For more information about custom 3D animations, visit www.amerra.com.This animation shows how cholesterol is a lipidic, waxy alcohol found in the cell membranes and transported in the blood plasma of all animals. It is an essential component of mammalian cell membranes where it is required to establish proper membrane permeability and fluidity.

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Medical Tourism

Whenever we hear the term “Medical Tourism”, it invokes a mixed expression in our minds, one as a promising new alternative for the people who had to rely on already outstretched Public healthcare system in western countries, and the second is the uncertainty about the quality offered. The portmanteau “Medical Tourism” was made way back in the late 80’s by Travel agents and media as a catchall phrase to describe a new trend where people travel to other countries to obtain cheaper medical care. As we speak, this phenomenon has reached to a point where it has become one of the most promising foreign exchange revenue earners in some Asian nations predominantly India, Singapore and Thailand.

The reasons patients travel for treatment vary. Many medical tourists from the United States are seeking treatment at a quarter or sometimes even a 10th of the cost at home. From Canada, it is often people who are frustrated by long waiting times. From Fantastic Britain, the patient can’t wait for treatment by the National Health Service but also can’t afford to see a physician in private practice. For others, becoming a medical tourist is a chance to combine a tropical vacation with elective or plastic surgery.

And more patients are coming from poorer countries like Bangladesh, Cambodia, Vietnam, and many African nations, where treatment may not be available.

Medical tourism is really thousands of years ancient. In ancient Greece, pilgrims and patients came from all over the Mediterranean to the sanctuary of the healing god, Asklepios, at Epidaurus. In Roman Britain, patients took the waters at a shrine at Bath, a practice that continued for 2,000 years. From the 18th century wealthy Europeans travelled to spas from Germany to the Nile. In the 21st century, relatively low-cost jet travel has taken the industry beyond the wealthy and desperate.

Countries that actively promote medical tourism include Cuba, Costa Rica, Hungary, India, Israel, Jordan, Lithuania, Malaysia, Singapore and Thailand. Belgium, Poland and Spain are now entering the field. South Africa specializes in medical safaris-visit the country for a safari, with a stopover for plastic surgery, a nose job and a chance to see lions and elephants.

India

India is considered the leading country promoting medical tourism-and now it is moving into a new area of “medical outsourcing,” where subcontractors provide services to the overburdened medical care systems in western countries.

India’s National Health Policy declares that treatment of foreign patients is legally an “export” and deemed “eligible for all fiscal incentives extended to export earnings.” Government and private sector studies in India estimate that medical tourism could bring between $1 billion and $2 billion US into the country by 2012. The reports estimate that medical tourism to India is growing by 30 per cent a year.

India’s top-rated education system is not only churning out computer programmers and engineers, but an estimated 20,000 to 30,000 doctors and nurses each year.

The largest of the estimated half-dozen medical corporations in India serving medical tourists is Apollo Hospital Groupwith 37 hospitals, with a total capacity of 7,000 beds, which performed an estimated 60,000 surgeries on visiting patients between 2001 and 2004, and now under negotiations with Britain’s National Health Service to work as a subcontractor, to do operations and medical tests for patients at a fraction of the cost in Britain for either government or private care.

Medical Tourism in India started to grow in the mid 1990s, with the deregulation of the Indian economy, which drastically cut the bureaucratic barriers to expansion and made it simpler to import the most modern medical equipment. The first patients were Indian expatriates who returned home for treatment; major investment houses followed with money and then patients from Europe, the Middle East and Canada started to arrive.

Thailand

While, so far, India has attracted patients from Europe, the Middle East and Canada, Thailand has been the goal for Americans.

India initially attracted people who had left that country for the West; Thailand treated western expatriates across Southeast Asia. Many of them worked for western companies and had the advantage of flexible, worldwide medical insurance plans geared specifically at the expatriate and overseas corporate markets.

With the growth of medical-related travel and aggressive marketing, Bangkok became a centre for medical tourism. Hospitals like Bangkok’s International Medical Center and Piyavate Hospital offer services in over two dozen languages, recognizes cultural and religious dietary restrictions and has a special wing for Japanese and Arabic patients.

Even though most of the medical tour companies targeting cosmetic surgery patients often place emphasis on the vacation aspects, offering post-recovery resort stays and holiday packages, private healthcare consulting companies, like, MedAsia Healthcare who specialize in critical care services like open heart surgeries had gone one step further by providing personalized care to the patients by offering surgeon screening, treatment plotting, insurance support and even the surgery loan processing on behalf of the patients. With medical professionals who know the psyche of the patients, they can provide that extra comfort on quality and trust.

Emerging Destinations

Other countries interested in medical tourism tended to start offering care to specific markets but have expanded their services as the demand grows around the world. Cuba, for example, first aimed its services at well-off patients from Central and South America and now attracts patients from Canada, Germany and Italy. Malaysia attracts patients from surrounding Southeast Asian countries; Jordan serves patients from the Middle East. Israel caters to both Jewish patients and people from some nearby countries, and South Africa offers package medical holiday deals with stays at either luxury hotels or safaris.

Dental Tourism

The newest and fastest-growing area of medical tourism is a visit to the dentist, where costs are often not covered by basic insurance and by only some extended insurance policies. India, Thailand and Hungary attract patients who want to combine a teeth whitening, extraction or root canal with a vacation. Most notable destination for Dental tourism is Thailand, where the competitions between the clinics for expatriate customers are clearly visible. In a way that competition is really serving excellent for the customers, as the clinics deploy the latest cutting edge technologies, use overseas trained and qualified doctors, and multi lingual marketing team to keep their edge on the market; says Dr. Bob of Bangkok Smile Dental Clinic, a pioneer in the dental tourism industry with multiple clinics in Bangkok. Clinics like Bangkok smile offers the latest same dental implants where by the patient can glide in and get the implant fixed on the same day and glide back on the next day instead of the 2 – 3 visits before, at their clinics for nearly 15 – 30 % of the cost one would have to pay if they get it done in US, Canada, Australia or UK. As we speak, Australia is one of the largest markets for these clinics, and tour companies like Aussie Dental Tours based in Perth, Australia are quick to realize that and offers escorted dentist visits to Thailand.

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The relationship between the Administrator, Director of Nursing and Medical Director is similar to a tightly wound rope. Each represents a different function and is independent of one other; but, each must work together to ensure the operations and standards of the nursing facility are being upheld and maintained.

Together, these roles make examinations and decisions that ultimately affect the well-being of residents and the overall operation of the nursing facility (Singh, 2003, pg. 274-275). Each is an expert in their own realm and must work together to alleviate conflicts, increase resident satisfaction and reduce staff turnover.

According to Drucker (1974), the main components of the responsibility of an administrator include managing the nursing facility, managing the staff and managing the nursing facility in regards to the community. Additionally, Drucker states that this balance is required because “a choice or action that satisfies a need in one of these functions by weakening performance in another weakens the whole enterprise” (pg. 398).

The administrator maintains balance between mission and margin “through forecasting, plotting, organizing, staffing, directing, evaluating, controlling quality, innovating, and marketing decisions” (Allen, pg. 43). The administrator is usually non-clinical; but, is required to know the basic aspects of health care including clinical terminology, practices and professional requirements (Davis, et al, p.27). It is the role of the administrator to familiarize himself with these concepts to better: (1) Know the delivery of care that is being given to residents, (2) Help health care professionals solve problems associated with resident care, and (3) Evaluate the quality of care that is being delivered to residents.

According to Singh (2003, pg. 271), the medical director is considered to be the “chief medical officer” of the facility. He is responsible to ensure professional services are upheld and maintained; this can be accomplished through effective leadership, teamwork and routine observations of the staff and facility.

The medical director is responsible for implementing resident care policies and coordinating medical care in the nursing facility. The medical director is normally paid on a contractual basis and, according to Singh (2005, pg. 268), is expected to spend approximately 2-4 hours in the facility per week (estimation for 120-bed facility). The medical director assists the director of nursing with delivering excellent quality of care to its residents of the nursing facility (Allen, p. 126) and sets standards for clinical staff in appropriateness of caring for the elderly.

Additionally, the medical director should also participate in staff meetings, committees, educational opportunities, in-services, presentations and making rounds on a regular basis (Kane, et al., pg. 439). The medical director is clinical and has a reporting relationship to the administrator; but, acts as a clinical advisor and educator to staff and is a representative of the facility (Singh, 2005, pg. 268-272).

The director of nursing heads the nursing department, which is the largest department of a nursing facility. It is a position with fantastic responsibility, and according to Singh (2003, pg. 273), the director of nursing is next in charge after the administrator; although they are not stereotypically skilled in management.

The director of nursing is expected to make daily resident rounds to ensure excellent quality of care (Allen, pg. 137). This increases morale, educational opportunities and promotes resident satisfaction. Overall, the director of nursing possesses clinical, administrative and supervisory responsibilities to the nursing facility. Additionally, the director of nursing is involved with staffing, training and patient care (Singh, 2003, pg. 274).

Areas where the administrator, medical director and director of nursing roles overlap include involvement in staff meetings, committees, in-services and representing the nursing facility to the general public. Additionally, each possesses responsibilities in the following areas: (1) Leadership, (2) Advocacy, (3) Education, (4) Policy, (5) Clinical and (6) Administration. Although levels of proficiency will vary based on the aforementioned role, each is responsible, in their own scope of work, to take ownership of such areas.

As an example, an administrator, medical director and director of nursing are all responsible to provide leadership to the staff of the nursing facility. The administrator may find himself doing this by continuously walking around throughout the facility recognizing staff for their hard work and dedication to their residents. This supportive style of leadership (Singh, 2003, pg. 430) enhances staff’s ability to perform well. Likewise, the medical director may provide leadership by being readily available and involving staff when conducting rounds and incorporating their knowledge of residents’ into individual care options. This coaching style of leadership (pg. 430) encourages staff’s involvement with resident care. Finally, the director of nursing may provide leadership by meeting regularly with staff to inform them of expectations and model effective methods of excellent quality of resident care. This directing style of leadership (pg. 430) enhances staff’s ability to feel well-educated and secure in their direct care roles.

Potential conflicts associated with successful direction from the medical director include staff retention and turnover, hard expectations from residents, families and staff, and administrative issues (Bern-Klug et al., 2003). Likewise, conflicts can occur from the administrator and director of nursing when there is a lack of effective communication. Each role is vital to the operation of the nursing facility. Similar to the tightly wound rope, each must work together to ensure all aspects of operation are running smoothly.

Strategies to improve the effectiveness between the administrator, director of nursing and medical director include increased awareness and communication between departments, effective preadmission screening procedures and the continued use of quality improvement initiatives (Kane, et al., pg. 439). This can be accomplished by meeting on a regular basis (such as a weekly Triad Meeting) to discuss areas of concern, improvement and development, working together as one team that emulates the organizations’ mission and finally, understanding each others’ roles as it pertains to the overall success of the nursing facility.

References

Abrass, I., Kane, R., and Ouslander, J., (2004). Essentials of clinical geriatrics (5th ed.). Hightstown, NJ: McGraw-Hill Company.

Allen, J. (2003). Nursing home administration (4th ed.). New York, NY: Spring Publishing Company, Inc.

Bern-Klug, M., et al. (2003). I get to spend time with my patients’: Nursing home physicians discuss their role. Journal of the American Medical Directors Association 4, no. 3: 145-151.

Davis, W., Haacker, R., and Townsend, J. (2002). The principles of health care administration. Bossier City, LA: Professional Printing and Publishing, Inc.

Drucker, P. (1974). Management: Tasks, responsibilities, practices. New York, NY: Harper and Row Publishers.

Singh, D. (2005). Effective management of long-term care facilities. Sudbury, MA: Jones and Bartlett Publishers.

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BioDigital Systems made a 3D animation of a colonoscopy procedure.

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Medical billing is the organized process of submitting and following up on claims to insurance companies in order to receive payment for services that have been rendered by a health care provider. Complete information is easily available online on how to start a home medical billing business and develop a career through an online billing course program. Following your training you can either work on-site for a company or in the privacy of your own home.

Someone who has trained in medical billing is called a medical billing specialist. There are more than one million medical specialists in the US, according to the latest statistics. Doctor’s offices, insurance companies and hospitals need especially trained personnel to handle billing responsibilities.

You can easily perform a search on the Internet and find training courses. J jobs are available all across the country, with earnings ranging from $10 to $20 per hour depending upon your experience, location, and the time you have available for online billing work. In order to be clear on the payment of a claim, the doctor must have complete knowledge of different insurance plans that insurance companies are offering, and the laws and regulations that preside over them.

If you’re hesitant to commit to an online medical billing course then consider taking one of the introductory free courses to see if you like it. Training includes learning medical terminology, billing and accounts receivable management and claims and claims processing.

Investigate all the financial help programs that are available to you. Apply for grants. Check out federal help programs. There is federal money available for online degree programs. Check to see if your course or program qualifies. There are education loans available. If you need money to pursue your medical billing career keep looking for the solution until you will find it.

Visit a local medical billing company and take a tour. Talk with the specialists and find out what they’re doing. What you visualize you’d be doing may not be realistic. Question what the drawbacks are. Question yourself is this what I want to be doing with my life’s energy?

Learning at home online may be the best way to learn how to start a medical billing career from your home. Join at least one professional organization so you can keep abreast of changes, network with others in the field and learn about job opportunities. A reputable college or training course may provide you with placement help after you’ve completed medical billing training if you plot to work away form home.

If you’re thinking about becoming a ‘medical biller’ choose whether or not you want to attend a local college or take an online training course or a home study course for that medical billing job. You will be using a variety of medical records software and medical billing software packages to learn the standard practices. The best career training online or at a local college should include certification once you have completed the course.

Make sure to compare the costs and benefits of the various types of training available. The best course should give you a step-by-step system on how to perform the job of a Medical Biller and Coder so you’ll be prepared for employment or to go into business for yourself. So deciding where and how you’ll take your job training is one of the first steps.

Because the medical industry continues to grow by leaps and bounds, the demand for medical billing specialists is also growing. And as we may have mentioned, you don’t need an accredited college degree or an accredited university degree to succeed.

There are quite a few Internet training programs that offer introductory, intermediate, and advanced classes. Look for quality low cost or cheap medical billing training programs. Make sure to get informed online about medical billing training, software, services, jobs and work-from home courses.

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Medical billing outsourcing, also known as third-party medical billing, is regulated by the Office of the Inspector General (OIG). The OIG was made by Congress through the Inspector General Act of 1978 in response to a series of government scandals that occurred within nearly every major Federal Agency throughout the 1960s. Lawmakers believed that by making an independent Office of Inspector General for each Federal Agency; the government would be better able to detect fraud and prevent the waste and abuse of Federal taxpayer monies. The hope was that these Federal watchdogs would reestablish the public’s confidence in government agencies.

The Office of the Inspector General, in conjunction with the U.S. Department of Health and Human Services, developed and released the Compliance Program Guidance for Third Party Medical Billing Companies on November 30, 1998. The intent of this program is to promote a higher level of ethical and lawful conduct throughout the entire health care industry; and to protect the solvency and stability of the Medicare Trust Fund (also known as Medicare).

Before we go on any further don’t get the impression that the U.S. Department of Health and Human Services (HHS) carries some sort of grudge against or questions the validity of medical billing outsourcing services. Prior to the Compliance Program Guidance for Third Party Medical Billing Companies was established, the HHS had already issued compliance programs for the clinical laboratory and hospital industries as well as home health care agencies.

The legislation comes in response to the proliferation of medical billing out sourcing companies throughout the health care industry; the undo influence these medical billing services could have on a physician’s billing and coding practices; and the potential negative effects of unscrupulous billing and coding practices by these medical billing services on Medicare.

Like most OIG-issued compliance programs, conformity to the Compliance Program Guidance for Third Party Medical Billing Companies is strictly voluntary. On other hand, issues that arise due to a failure on the part of the medical billing service to abide by these “voluntary” compliance programs could expose the billing service to legal actions brought on by the U.S Government. Protect yourself and your business by interpreting “voluntary” as “mandatory” or be prepared to suffer the consequences.

The OIG has identified seven fundamental elements to an effective compliance program. They are:

1. Implementing written policies, procedures and standards of conduct;

2. Designating a compliance officer and compliance committee;

3. Conducting effective training and education;

4. Developing effective lines of communication;

5. Enforcing standards through well publicized disciplinary guidelines;

6. Conducting internal monitoring and auditing; and

7. Responding promptly to detected offenses and developing corrective action.

In future articles I will continue to clarify the Compliance Program Guidance for Third Party Medical Billing Companies in plain English so you can take the steps necessary to protect your medical billing service from unwanted government intervention.

If you are a health care professional outsourcing to a medical billing service you too should be interested in this program. Question your medical billing service to provide you with documentation showing the steps they take to insure compliance to this very vital program. Be a smart business owner and protect your practice from unwanted government action.

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