Expert Medical Services in Hamilton
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FAQ
Q: What is a nurse practitioner anyway and can you do what a doctor would do for me?
A: Nurse Practitioners (NP) are clinicians that blend clinical expertise in diagnosing and treating health conditions with an added emphasis on disease prevention and health management. Their approach and perspective are comprehensive and personalized. All NPs must complete a master's or doctoral degree program and have advanced clinical training beyond their initial professional registered nurse (RN) preparation. NPs must undergo rigorous national certification and maintain ongoing self-directed continued education and professional development throughout their career. For more detailed information please visit the following site listed below:
What's a Nurse Practitioner (NP)? (aanp.org)
Q: Are prices for outpatient and inpatient services consistent among hospitals?
A: Not at all. Effective on January 1, 2021, The Transparency in Coverage Final Rule, issued by the Centers for Medicare and Medicaid Services (CMS), requires health insurers to disclose pricing for covered services and items. Insurers must include the rates they have negotiated with participating providers for all covered services and items, as well as the allowed and billed amounts for out-of-network providers. Allowed amounts are the maximum rates insurers will pay for a given service and billed amounts are what providers have actually charged. Per the CMS site, beginning July 1, 2022, most group health plans, and issuers of group or individual health insurance will begin posting pricing information for covered items and services. This will allow third parties to assist consumers in better understanding the costs associate with their health care. Below, I have included the links to access pricing to the 3 main hospitals in our surrounding area. In order as listed below: Providence St. Pat Hospital (Missoula, MT), Community Medical Center/Billings Clinic (Missoula, MT), Bitterroot Health Daly Hospital (Hamilton, MT).
Pricing Transparency and Price Estimates for Providence Montana Hospitals | Providence
Cost Estimator Tool | Community Medical Center
To find out how much outpatient surgery and imaging tests cost in Montana in 2019-2020. Compare MT hospital charges for ambulatory surgery and diagnostic tests. All prices EXCLUDE surgeon fees and other physician costs. PricePoint system shows facility prices in the past from July 2019-June 2020. Consumers may wish to add medical inflation to estimate 2022 prices. This also allows for direct comparison of facility pricing at one site. The site provides information for number of cases done and the low, median, highest facility charges for services. It then compares the charge to other facilities in the same Medicare class and to hospitals throughout Montana.
Montana Hospital PricePoint System (montanapricepoint.org)
Q: Is care the same at every location?
A: Too often, consumers make decisions on which facility to utilize, without enough information to guide them. Many consumers are uncertain where to turn for trustworthy information on hospital quality and thus make choices based only on a hospital’s general reputation, the experiences of friends, or where a physician has admitting privileges.
The Centers for Medicare & Medicaid Services (CMS) aims to change that by giving consumers information on hospital quality performance. Its new Hospital Star Ratings program will allow consumers to more easily access information about how a hospital performs on important benchmarks. Consumers will be able to see a summary score and overall grade for each hospital, which is based on more than 60 performance measures. The Hospital Star Ratings program will help give consumers more meaningful information to guide value-based and informed decisions about their healthcare. It’s the kind of comparative information consumers are accustomed to using when they make other important decisions or purchases.
The link to access this information, below.
Find Healthcare Providers: Compare Care Near You | Medicare
Q: If I have an imaging order, such as a CT scan, why can't I get it done right away?
A: If an imaging test is ordered non emergency, and you are insured, the test must go through a prior authorization process. Prior authorizations are a management process used by insurance companies to determine if a prescribed product or service will be covered. This means if the product or service will be paid for in full or in part. The overarching benefit is to ensure safety, optimize patient outcomes, as well as reduce costs to the patient and the entire healthcare system. The process can take as little as a few days, to several weeks. Other impacts to scheduling include availability. Many smaller facilities may only have a single MRI machine. An MRI can take 15-90 minutes depending on the specific MRI order resulting in a limited availability for each business day.
Q: Going to my healthcare provider is expensive. Why can’t I discuss everything on my list at the same visit?
A: Your time and finances are valuable. Nobody likes to come to an 8:30 appointment to not see their healthcare provider until 9:15. For the day to run smoothly, accurate scheduling is crucial. If you are scheduled for a sore throat, the average time with clinician is likely 5-10 minutes. If however, you want to also discuss weight loss, depression, headaches, that can not be efficiently and safely addressed within 5-10 minutes without severely impacting the rest of the schedule. Accurate diagnosis and treatment plans require time for the clinician to ask you detailed questions, perform a focused physical exam, discuss treatment options and provide educational information.
In addition, many symptoms may be impacted by other ongoing conditions. Sometimes addressing one issue will resolve the remaining concerns and thus a stepwise approach to management may be safer and more efficient. If tests are required to reach a diagnosis, this will often require a second visit to thoroughly review the findings with you and present the treatment options. It’s a higher quality of care to present the information to you face to face. Clinicians too need work-life balance to be their best for providing you the highest quality of care. To accomplish this, our workday must be well structured.
Tips on how to get the most out of your healthcare visit can be found in link below.
Top 6 ways to get the most out of your doctor visit - Harvard Health
If there are topics that you have always been curious about or wanted to understand better, don’t hesitate to bring this to our attention. You are not the only one with the same question and we would be happy to post future Q and A topics here.