment information, under one website. Electrolink can also be used as a payment clearinghouse if needed. Being expedient in a world of just awful salaries is what Electrolink can assist with. Electrolink combines all of the health insurers together and this is a nationwide clearinghouse and healthcare reimbursement payment solution!
What if you're just a small private medical practice that does not bring in enough to make ends meet? Where do physican's go to obtain money in order to remain in business? To be honest Medicaid, or the entire application that needs to be completed, is rather lengthy. I know when it comes to the government everything goes slow and takes a great deal of time and for some reason there always seems to be an abundance of paperwork. Of course once the application becomes complete and a physician is now allowed to see Medicaid patients then they will get paid. But what about subsidies for small offices that are needed to see patients that other physician's will not see due to the many different insurances? I think this should be an option. I know it sounds confusing but think of it this way. More patients are having to go to the hospital, clinic or urgent care due to insurance reasons. If a physician does not take Medicaid then they cannot see the patient or if they do then they will not get paid. How is a physician expected to pay his or her staff and other bills once this occurs? The government hold-up is Medicaid and the fact that the government should offer physician based subsidies for every patient that has Medicaid, regardless if a physician is enrolled or considered participating in the Medicaid program. For example Dr. Howlonguntilretirement is not participating with Medicaid, so when patients who have Medicaid as a secondary insurance get billed for the visit, Dr. Howlonguntilretirement either must write it off or haggle with the patient regarding how much the patient is able to pay in order to be seen on the next visit. The front office staff becomes exhausted regarding all of the other things they have to do including completion of the Medicaid application and telling patients that the need to pay something in order to be seen by the physician. The Medicaid process can be a lengthy one and, it should be more simplified so that a physician can complete it and so that the front office staff, does not have to go around remembering graduation dates for each physician. During that time the government should be offering reimbursement subsidies for physicians who see Medicaid patients as this prevents hospital or urgent care visits. Dr. Howlonguntilretirement obtains all of the lengthy forms he has to complete and really has to think about his education and other employment, it was that long ago. But with the government Medicaid reimbursement subsidies program; Dr. Howlonguntilretirement can see Medicaid patients and get reimbursed through the Medicaid reimbursement subsidies program. All Dr. Howlonguntilretirement has to do is to go online and complete a Medicaid reimbursement subsidies waiver and be given a temporary identification. The waiver indicates that the physician must be in the process of enrolling in the Medicaid program. Once this is completed online, that temporary identification can be used and the physician can now collect Medicaid health insurance reimbursements until their application is complete and accepted by Medicaid for regular physician participation. In doing so there are less write-off's due to Medicaid insurance and perhaps physicians can remain in practice longer; although that depends on the front office staff who seem to be anxious about retirement-so much work!
Thermal imaging has been around for quite a while. Yes, it's cold out there. Thermal imaging enables someone to determine the health of the body, or whatever you are using it for by the use of thermal infrared scanners that can determine wellness by heat and temperature. When looking at a scan through a thermal camera, it is similar to a bone density. Which is the point here. Thermal imaging is not designed to put medicine out of the office but it should be used to enhance such services. For example, there now exists teledocs that you can contact when you're feeling ill and need to know what to do. Many patients call their physician and depending on the severity of symptom they are either seen, or sent to the ER or urgent care. I am one who likes to try and expedite things although many people disagree with it. But hey, I'm only one person and so be it! Thermal imaging can be of great resource to a physicians office since imaging can be sent to a physician, once technology makes it so. Now when I say expedite, I mean if you're sick and gots no energy whatsoever to get to a physicians office and wait several hours to be seen or to visit an ER to become sicker by people who are worse off than yourself, then this is where technology can help you along the way. In the future, most cellphones will enable thermal infrared imaging. Once this occurs, if you're feeling very ill and you need to see somebody a physician can chat with his or her patient via face/screen app and it will be then that once you select the thermal infrared picture on your phone and begin to scan the parts of your body that are in pain or are affected, the physician can determine what particular problem you are having by the way the thermal infrared images show heat that is reflected from the body during the inflammatory process within tissues in the body. Thermal infrared imaging can also be used in very early detection of heart disease, in patients who may be considered too young to have an echocardiogram. Thermal infrared imaging is also good for determining other types of diseases or illnesses on the cellular level very early on before other types of exams or procedures can determine them. People like to be catered to and thus the reluctance of wanting to use technology, because you have to actually go on and do it yourself. Yes, it may be cold out there but if you could avoid H---, by using thermal infrared imaging long before, would you?
Ever have a patient that needed at least two people? It happens, they have lots of medications, and many tests that need to be done. The problem becomes that the front office staff is not in the exam room with the patient and the physician because they are doing precerts, referrals, answering phones, processing labs, routing medications, ekg's ect.. Requests, requests, requests. Could the work of a physician be expedited if there were an office staff person who could teleconference with the physician so that they could enter test prescriptions, and the next appointment via computer during the patients visit? It's worth a try, because how many times do patients come out from their visit with the physician and then then are still more things to do regarding the patient. Paper, scanning, appointments referrals, precerts, prescriptions all once a patient leaves the exam room. That in itself is an appointment. And of course, it's time to put the next patient into the room. If the front desk could wear a headpiece, no not a nurses cap, but one of those things where they could speak with a physician from room to room, as in medical room/office teleconference equipment; this would enable a physician to prepare with the front office staff what will be needed once the patient leaves the exam room or is finished with his or her visit. The office teleconference equipment would have each physician and office staff person wearing a head piece or headphone with microphone. The physician would speak into the microphone and then what they requested can be heard to the front office staff without anybody else including other patients, knowing what is being done or requested of another patient. If a front office staff person were told during the patient visit what is being requested then prescriptions, pre-certifications, vaccines can all be entered into the computer as the physician continues to examine the patient and then once the visit is complete the patient can have their computerized generated prescriptions and all the physician has to do is a peer to peer if pre-certification requires it. It's difficult to navigate all of the patient needs when you are outside the exam room and of course HIPAA. Now, the physician does not have to contact the front office medical staff for each and every thing, but for things that can be done during a patient visit can certainly create quality patient visits and alleviate the medical staff with having to do the incoming of patient information coinciding with outgoing patient information and tasks.
You may find this difficult to believe. But how can someone be working but yet unemployed? I said the same thing, but now I realize such a category exists. As an adult your responsibility is to take care of yourself and those who you are responsible for as minors, disabled ect. But, life is strange because when you're a kid or a child, parents and elders around you grunt about giving you responsibility and learning what it is to be an adult, so there you have it; as a child you were often treated as an adult. Then of course once you actually become one, then the elders around you want to take all that away and want to return you to your child like life. These ass----- make decisions for you and make your adult life f----- misery. The concept here is school or skill then work and then provide and take care of yourself. The bias of all of this is obvious, if you school or skill and then those in command say no job and thus no money then, you are treating people like children because, you're making them go to the government for assistance. Is that adult like, because you don't want to employ people as you make excuses to keep them as children? Yes, it is abusive because let's see in seven years I will be 60 and have lived in the biased realm of survival for as long as I can remember and oppression by way of treating people like children is the only way those who are of biased constituent feel they can still maintain a superior complex over something. Anyway, this is how people become what is known as "the working unemployed". Someone may have a job, but they are unable to earn money if their place of employment does not have any money to pay them with. Now, if they go to unemployment in attempts to collect, unemployment may deny their claim and state the fact that they have a job. You then ask, how do I afford they pay certain bills of my own if I do not receive a paycheck from this job? What would the Department of Labor-unemployment's response be? What should it be? The argument becomes: are you actively looking for a job? Answer: Yes and I also actively work at one who is unable to pay. Should The Department of Labor allow people in these situations to collect unemployment insurance until they find employment that provides a salary or until the job that they are working at can pay them? An employer may be reluctant to cease business just yet, although it happens and sometimes without notice. So who pays the bills of the adult and why are you taking away adult responsibility from a person by not wanting to employ them, especially when they are capable? And you say you're not biased. Those in control say, "Pull yourself up by your own bootstraps." It's enough to say that I'm wearing them!
Varices or esophageal/gastric varices are actually dilated veins that are located in the esophagus. Esophageal varices rupture as a result of what is knows as portal hypertension. The liver needs an adequate blood supply to function and it receives that through the portal vein. The liver also gets it's nutrients from the portal vein also. When blood flow is restricted from normal flow in the portal vein, the portal vein then becomes elevated in pressure and as a result causes liver problems. Many physicians, do the routine blood pressure test during a patients visit, but I have yet to find that any patient is sent for an ultrasound of the liver or hepatic system or being sent to see a GI or hepatologist or liver specialist to determine if the portal vein is elevated in pressure. As a result esophageal/gastric varices can rupture and bleed due to portal hypertension. This can cause conditions such as: ascites- this causes abnormal fluid in the peritoneum(sac where the intestines are), liver disease and enlargement of the spleen. Once esophageal/gastric varices occur, it is imperative to stop the bleeding. When you have a patient with other health problems or who is fragile to due being an older age, performing out and out "I'm going in!" surgery is probably out of the question. Especially with the older ones you're using and putting all that high-tech stuff on them, so it can take some getting used to. However, it may be possible to perform an endoscopic sclerotherapy procedure on them. Sclerotherapy is a procedure that a physician uses a blood clotting solution directly onto in esophageal/gastric varices in order to stop the bleeding. This may prove to be beneficial when the portal vein will not tolerate banding or any type of shunt. The older the person the more "out of it" they are with medical procedures and the use of them. This is not to say that all people of a certain age are that way but many people are not used to the complexities and procedures that can be done and may not be willing to put their body through a new age strain. Endoscopic sclerotherapy may be a less complicated way of stopping damage done by ruptured varices.
I tell you, I am somewhat annoyed. People seem to just expect someone to know many different languages or their translation. The problem becomes when you work in a medical office that is not part of a hospital or a large group that may hire translators or have people who are bilingual available. In a small office, there may not exist an employee who has traveled the world and comes from a background whereby another language other than English was spoken. You are who you are and, well if you don't go around on a daily basis talking to the maid then you don't really have a need to use a language outside of what you normally speak. Patients call looking for physicians, who speak "their language". The front desk informs patients of the languages that the physicians do speak, but if it does not include a language a patient is looking for then what else can be done? It becomes costly to set up phone lines dedicated to speech language translation. After all these phone lines are live and you have to actually wait for an interpreter to get on the phone with you in order to translate a particular language. This becomes a problem. When there becomes fewer and fewer customer service people available to assist with a problem of translation, it would be just like talking to someone at a health insurance company. A person who needs to be understood by speaking their language must wait during their appointment to have a translator speak with them. If wait times are long then this delays other patients and their scheduled appointments. We need something more computer generated. You know like that vocoder thing, for music audio. Really simple, it just takes your voice and translates in into any sound. In the medical world we would need on for languages. There can even be a video/audio theremins vocoder that can produce the word or letter when using sign language. I think I'm trying to simplify things here, I really do. The vocoder language interpreter works this way. Just as the physician sits at a computer, right next to him or her will be the vocoder language interpreter. There are two microphones, they can be gooseneck if you want. The vocoder is turned on and the language selection is selected, for example: Physician- from:English to:Spanish and for the Patient-from:Spanish to:English. There is a speaker for each microphone or you can use headphones if you prefer. The physician talks into the microphone and the vocoder translates from English to Spanish, and as it does the vocoder will speak in a voice of Spanish translation to the patient. Once the patient hears to questions being asked the patient will respond by speaking into the microphone in Spanish and the vocoder will speak in a voice of English to the physician. See-no wait times or additional phone setup's. Now, when it comes to sign language, the video/audio theremins vocoder has it all. The patient begins to speak with his or her hands over the theremins and as the hand signal or expression is acknowledged via the theremins, it is then interpreted into words from the vocoder and then the vocoder will interpret the sign language of the patient. Now all the physician has to do is to speak into the vocoder and the video/audio theremins will display a sign language picture of what the physician is asking or trying to tell the patient. And of course there are no wait times for someone to locate an interpreter or to actually have to hire people who know several different languages and then some. The only wait is technology, so that every office can have a vocoder language and/or video/audio theremins vocoder language interpreter that is affordable!
Usually by this time of year you at least know how much in taxes to withhold from your paycheck. It's 2018 and it seems to be taking an eternity to get any information, from the federal government regarding this information. Also, the 1040 forms and instructions, for those that sort of like to know how much they will get refunded or owe, for 2017 are also not available. The new tax laws have implemented some changes and in doing so it is taking longer than usual to provide all of this to everyone else. I just wished that those who make more than $300,000 a year had some understanding of what it is like to live on less than $30,000. America used to be known as the land of opportunity and somehow that was all stripped away in favor of America not bestowing or owing anything to anyone except for that favored one percent. Now that we all have combined wages of poverty what does America expect of it's economy? Or, so what now? Let's think about ways to reduce the cost of living since wages make the necessities of living unaffordable. Brands, brands, brands, many of them have high end prices. Suppose, just like medications, things including: housing, clothes, toiletries, food, transportation of sorts could be made rather generically. This would make things more affordable and allow everyone to be able to buy and or shop like they did in the "old country". Dollar stores or stores that have heavily discounted items should have more of a shopping presence. If I were some elected official and I were in charge of a town that had land available and could be best put to use, it would be to create a conglomerate of stores, that sold generic brands of almost anything to the public. Why? Because salaries determine what a person can afford, honestly or even legally. In keeping with the law we must live within our means and therefore we should have a society that enables all citizens to afford such necessities in life. Health insurance among other things is still very expensive. My only other questions are, now that many people spend approximately half a paycheck on health insurance, how does the federal government think that people will be able to support themselves after it is paid for in premiums and what is civil about working 16 hours a day, only eating once a day and not sleeping more than three hours a day? America- are we paying too much?
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