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In the health insurance and the health care industries, FFS occurs if doctors and other health care providers receive a fee for each service such as an office visit, test, procedure, or other health care service. [5] Payments are issued only after the services are provided. FFS is potentially inflationary by raising health care costs. [6]
For example, an insured person might pay a $45 co-payment for a doctor's visit, or to obtain a prescription. A co-payment must be paid each time a particular service is obtained. Coinsurance : Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that an insured person ...
There is a large volume research indicating that self-referral has a major effect on increasing medical costs in the US. David Levin estimated the cost of unnecessary self-referred imaging in 2004 to be, conservatively, $16 billion per year. [3] There are several examples showing that self-referral increases utilization and costs:
Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician (or an immediate family member) has a financial relationship with that entity.
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Physician Dragan Djordjevic used to see up to 30 patients a day in a busy internal medicine practice in Chicago. Visits lasted as little as 15 minutes, not long enough, he felt, to provide the ...
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