Training and Certification Methods For Healthcare Risk Management

In the medical arena there is plenty of room for mistakes and errors to occur and practices are constantly at danger from their own in house errors and in trying to manage the healthcare risks of their patients. Practice professionals, themselves need to understand the principles of healthcare risk management.

Pre-Certification Program in Healthcare Risk Management is a professional certificate for people working in this area. This program is aimed at both medical and contingency management professionals who may need some training if they are to understand the subject’s intricacies as well as to further their own professional development.

This is approved by the Commission on Healthcare Certification for those who want to become a healthcare risk management specialist. This particular course is recommended by the Florida School of Nursing In spite of this recommendation the course does not meet the pre-license requirements for those people who want to become Licensed Health Care Risk Managers in Florida.

Professional Certificate in Healthcare Risk Management is for those people who really want to make a career in this area. Medical practice staff need to have some understanding of and training in danger management in healthcare. There are now several kinds of professionals who may not be medically qualified but who are trained and qualified in all the aspects of risk that can arise in the healthcare arena.

Many people may take the Professional Certificate in Healthcare Risk Management that is designed to help working risk management practitioners and healthcare practitioners train in an area that will further their professional development in the field of healthcare administration, patient safety, and clinic quality improvement. This course is offered by the University of Florida and is aimed at professionals already working in the field.

There are some other courses offered, e.g. the Life Wings training, that are aimed at professionals already working in the healthcare arena and that do not give certification. You can also study online with the University of Florida on the Healthcare Risk Management Certificate program and is approved by the Agency for Healthcare Administration. This particular course also meets the licensing requirements.

In healthcare the risk management specialist is there to identify areas that could be problematic and to reduce as far as possible, the amount of probable exposure. They are also expected educate the others that they work with into risk management practices.

Risk managers may come from a variety of professional backgrounds and because of the way that this profession has evolved; there are various methods of education and training for the role. Many have some sort of clinical background either as nurse or other healthcare professional.

The main objective in healthcare risk management is to both promote quality care and enhance parent safety. They may also be involved in managing any claims against the organization and to coordinate insurance coverage and risk financing.

Florida Lawmakers Are Considering Expanding Child Health Insurance Coverage

Florida state legislatures are planning to file legislation this year that will extend state-subsidized health insurance coverage for more children across the state. Currently, KidCare–Florida’s state-sponsored health insurance program for children–is sponsored by the state of Florida as well as the national government.

However, KidCare does not cover health policies for children of legal immigrants who have been in the U.S. for fewer than five years. Because the federal government would not pay for children of immigrants who have been in the U.S. for fewer than five years, the Florida government also excluded coverage for the children in 2004.

With the passage of the proposed legislation, KidCare will extend health coverage to those children as well as to children of state employees in Florida. The new legislation is expected to be filed this year in response to the federal government’s agreement to help pay for the increased coverage to children of immigrants who were previously uncovered.

However, the federal government is still not in agreement to help pay for healthcare for children of state workers unless they are also eligible for Medicaid coverage. Many state workers make too much money to be eligible for Medicaid coverage, but do not make enough money to be able to easily afford to pay for health coverage for themselves and their families.

According to Karen Woodall, a children’s advocate, the federal government assumes that states will pay government workers enough to cover health care for their children, or offer them insurance. In Florida, that’s not always the case.

The proposed legislation is bipartisan and is being drafted by Democrat Sen. Nan Rich and Republican Rep. Jimmy Patronis. While the legislation does extend coverage to children of immigrants, the legislation does not extend coverage to children of illegal immigrants, who will still be ineligible for any state health care coverage.

In addition to providing coverage to children of state employees and legal immigrants, the legislation will also increase eligibility for Medicaid to include pregnant women who are making up to 200 percent of the federal poverty level limit. As the legislation currently stands, pregnant women who make up to 185 percent of the poverty level are eligible to have Medicaid cover only some prenatal and post partum health care expenses.

Florida Health Insurance – Take Advantage of the Internet’s Price Transparency

Florida health insurance companies are now feeling the effects of the increased price transparency that the Internet brings. Now longer is it a process of days or even weeks to obtain multiple health insurance quotes from top Florida health insurance companies. The simplest and most efficient way to obtain health insurance in Florida is simply to make the top health insurance companies in the state (Golden Rule/United Healthcare, Aetna, and Humana) compete for your business!

If you cringe at the thought of a United Healthcare agent, an Aetna agent, and a Humana agent all clustering around you amongst a swarm of other Florida health insurance agents and trying to push their company’s policy upon you then read on; for health insurance shopping on the Internet has simplified everything. There are numerous Florida health insurance websites that offer Florida health insurance quotes but there are quite a few very important distinctions between the different types.

There are two main types of websites that offer Florida health insurance quotes to Florida health insurance shoppers: Marketing Organizations and Insurance Agencies.

Marketing Organizations do not sell insurance, are not regulated by any insurance department, and generally have no knowledge whatsoever concerning Florida health insurance. However, they can offer consumers a somewhat appealing service. How can they assist in purchasing health insurance?

They act as a middleman between Florida health insurance shoppers and Florida health insurance agents. When Mrs. Smith in Tampa, FL requests a health insurance quote then the marketing company sells her information as a lead to 5 or more Florida insurance agents.

Ignoring the privacy issues and the issue of the qualifications of the health insurance agents that will be purchasing your information there is the larger and more practical issue of do you really want to have 5+ insurance agents aggressively seeking your business?

Imagine that each health insurance agent is taught in their sales training to call you at least 5 times and email you at least 3 times before “giving up” on you as an insurance prospect: that means that you have received 25 phone calls and 15 emails from various insurance agents!

The second type of website that offers Florida health insurance quotes is the website that is run by an insurance agency (note that it is very important to find only an independent Florida insurance agency – meaning an agency that is not tied to working with only one health insurance company but can show you health insurance quotes from all of the top Florida health insurance companies. This is also why we will ignore the quasi third group of websites that offer Florida health insurance quotes: the health insurance carrier websites themselves. These can be a good service but very time consuming. There is a better way to shop for Florida health insurance. Read on-).

Most independent insurance agency websites offer a feature that will allow you to request Florida health insurance quotes. However, there is a much better way to shop for Florida health insurance! Rather than waiting for your request for health insurance quotes to be filled; look for a website that offers instant and LIVE Florida health insurance quotes from top Florida health insurance companies.

With instant LIVE Florida health insurance quotes you have the best of both worlds: you receive the benefits of competitive pricing by viewing the top Florida health insurance companies quotes side by side (the strong point of the marketing organization website model) as well as personal, expert help (the strong point of the insurance agency website model). Not to mention the added benefit of viewing the health insurance quotes from the different health insurance companies in the same format – enabling easy side by side comparisons of benefits. This allows for a true “apples to apples” comparison.

Group Health Insurance Vs Individual Health Insurance In Florida

If you are a small business Florida with four to fifty full-time employees, your employees might have been pressuring you on getting a term health care insurance that you would have to pay.

While it is always advisable to keep your employees happy, getting term healthcare insurance for your employees as a member of your organization may not always suit their needs and may not be cost effective for your business too.

In order to be accepted in their Florida health insurance programs, most healthcare providers require for a small business to be operating for at least a year in Florida. Eligible business must also have been paying for their quarterly taxes. Small business in this case is a company with four to 50 full-time enrolled employees.

Some health providers allow employers to get a combination of PPO plans and HMO plans – and some employees can be on PPO while others on HMO. Although they offer similar services, PPO plans and HMO plans have some distinct differences. The aim is ultimately to allow people to save on their healthcare costs through their network of physicians and hospitals. However, with a PPO, you may see your favorite doctor or visit your favorite hospital – the insurance company will pay between 70% to 80% of the total cost. HMO plans are known, and in fact, limit you to their list of providers and hospitals. PPO plans are offered in all of Florida’s counties.

If You Can’t Afford It

If you have less than 25 employees, you are not required to offer healthcare or HMO options to your employees if you go back to the Health Maintenance Organization Act of 1973.

If you are such a small organization, then you might want to encourage your employees to get an individual health insurance plan. This type of plan is not issued to individuals as employees, business owners or as self-employed people. They are issued to people individually as breathing and living people with healthcare concerns.

Individual health insurance plans have advantages over group health insurance and vice versa.

Insurance companies usually have guidelines for accepting companies into their program. Your company might not qualify to be accepted into a group health program. However, if it does qualify, the insurance company must accept all individuals regardless of their pre-existing health conditions – they even include maternity benefits. Therefore, premiums under group healthcare can be more expensive than individual plans.

Insurance companies usually offer better, cheaper rates with individual plans since they can accept, rate or decline an application for an individual plan. Maternity benefits can only be had as an option in this case.

Top Florida Allied Health Care Degrees

Over the last few years, career in allied health care has climbed the ladder of immense popularity. Today it is counted among one of the few career options that provide ample of opportunities to earn a decent salary and learn different skills. If you are working as an allied health professional, you may among few professionals in health care industry enjoying highest paid jobs. However, when it comes to pursuing a degree course in allied health, Florida is one of the few top cities in the United States that is known for providing quality education. This city has number of colleges affiliated to renowned universities and always known for providing standard education with the most sought curriculum. The courses are sufficient to train students for practical knowledge required for job responsibilities. So, if you are actually looking forward to making career in the allied health, here are some of the top Allied Health Care Degrees or programs that you can opt in Florida:

Dental: The allied health dental program primarily focuses on studying health problems afflicting the teeth, gums, mouth and other hard or soft tissues of the oral cavity. These programs play very important roles in the whole healthcare system, as there are many new fields introduced in this stream like, periodontics, pathology, orthodontics, which has enhanced the scope of this field. Diploma Program and Associates Degree are some of the programs that can be availed in the dental stream. The Lincoln College of technology located in Florida is one of the top colleges offering allied health dental degrees with all practical as well theoretical classes. On successful completion of the course you can specialize as dentist in different dental fields.

Nuclear medicine technology: You can attain Associates Degree in Nuclear medicine from Keiser University in Florida. Usually, the coursework in this allied health care program comprises of imaging techniques, radiopharmaceuticals, physical sciences and safety procedures. These days, nuclear medicine has a very significant role to play in human health care because it is widely being used together with monoclonal antibodies to treat cancer. Upon acquiring an associated degree in this allied filed you can become a nuclear medicine technologist in hospitals. Adding to this, you can even attain advance positions like chief technologists, supervisor, department administrator and director after gaining the sufficient experience.

Surgical technical and technology: The Allied Healthcare Program in Surgical Technology (AST) train students to assist registered nurses and surgeons in the operation theatre during various types of surgeries. To become surgical technologists, assisting surgeons and other medical staff you can opt for Associates Degree or Diploma Programs provided by High tech Institute or Keiser Career collage. Since these programs in Surgical Technology are short term, it is a good option for a fast-paced career in health care.

Biomedical technician and technology: If you are interested in both the concepts of engineering as well as human healthcare then you can combine your interests by earning an allied healthcare degree in Biomedical Technology. While pursuing this program, you may have to complete coursework in science, calculus, anatomy, biology, physics and engineering. You can opt for MedVance Institute in Florida for a diploma program in Biomedical Technologies, through which you can continue your careers in biomedical technology, biomedical engineering or clinical laboratory technology.

Apart from these degree programs, there are many other programs you can choose to go into various streams of allied healthcare. Introduction of many new fields in allied healthcare domain has allowed various other areas and fields to emerge. Undoubtedly, today where allied health care career is seen as the most respectful job, it also offers great diversity.The availability of degree and courses in some of the leading universities and colleges of Florida has made it easy to cop-up with the challenges of different jobs in allied health care industry.

The 5 Biggest Health Insurance Providers in Florida

There is well over 100 insurance companies in Florida which provide health insurance to either individuals or businesses. In fact, in a report put together by the Florida Office of Insurance Regulation for the 2009 calendar year, there was a total of 139 different providers listed. Which of these insurance companies are the biggest, and by choosing the biggest providers, are you assured of getting great Florida insurance at great prices?

Blue Cross & Blue Shield of Florida: Out of all of the insurance companies in Florida, Blue Cross & Blue Shield is the biggest health insurance provider. They hold a 27.14% market share in the state, and earned direct premiums of nearly $4 billion, while covering over 1.1 million people.

United Healthcare Insurance: United Healthcare Insurance is number 2 on this list, with a 15.39% market share, $2.2 billion of premiums and 690,000 lives covered.

Aetna Health: Aetna is next on the list of the biggest insurance companies in Florida, with a 13.66% market share. What’s interesting is that they make almost as much as United Healthcare in premiums, with $1.9 billion, but they cover only half as many people, 387,000.

Avmed: All of the companies take a substantial drop off in market share after the top 3. Avmed is next up, with a 5% market share, $726 million in premiums earned, and 189,000 lives covered.

United Healthcare of Florida: Listed separately then United Healthcare Insurance, the Florida branch has a 4.56% market share and $654 million of premiums while protecting about 127,000 people.

Now that you know the biggest insurance companies in Florida, it’s time to ask whether or not you should just immediately go with the big guys at the top of this list. First, it must be said that the biggest companies typically get there with good reason – by providing affordable and high quality protection.

That doesn’t mean that the number 1 or number 2 company is going to get you the lowest price, or the best coverage, for your own unique needs, wants and circumstances. It’s important to be able to shop around and compare what’s available to you, and you don’t want to make any assumptions before you can see for yourself the differences and what will be most beneficial for you.

Working with Florida insurance specialists is a great way to get this done, as they’ll shop around and do the legwork for you, and will find a match that’s perfect for your budget and desired level of protection. The biggest insurance companies in Florida are there for a reason, but don’t blindly choose one over the other.

How the Proposed Health Care Bill Will Impact Florida Residents and Health Care Providers

The nation is abuzz with talk of the proposed healthcare bill, which may be signed into place in 2009 – and may be signed as soon as Christmas Eve. As it stands now, the proposed bill will cost the nation at least $871 billion and change the way Americans receive and pay for their healthcare. The Congressional Budget Office estimates that the proposed national healthcare bill will ensure health insurance for an additional 31 million Americans while, simultaneously, cutting the federal deficit by a whopping $132 by 2019.

According to the most current draft of the healthcare reform bill, every American will be required to buy health insurance. However, Medicaid programs will also be expanded to provide more healthcare coverage to the poor. Moderate income individuals will receive a federal subsidy to help them afford health insurance or health care.

For Florida residents, this means that health insurance rolls in the state will increase by 2.4 million by 2019. Additionally, nearly one million Florida seniors will be blocked from the proposed budget cuts to the popular Medicare Advantage program. But that’s not all – health care providers and recipients will be affected by the proposed national health care bill in many more ways.

The impact of the proposed health care bill on Florida residents and health care providers

In addition to the new mandate that all Florida residents will have to have health insurance or another form of health care coverage (such as federally subsidized coverage), many Florida residents can expect their healthcare expenses to increase in response to the passage of the health care bill.

While the proposed cosmetic surgery tax was eliminated from the bill, there is a new ten percent tax on indoor tanning services. From this ten percent tax alone, the government expects to raise about $2.7 billion over the next decade. While the government stands to benefit from the increase revenue, tanning salons may be hard-pressed to maintain their businesses. “This is really going to be tough for these businesses – they’re already struggling,” said John Overstreet, executive director of the Indoor Tanning Association.

Additionally, individuals making more than $200,000 per year and families making more than $250,000 will have to pay a 2.35 percent tax for Medicare. This figure represents a 0.9 percent tax increase for these high-earners.

However, Florida Senator Bill Nelson was able to secure an amendment to the health care bill that would protect about 800,000 Medicare Advantage policy holders from cuts to Medicare Advantage plans. While existing Medicare Advantage participants will be grandfathered in, new Medicare beneficiaries will have to deal with the program cuts.

The good news for many Florida residents is that Florida community health centers will receive an additional $10 billion in the most current version of the bill.

Additionally, the proposed five percent tax on elective cosmetic procedures was also eliminated from the most current version of the health care bill. That’s good news for health care providers offering elective procedures said Dr. Kent V. Hasen, a board-certified area plastic surgeon. “In general, cosmetic surgeries are down 30 to 40 percent because of the recession. You tack that on and it will be the death knell for the practices.” That five percent tax would, however, have generated about $6 billion in taxes.

The proposed health care bill has been hotly debated in the Senate since November and is expected to be signed into action as soon as Christmas Eve of this year. Once the bill is in place, Americans will want to reevaluate their current health insurance plans, as the bill proposes many changes to the health care and health insurance industries that will affect every American in some regard.

When evaluating their health insurance plans and health care needs, many individuals will find it beneficial to speak with a qualified health insurance advisor for specific information about which health insurance plans suit their unique needs, budgets, and lifestyles – especially in light of the many changes that will soon take effect.

Charlie Crist Program – All Florida Kids Insured

When your child, ages 0 to 18, needs medical coverage and you live in Florida, the Charlie Crist program, KidsCare, is a tailor-made health care program just for your family. With one of the health insurance options made possible by this program, you, the parent or guardian, can have peace of mind that your child is going to be covered if a medical emergency arises or when their well child checkups are due. There is the option for families who make over the median income to buy a reduced cost health insurance as well as plans for families who are low income that include reduced prices of 15 or 20 dollar a month plans and completely free plans.

With the Florida Healthy Kids Corporation, the Agency for Healthcare Administration, the Department of Children and family and the Department of Health a great team has been built to ensure that all uninsured children will be well cared for. All you have to do as a parent or guardian is apply to the Charlie Crist program by way of KidsCare. This program has multiple extensions that gives individualized care to the special children they cover. These extensions are Children’s Medical Services Network (children with special needs 0 to 18 years old), Healthy Kids (children 5 to 18 years old), MediKids (children 1 to 4 years old) and Medicaid (children 0 to18 years old). Your child will be placed with correct care extension after you apply to the program.

All of the departments and administrations involved in the Charlie Crist program have specific purposes and care for specific needs of the program. This can range anywhere from assisting families with children who have special health concerns to low income families who need complete coverage to managing the money and customer service centers or even working closely with the federal government to ensure that all the t’s are crossed and the i’s are dotted.

Overall, the Charlie Crist program is there to make life better for all who live in Florida. It is available to make sure that no matter if a child is at school, at home or playing little league baseball they will be covered if and when an emergency or accident happens. Health insurance for all children is the goal of this Florida healthcare program. As always, make sure that you research all of the details before agreeing to any contract or program.

Increase In Florida Health Insurance

According to a report released recently, approximately 4,000 of Florida’s sickest uninsured residents have enrolled and started receiving benefits in the new health insurance program of the federal government.

What Is This Pre-Existing Condition Insurance Plan All About?

Nationwide, approximately 49,000 people are enjoying the benefits of this new health insurance program sponsored by the federal government. This new health insurance program was created by the Patient Protection and Affordable Care Act to help people who have been without any form of health insurance coverage for at least six months or have been denied coverage due to a pre-existing condition. This federal health insurance program is called the Pre-Existing Condition Insurance Plan or PCIP for short.

This is a temporary program created to give assistance to people with health problems. It allows them to get the health coverage they deserve while they wait for the full implementation of the health care reform law in 2014. Beginning in 2014, insurance companies will no longer be allowed to charge higher rates or deny a person health coverage due to a pre-existing condition as mandated by law. People with pre-existing conditions can also join the state-based health insurance exchange for individuals and small businesses to get affordable Florida health insurance premiums.

The health care reform act gave the states the authority to create their own pre-existing condition plans. However, since Florida and 22 other states did not establish their own PCIP, these states are now part of a federal plan. The PCIP program was allotted $5 billion in federal funds. But, this is not enough so individuals will still have to pay hefty premiums.

What Florida Health Insurance PCIP Means For Those Who Joined The Federal Program?

For some people who enrolled in a PCIP plan like Kathleen Watson, 50, who runs a small medical transport business in Lake City, the plan meant that she now got “excellent insurance.” After her husband became disabled in 2004, she lost her health care coverage because she could not stay under her husband’s employer-provided Florida health plan. She couldn’t get any individual Florida healthcare policy because she has a series of health problem that includes non-Hodgkin lymphoma (cancer of the lymph nodes). Watson said she attempted to pay off her medical bills. However, this only resulted in their finances hitting rock-bottom.

It is common for Florida insurance companies to reject the application of people with medical problems. Because of the fact they pose a greater financial risk.

When the PCIP program started two years ago, she couldn’t afford to pay the $700-plus monthly premiums that come along with it. Fortunately, the federal government cut premiums by 50 percent last year. That was the reason why she was able to afford it. In July, she paid $363 per month for her PCIP that allowed her to get the medical treatments she needed and couldn’t have afforded on her own.

As of December 31, 2011 in Florida, 3,736 people are covered by this plan. This number represents less than one-tenth of the one percent of the 3.8 million uninsured residents in Florida. According to Steve Larsen, a deputy administrator with the U.S. Department of Health and Human Services, he said that the national participation of uninsured Americans in the PCIP program increased by 400 percent from the first to the second year. He is expecting that numbers will keep on rising.

Aside from the monthly premium paid by Watson, she also has to pay an in-network $1,000 deductible for medical services, another $500 deductible for preferred list prescriptions and a $750 deductible for prescriptions that are not included on the list.

She also must pay a co-insurance charge of 20 percent for most in-network healthcare costs. In order for her Florida health insurance PCIP to cover all in-network costs, she needs to spend an out-of-pocket cost of $4,000. For out-of-network providers, she has a $1,500 deductible and maximum $7,000 out-of-pocket.

Unlike other Florida health insurance plans, the PCIP does not have a waiting period to get treatment. This is how the new health program helped people with medical issues get their much needed healthcare.


How Florida Health Insurance is Making News With Innovative Ideas

Residents of Florida can choose from many Health Insurance Plans in Florida to get the right coverage for their individual or family needs, and several of these providers are making news with innovative programs to help their members.

Aetna and Anthem Offer Mail-order Prescription Medications

Two the largest providers of Health Insurance for Florida — Aetna and Anthem — are offering at-home delivery for many of the most popular medications, including maintenance medications that are used to treat diabetes and heart disease. Their members can receive 30-, 60-, and 90-day prescriptions for many commonly used medications.

Members who enroll in mail-order prescription programs may also receive a discount for the first time they fill a prescription. Many programs offer additional coupons, free shipping, and other perks to make filling prescriptions affordable and convenient. Some programs even offer reminders when it’s time to refill a prescription.

Anthem Offers Members Full Coverage for H1N1 Vaccination

As a major provider of Florida Health Insurance Plans, Anthem is providing full coverage for H1N1 vaccination for its members. On its Website, Anthem has stated that it is offering the no-cost vaccination coverage to support public health agencies, including the Center for Disease Control, in efforts to stop the spread of H1N1.

Anthem members can receive the vaccination by injection, or nasal spray. To make the cost of vaccination free to members, Anthem is waiving any coinsurance, co-pays, and deductible associated with the vaccination, including a doctor’s office co-pay. To receive the free vaccination, members must obtain it from a participating provider.

Anthem is also offering fully-insured members low-cost flu-related treatments, such as Relenza and Tamiflu.

Anthem Partners with WebMD to Offer Online Health Assessment

In addition, Anthem has also partnered with a leading online resource for health-related information — WebMD — to provide members with helpful health assessment tools through the MyHealth Anthem online portal.

These tools are interactive to help members assess their overall health with a blood alcohol estimator, body fat calculator, body mass index calculator, ideal weight calculator, interactive personal trainer, nutrition toolbox, sleep disorder assessment tool, smoking cost calculator, and target heart rate calculator. The online tools are designed to help members understand their current health, and take steps to improve their own well being.

Blue Cross and Blue Shield Launches Physician Recognition Program

Leading Florida Health Insurance provider — Blue Cross and Blue Shield of Florida — has launched a program to recognize high-quality healthcare providers in Florida. Their Recognizing Physician Excellence program rewards physicians who deliver high-quality care, and service to patients.

Blue Cross and Blue Shield of Florida has opened the program up to many different healthcare providers, including family practice, general practice, geriatrics, gynecology, internal medicine, obstetrics, and pediatrics physicians who participate in the Blue Cross and Blue Shield NetworkBlue health insurance program.

NetworkBlue is for all BlueOptions PPO point-of-service health insurance plans in Florida. More than 4,000 Florida physicians (more than half of the eligible physicians and healthcare providers for 52 percent of Blue Cross and Blue Shield’s members) participated in the NetworkBlue program in 2008. Blue Cross and Blue Shield of Florida serves more than 8.3 million members across the state.