The healthcare system is a complicated structure of providers and institutions that offer services and resources to people in the community. If you want to work in the field, you’ll need to understand this system and its components. Here are the 4 most important parts you’ll need to understand:
Did you know that there are several different healthcare delivery systems? You’re probably familiar with managed care plans, which offer low-cost health care through certain networks of physicians and facilities. These plans include Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), which offer their services on a per fee or monthly fee basis. But you may not be as familiar with these newer delivery systems:
- Concierge Services—Patients pay a monthly fee to retain a physician’s services.
- Self-Directed Services—Patients can find a provider rather than go through an agency or network that would do the work for them.
- Telemedicine— This system gained a lot of popularity during the pandemic. It is most convenient for patients who are homebound or who live in rural areas because it allows physicians to diagnose and treat them remotely.
Patient information is and should always remain confidential. As a healthcare worker, part of your job will be to safeguard that information according to HIPAA laws. HIPAA is the Health Insurance Portability and Accountability Act, which was enacted to prevent healthcare fraud and information theft, and allow people to take their health insurance with them when they change jobs. All healthcare facilities should keep medical records protected and only provide access to the staff when necessary. HIPAA violations carry fines and require additional training or even dismissal for those who don’t abide by the rules.
Medical Billing and Coding
You’ll also need to have a good understanding of how the billing and coding process works. Unless you work in this area, you won’t have to familiarize yourself with every single code. But you should know that the codes in a patient’s medical record tell the billing team what procedures or treatment was provided. This information allows them to file the insurance claim properly. If there’s an issue with the claim or if it’s rejected, it may need to be resubmitted to the insurance company.
The Occupational Safety and Health Administration sets standards that health facilities must follow to prevent injury or death in the workplace. You’ll need to learn about these standards and follow them every day. You should know:
- What personal protective equipment you should wear to protect your skin, eyes, and face
- How to handle biohazards
- How to avoid exposure to pathogens and hazardous chemicals
There’s a lot to know to work in health care. But it’s a booming, multi-trillion-dollar industry. Interested in entering the field? Charter College offers a variety of health care training programs that can prepare you for a dynamic career in health care administration, medical billing and coding, nursing and more. Call us today at 888-200-9942 or fill out the form to learn more.