Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Ah, I should have been more clear. Edward was referring to selecting a plan, so I addressed my remarks to simply selecting a plan.
Claims are a whole other matter; and you are correct, Nat, when you infer that claims under American policies can be a lot more complicated.
Just touching on selecting a plan a little more. I personally think that we do not have enough options in the U.S., not too many. One system I admire quite a bit is the Swiss HC system and one of the many reasons is the amount of options they have to choose from. Depending on where in Switzerland you reside, you could have up to 80 different private insurance options to choose from. The amount of options does not intimidate me in the least.
I have both worked on HC related projects in Switzerland and along with Swiss based teams in other countries and enjoy picking their brains about their system. I once sat down with a colleague who ran me through a mock sign up process and the options that you are presented with are very impressive and tailored to the individual in a way that we have not been able to achieve in the U.S.
As far as claims are concerned that is not exactly the most confusing process either. Typically you hand them your insurance card and you don't hear from them again. The entire claim process is handled by the medical staff. Keep in mind that this is how these people are compensated for their time. It is in their best interests to handle the reimbursement process themselves. Uncompensated care is not how they make money, those expenses are typically written off at a ridiculously high rate. Keep in mind that each patient carries one type of insurance, so from the perspective of the patient they technically are enrolled in a "single payer" style program.
Under the ACA walk in/urgent care clinics were reclassified as of 2014. They are no longer subject to network restrictions. This was pretty big news and clearly stated in the bill, but of course once again your have no idea WTF you are talking about.
Walk in Clinics in Canada are staffed by doctors. You can get a full medical check up done there, lab test etc. They are fully integrated into our healthcare system.
From what I've read, Walk in Clinics in the US are staffed by Nurse practitioners and offer a much more limited service than in Canada.
Doctors in the US are, according to this article, against them because they supply "disjointed care "
"As the Affordable Care Act reshuffles the health-care deck, some of the winners are walk-in clinics in drugstores and supermarkets, which offer treatments for simple illnesses and provide some preventative-care services such as flu shots.
These clinics are booming because they offer streamlined medicine in a less-regulated environment. Walk-in clinics do not have the cost burden of malpractice insurance borne by physicians’ offices. Nor do they have the conflict-of-interest rules that prevent some doctors from offering X-rays.
Walk-in clinics are staffed by nurse practitioners and physician assistants who are able to write prescriptions, but are paid far less than doctors. The “menu” of services is limited, and the pricing is straightforward. People often pay out of their own pockets, and so they shop around."
The article also states that walk in clinics are not country wide, as they exist in 42 states.
So it appears they are not really the same thing. So drop the attitude.
Walk in Clinics in Canada are staffed by doctors. You can get a full medical check up done there, lab test etc. They are fully integrated into our healthcare system.
From what I've read, Walk in Clinics in the US are staffed by Nurse practitioners and offer a much more limited service than in Canada.
Doctors in the US are, according to this article, against them because they supply "disjointed care "
"As the Affordable Care Act reshuffles the health-care deck, some of the winners are walk-in clinics in drugstores and supermarkets, which offer treatments for simple illnesses and provide some preventative-care services such as flu shots.
These clinics are booming because they offer streamlined medicine in a less-regulated environment. Walk-in clinics do not have the cost burden of malpractice insurance borne by physicians’ offices. Nor do they have the conflict-of-interest rules that prevent some doctors from offering X-rays.
Walk-in clinics are staffed by nurse practitioners and physician assistants who are able to write prescriptions, but are paid far less than doctors. The “menu” of services is limited, and the pricing is straightforward. People often pay out of their own pockets, and so they shop around."
The article also states that walk in clinics are not country wide, as they exist in 42 states.
So it appears they are not really the same thing. So drop the attitude.
You are referring to walk in minute clinics, which of course are not meant to handle full work ups from start to finish. That is why I clearly stated "walk in/urgent care clinics". Urgent care clinics are staffed by physicians and offer the same services that are available at walk in clinics in Canada.
So once again you are unable to search correctly because you are not familiar with the terminology. For the record I have personally used walk in clinics in the GTA and also urgent care throughout the U.S. And the services offered are the exact same. The only recent change was the network restrictions were lifted under the new law, which makes it more accessible.
Maybe I am getting a tad snippy, but it is somewhat frustrating when you are dealing with a person that has no desire to educate themselves on the topic they are discussing.
You are referring to walk in minute clinics, which of course are not meant to handle full work ups from start to finish. That is why I clearly stated "walk in/urgent care clinics". Urgent care clinics are staffed by physicians and offer the same services that are available at walk in clinics in Canada.
So once again you are unable to search correctly because you are not familiar with the terminology. For the record I have personally used walk in clinics in the GTA and also urgent care throughout the U.S. And the services offered are the exact same. The only recent change was the network restrictions were lifted under the new law, which makes it more accessible.
Maybe I am getting a tad snippy, but it is somewhat frustrating when you are dealing with a person that has no desire to educate themselves on the topic they are discussing.
Then why if there are no more network restrictions, why do places like this still state that they don't accept all insurance policies?
By no network restrictions, do you mean that these places have to accept your insurance policy since 2014,even though their sites day differently?
Also how many of these places bill you first, and then you get reimbursed later?
If so, my point about Canadians having it easier still stands. We just walk in, present our card..and that's it.
Urgent care clinics still need to specify because not all states have an up and running health exchange and were granted a waiver to operate under the federal exchange for another FY. If you compare all the approved plans under the CT exchange to the list posted you will see they match up plan for plan. In other words if you are still carrying a plan that does not meet ACA minimum coverage standards then you are not protected by the law. Of course these grandfathered insurance policies will cease to exist in the coming years, but until then you need to specify in states that still allow their residents to carry this coverage.
As far as Swedish medical center is concerned, the site you linked states this:
This insurance acceptance information applies to all Swedish campuses, Swedish Medical Group clinics, Minor and James Medical, PET/CT Imaging, and First Hill Diagnostic Imaging, unless otherwise specified.
I don't see the Redmond based urgent care clinic mentioned at all there. We are speaking about urgent care not the entire medical center itself and its partner clinics and physicians.
Billing first and reimburse later? How do you think these clinics operate? Everything is done electronically now. You hand them your card, pay your co pay and they bill the insurance company directly. The computer tells them if you are carrying an active policy or not.
Once again no one is arguing about the system being less complicated. I actually said above that Canadian provinces may have the least complicated system in the world. So not sure why you feel the need to keep repeating that. I am simply saying that if you think the U.S. System is complicated then you really have no idea what else is out there. There are some counties that would probably give you a complete mental breakdown if you were forced to live there.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
