If you plan to become a medical billing and coding specialist, it is necessary to understand insurance companies and how they work.  That is why I have been harping on this information for the past week or so.  I decided it might be helpful to sum things up today, cause I am tiring of the topic (as I am sure you are too.)  Basically, the patient primarily pays for healthcare in the United States through the medical insurer rather then directly.  This is where medical billing and coding meets insurance agency.  Medical insurers usually negotiate fees with health care providers in order to control the cost of medical expenses.  There are two types of health care providers: for profit, and not for profit.  For profit healthcare providers operate as a business who’s goal is to make money, while non-profit healthcare providers operate as more of a service that usually requires financial funding  from charity events, donors, and the government.  Today’s healthcare system has evolved from a time when patients purchased insurance to cover loss of wages, rather then paying medical bills. The healthcare system continues to evolve today. When the United States moved from mainly farming communities to a more urban setting more people lived closer together.  Because of the closer proximity to one another, this caused the spread of illness and an increased need for medical care.  Blue Cross was the first medical insurance company to attempt at meeting this need. It began by just covering stays in the hospital.  Blue shield was formed shortly there after to provide insurance coverage for when you visited a  physician. Medicare and medicaid are government medical insurances that were formed in the sixties to help the elderly.  They were having problems getting insurance at a reasonable rate due to pre-existing conditions. Medicare and Medicaid attempted to help those who could not afford other forms of medical insurance.  It will be interesting to see how our new health care reform will affect the allied health industry.  Is social reform the answer?  Things continue to evolve.

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