In order to curtail health insurance costs from spiraling out-of-control, Ortho Spine & Sport Clinic (OSSC) have instituted a variety of Medical containment procedures which benefit to cost-containment efficiency to their Individual and Group health insurance plans. Common medical-containment procedures include:
1. Same day surgery admission - instead of allowing a person to be admitted the day before surgery which results in a charge for an additional day of hospitalization charges, the patient is required to be admitted the day that the surgery is to be performed.
2. Pre-admission testing - before authorizing hospitalization or surgery in a non-emergency situation, additional testing to determine whether hospitalization or surgery is required must be performed.
3. Outpatient surgery requirement - many surgical procedures may now be performed on an outpatient (non-hospitalized) basis reducing the need for reimbursement of hospitalization costs.
4. Prior consent for hospitalization - the insured patient is required to present to the insurance company the particular course of treatment proposed before authorization for coverage will be provided.
5. Limitation to "usual, customary and reasonable" charges - such a limitation are enabled to determine that health care procedures, services and related medical expenditures are outside or exceed the "usual, customary and reasonable" charges for particular courses of care or procedures used for treatment of particular conditions or exceed the costs for a given geographic territory.
6. For emergency cases - the medical control is our strategy for the Medical Containment procedure must obtains ; fast response Focus on the required investigation NOT long list of Laboratory and Technology based Tests that always BENEFIT the provider, NOT Patients the receiver. the medical containment procedures only accept and support the quick, prompt, effective, convenient procedures saving life with reasonable cost
7. The Medical Containment procedures also can provide, support and obtains; arranging the best medical services what a patient’s require and the medical information from hospitals and/or doctor and relates this information into the medical containment report. This report is designed according to the requirements of our consultant. Customized medical reports enable us to provide the necessary information to each insurance