Patient Direct Payment

In evaluating the medical practice management strategies, need to take into consideration the difficulties may be facing in collecting money from the private-pay patients. With out of pocket costs increasing and higher unemployment, people still need care – and to succeed, need to be able to manage their need for care versus the need to make a living. Educate the patients about what they will be responsible for up front. Don’t let the patients be surprised by a bill in the mail have the staff let them know before they see what their insurance will and won’t pay and what they are going to owe. Then give them an opportunity to pay or set up a payment plan immediately. Set up payment plans so the patients can manage their health care costs as a regular part of their budgets. Working with patients can increase the amount thee paid as patients realize there doing the best for them. If have someone who chronically misses payments or doesn’t pay, consider requiring that patient to pay the practice up front before receiving treatment. Once set up a payment plan between the patient and the practice, give the patient a coupon book rather than sending statements. This will decrease the operating costs and provide the patient with a physical reminder of their debt. Collect fees up front as much as possibly can, including known co-pays and fees for elective visits. Create a Web site that has a shopping cart feature that patients can use to pay the practice online. Consider instituting an online debiting system using patient’s credit cards or bank accounts. Set up a subscription plan with patients that allow them to pre-pay for services. Guarantee a discounted price on select services for patients who join the plan. Accept cash only from patients who have bounced a check with the practice or included their debt to the practice in a bankruptcy. Most physicians don’t like having to think about the possibility that they won’t be able to treat any patients just because they lack the means to pay. But need to have good medical practice management strategies around payment to keep the practice in business. With potentially shrinking reimbursements from the government and private insurers, the practice may become increasingly dependent on private pay dollars. Work with the patients and educate them up front, collecting that money won’t be such a difficult accomplishment. Some physicians have had such an easy time managing private-pay patients that they’ve gone to a cash-only model and shut out private and public insurers alike. This management practice certainly cuts overhead costs while giving the doctor more autonomy in treating patients. Choose to manage the private pay patients, need to institute good medical practice management strategies now to avoid losses and frustrations later.

Hormonal Acne Treatments

In females, hormonal treatments can improve acne. The common combined oestrogen and progestogen methods of hormonal contraception have some effect, but the antiandrogen, Cyproterone, in combination with an oestrogen (Diane-35) is particularly effective at reducing androgenic hormone levels. Diane-35 is not available in the USA, but a newer oral contraceptive containing the progestin drospirenone is now available with fewer side effects than Diane-35 or Dianette. Diane-35 is effective where blood tests show abnormally high levels of androgens. Along with this, treatment with low dose spironolactone can have anti-androgenetic properties, especially in patients with polycystic ovarian syndrome.

Cortisone

If a pimple is large and does not react to certain acne treatments, a dermatologist may administer an injection of cortisone directly into the lesion, which will usually reduce redness and inflammation almost immediately. This has the effect of flattening the pimple, thereby making it easier to cover up with makeup, and can aid in the healing process. Side effects of cortisone are minimal, but may include a temporary whitening of the skin around the injection point; and occasionally a small indent, or depression, in the skin forms, which usually fills out over time. Cortisone treatment methods also carry much smaller risks of scarring than surgical removal.

Concierge Medicine

Concierge medicine goes by many names, boutique medicine, retainer medicine, executive health, VIP medicine, and personalized medicine. By any name, concierge medicine is the solution for doctors trying to maintain their integrity and independence in today’s difficult healthcare environment.Concierge medicine is a new style of practice with old roots, in which doctors limit their patient base in order to provide patients with personalized service, high quality care, 24-7 availability, and other amenities. In exchange for this enhanced personal attention, patients pay physicians an annual fee. This concierge fee enables physicians to increase their compensation while managing their workload. In addition to receiving an annual fee, most concierge physicians continue to receive reimbursements from health plans and private pay clients. Concierge medicine is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer. This may or may not be in addition to other charges. In exchange for the retainer, doctors provide enhanced care. Other terms in use include boutique medicine, retainer-based medicine, and innovative medical practice design.The practice is also referred to as membership medicine, concierge health care, cash only practice, direct care, direct primary care, and direct practice medicine. While all concierge medicine practices share similarities, they vary widely in their structure, payment requirements, and form of operation. In particular, they differ in the level of service provided and the amount of the fee charged. There are an estimated 5,000 concierge, or membership medicine doctors throughout the U.S. Concierge physicians care for fewer patients than in a conventional practice. All generally claim to be accessible via cell phone or email at any time of day or night or offer some other special service beyond the normal care provided. The annual fees vary widely, from $600 to $5,000 per year for an individual, with the lower annual fees being in addition to the usual fees for each service and the higher annual fees including most services. Some concierge practices do not accept insurance of any kind. These are as cash-only or direct primary care practices. By refusing to deal with insurance companies, these practices can keep overhead and administrative costs low, thereby providing affordable healthcare to patients. They become concierge only if the practice assesses an annual or monthly fee instead of or in addition to a fee for each medical service. Other concierge practices do take insurance, even Medicare, but ask for an annual fee for additional services exclusive of insurance plans. This annual fee is not a substitute for medical insurance, and generally does not cover consultations outside the practice, laboratory procedures, medicines, hospitalizations, or emergency care from other providers.