spanish speaking primary doctors near me :: Article CreatorHow To Find Doctors That Accept Medicare Near You
When researching Medicare plans, individuals can consider which doctors or healthcare facilities nearby accept Medicare. Several online tools can help locate a Medicare-approved doctor.
Medicare has a range of plans for healthcare coverage that many doctors, clinics, and hospitals accept.
Choosing the best Medicare plan for a specific location will grant a person access to a network of doctors and hospitals that accept Medicare payments. Selecting a suitable plan may also help a person reduce out-of-pocket expenses.
It is each person's responsibility to verify that their particular Medicare plan covers specific healthcare services. The person must confirm coverage before any treatment, as the hospital does not confirm coverage on their behalf.
This article explains how to check which doctors near you accept Medicare.
There are several ways to find a doctor who accepts an individual's Medicare plan.
Medicare
The official Medicare website provides resources and tools for finding local doctors and healthcare services that accept Medicare.
These services include:
dialysis facilities home health services long-term care hospitals inpatient rehabilitation facilities Medicare provides a Service Coverage tool that an individual can use to check whether their Medicare plan covers a test, item, or service.
The Physician Compare tool
The Centers for Medicare and Medicaid Services (CMS) provides a simple tool called Physician Compare.
A person can enter their zip code, and the tool will display a list of doctors and healthcare facilities in the areas that accept Medicare plans.
People can also search by a healthcare professional's last name, the practice name, or the medical specialty they require.
To filter the search, a person can select:
how far from their location they want to search the sex of the clinician they feel most comfortable visiting whether they are part of a group or running a solo practice their board certification status The doctors listed on Physician Compare accept Medicare, but the tool does not provide information about secondary insurance, such as Medicaid.
An individual will need to contact their secondary insurance provider to make sure their preferred doctor accepts the terms of their plan.
Learn more about Medicare coverage for doctor visits.
Insurance company provider information
Private insurance companies provide some Medicare plans, including Medigap and Medicare Advantage (Part C).
If an individual has a privately administered Medicare service, they should ask their insurance provider about local doctors who accept payments from this coverage.
Usually, insurance companies have a limited network of doctors, hospitals, and healthcare services that accept their payments.
Find your insurance company's customer service phone number or website in your enrollment documents or search for them online.
Ask other people
An individual could ask neighbors and other people who live in their area and who have Medicare about the healthcare services they use. Internet forums and other websites can also provide relevant information.
An individual can accept services from any healthcare professional. However, a doctor who does not accept Medicare may have higher rates.
If a person does not verify their Medicare coverage for a particular healthcare service, they may be responsible for the full amount.
Doctors who accept Medicare will charge a specially negotiated rate. Doctors must opt in for Medicare and agree to accept their plans as payment for services.
Opting in to Medicare means that they agree to the service terms set by the Federal government.
Learn how Medicare reimburses healthcare costs to healthcare providers.
If an individual has Original Medicare, they can visit any doctor or healthcare professional who accepts Medicare payments and provides eligible treatment.
The rules for Medicare Advantage are different and depend on the terms of a particular plan. Some Medicare Advantage plans require that an individual uses doctors in the provider network, unless in an emergency. These plans include:
Health Maintenance Organization (HMO): HMO plans often have lower costs than other Advantage plans because an individual must use service providers within the plan's network. A primary care doctor will coordinate all care and referrals. HMO Point of Service (HMPOS): HMPOS plans typically have provider networks. Visits to out-of-network service providers will usually cost more. Preferred Provider Organization (PPO): PPO plans usually cost less if a person uses in-network service providers. Doctors outside the plan's network could incur higher out-of-pocket expenses. An individual with a PPO need not choose a primary care physician. Special Needs Plan (SNP): Medicare designs SNP plans for people with specific health conditions. An individual must choose healthcare providers in the SNP network, except for emergency care or if an individual has end stage renal disease and needs out-of-area dialysis. Learn more about the difference between HMO and PPO plans.
With Original Medicare, an individual can choose any Medicare-enrolled doctor, healthcare professional, clinic, or hospital.
Some Medicare Advantage plans require that an individual chooses a primary care physician (PCP) from the network of providers. An individual can change their PCP whenever they want by contacting the insurance provider.
Most insurance companies have an online portal for selecting a new PCP, and they provide a list of approved local doctors who accept someone's particular Medicare Advantage plan.
Insurance companies can change their provider network as they choose and at any time.
If an insured person's primary care doctor leaves the provider network and the individual does not wish to change doctors, they have several options.
Change between Medicare Advantage plans
If an individual finds that their PCP is part of another Medicare Advantage plan's provider network, they can change to this plan during:
the open enrollment period, which is from October 15 to December 7 the Medicare Advantage open enrollment period, which is between January 1 and March 31 Leave the plan
A doctor may leave all Medicare Advantage networks but continue to accept Medicare. In this case, an individual can change to Original Medicare and receive coverage to see that particular doctor.
An individual with a Medicare Advantage Plan can make this change during the open enrollment period or Medicare Advantage open enrollment period.
Change plans during the special enrollment period
The special enrollment period allows individuals to switch to another plan due to certain circumstances, such as:
moving to a new address outside the current plan's service area getting married having or adopting a child losing employer-provided health insurance A person typically has 60 days before or after the event to enroll in the new plan.
Changes to the provider network may trigger the special enrollment period. This may occur due to changes in the contract between the CMS and the plan provider.
Alternatively, they may not renew the contract or may reduce the size of its service area.
If this happens, the plan provider will contact the individual. They can then enroll in a different Medicare Advantage plan or Original Medicare.
Find out about the different enrollment periods.
There are various sources that can help a person find a doctor near them who accepts Medicare. These include the Medicare website, the Physician Compare tool, and insurance company provider information.
Not every doctor accepts Medicare. It is up to the individual to check that the doctor accepts Medicare, or they may need to pay costs in full.
It is worth taking the extra step to verify that a doctor accepts Medicare coverage. This can help ensure a person gets the most from their Medicare benefits and keep out-of-pocket expenses to a minimum.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. Jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
Local Doctor's New Book Reaches Out To Spanish Speakers
Encinitas resident Dr. Brian Alman, PH.D. Traveled to India to share his insights on mind-body healing at ashrams.
He posed a persistent question to the many esteemed teachers he encountered: What is enlightenment?
"The very last guru I met asked me, 'How do you define enlightenment?'" Alman said. "I said, 'Well, you feel like you're above it all, you feel comfortable all the time, you can handle any stress, you're relaxed, you're very open and creative.
"He said, 'Oh, no, no. That's not what enlightenment is. And I thought to myself, 'Uh oh, What is it?' He said, 'Enlightenment is unconditional acceptance of yourself.'
"And I said, 'Wow, holy moly! I've been teaching that for decades. All my books are about that.'"
Among the numerous volumes Alman has authored, his latest release is "Menos Estrés para Niños: Un programa físico y mental para ayudar a niños de todas las edades a relajarse y manejar el estrés".
It is a Spanish translation of "Less Stress for Kids: A Mind-Body Program to Help Kids of All Ages Relax and Let Go."
Like all of Alman's books, talks and consultations, the goal is to spread his panoply of techniques to help people of all ages conquer their fears and anxieties.
"We have a big purpose here, which is improving mental health, which is obviously physical, emotional, and family health, for everybody in the world," Alman said in a recent interview at his office in the Encinitas community of Leucadia.
Spanish language cover of "Less Stress for Kids: A Mind-Body Program to Help Kids of All Ages Relax and Let Go."
"That's one of our big goals — to get everything we're doing into the work places, to employers to help their employees and to get it to their employees so they can bring it home and help themselves, because it helps the bottom line.
"Happy employees are more present when they're not absent. They have less medical visits, they have less workman's comp, less disability. When you're healthy and happy, you're just a more productive and happier employee.
"We also want to get (our message) into the school system because the happier the teachers and the staff, the happier the students will be. That will have a ripple and positive domino effect to the families, siblings, parents and grandparents."
Much of the approach stems from the groundbreaking Adverse Childhood Experiences Study pioneered by Dr. Vincent Felitti, who works with Alman.
The study asks respondents a series of questions probing experiences that have negatively affected their development.
"We learned in the ACE study that most of the problems people have come from their upbringing and childhood," Alman said.
As part of the effort to expand popularity of the Spanish version of "Less Stress for Kids," Alman said he attempted to narrate an audio rendition.
"I thought I would try to do the Spanish and so I did a little sample, and I tested it front of friends and colleagues that know me very well and have read all of my works.
"We got together and I played them the recording of me doing one section of the first chapter in Spanish. And they couldn't stop laughing. They were hysterical. They were crying. They had bellyaches. Their faces hurt.
"And I said, 'Why, Why Why?' They said, "We've never heard somebody speak broken Spanish with a Boston accent. It is the funniest thing we've ever heard.
"That was humiliating and a valuable lesson at the same time."
Alman gave up on the idea of translating "Less Stress for Kids" on his own and brought in various Spanish speakers to translate the book into audio.
English language cover of "Less Stress for Kids: A Mind-Body Program to Help Kids of All Ages Relax and Let Go."
"We had people record and help with the writing from many different countries that speak Spanish as their primary language.
"We even had people from South America so we could make sure that the writing was culturally sensitive and the voice was culturally in tune with Spanish-speaking countries and regions."
Both in English and Spanish, "Less Stress for Kids" offers 36 chapters on how to cope with and reduce worries. Each chapter is accompanied by an assignment encouraging readers to write or draw about their experiences with the techniques.
Information on the book, Alman's other publications and an Internet application on stress-reducing techniques can be found at drbrianalman.Com.
"All of the techniques in the books are approximately five minutes each," Alman said. "They get right into it. They're experiential, interactive, enjoyable, relaxing. You never feel worse before you feel better. You start feeling better right away. Everybody says, 'I've never felt this confident or this relaxed before.'
"(Parents say) thank you so much. My kid is doing so much better, not just socially, but also academically, and is happier, sleeping better, eating better, joining more activities and doing better in their sports from all of this…
"So whether it's the books or the app, the programs are helping helping small-sized kids, medium-sized kids and grown-up sized kids. It makes a big difference right away."
Originally Published: June 30, 2024 at 12:38 p.M.
Will Babylon's App Ever Speak Doctors' Language?
Babylon Health might be one of the fastest developing digital health innovators in recent months. It is attracting a lot of press attention and a small army of users that include the UK's newly-appointed health secretary Matt Hancock. Recently Babylon's CEO Ali Parsa put his artificial intelligence-based application to the test in a presentation that was live-streamed from London Royal College of Physicians.
Babylon Health's mission
Babylon's mission is to put an accessible and affordable health service in the hands of patients. They use a combination of cutting-edge technology and the medical expertise to deliver round-the-clock access to digital health tools to people across the world.
The company claims its AI system has demonstrated diagnostic ability that is "on-par with human doctors" after a series of robust tests. They included the relevant sections of the real-life final test each trainee general practitioner (GP) must pass to demonstrate their competence in knowledge and diagnostics.
Human versus AI in healthcare
These tests included a set of questions testing diagnostic skills from publicly available RCGP sources, as well as independently published examination preparation materials, mapped these to the current RCGP curriculum to ensure the questions resembled actual RCGP questions as closely as possible.
The average pass mark over the past five years for real-life doctors was 72%. In sitting the exam for the first time, Babylon's app scored 81%. As it continues to learn and accumulates knowledge, Babylon expects that subsequent testing will produce significant improvements in terms of results.
In real life situation GP's knowledge does not come from books alone, but also from face-to-face patient experience. To test these abilities the application faced seven "highly-experienced" primary care doctors using 100 independently-devised symptom sets.
The machine once more was more accurate than a human. It scored 98% against conditions seen most frequently in primary care medicine comparing to 52-99% range accuracy among experienced clinicians.
Could a computerised brain improve healthcare?
Ali Parsa thinks that the results clearly illustrate how AI-augmented health services can reduce the burden healthcare systems around the world face today.
"Our mission is to put accessible and affordable health services into the hands of every person on Earth. These landmark results take humanity a significant step closer to achieving a world where no-one is denied safe and accurate health advice," he said.
Babylon Health's mission becomes reality
Rwanda became the first country to make this technology available nationwide, following on the heels of the launch of a free digital NHS service in London. It was launched in Rwanda in 2016 and is already delivering accessible healthcare to 600,000 patients in partnership with the Rwandan government and the Bill & Melinda Gates Foundation.
Parsa said: "Our partnership with the Rwandan government shows what's possible. I am proud that this partnership means Rwanda is one of the first countries to offer its entire population accessible healthcare wherever and whenever they need it. It's a model that I hope can be used to make good healthcare more accessible around the world."
A watchful eye on the Babylon Health app
As much as the new technology is taking that one African country by storm and contributing to improving its healthcare system, it does not look all so promising in the UK. There the GP at Hand application was rolled out across the Hammersmith and Fulham Clinical Commissioning Group last year and is currently delivering an online doctor services to over 26,000 people.
But back in March this year the NHS issued a tender for an independent review of Babylon's app, and at the same time objected to plans for a significant expansion of this service beyond London following issues raised by the national independent healthcare standards watchdog Care Quality Commission (CQC).
The CQC found two cases of medicines being prescribed outside their licensed use without the required explanation for this use, and no records showing that patients were informed of this exceptional use.
The inspectors also found instances of GPs relying on a patient's word, rather than clinical evidence to support a diagnosis – for instance, there was no record of blood tests carried out for three patients with thyroid disease. The CQC also found information was not always shared with a patient's primary doctor to ensure prescribing was safe or appropriate. The standards watchdog also found there was no system to give assurance that patients' conditions were being appropriately monitored.
The report only became public after Babylon had tried, and failed, to gain a legal injunction to block it.
RCGP's cautious optimism
Helen Stokes-Lampard, chair of the Royal College of General Practitioners, said: "We need to be cautious about the claims being made at the moment. It's really exciting to see AI evolving and there will be great applications as its gets better, but right now we don't have independently-verified, peer-reviewed research – the scientific standard for accepting innovation and moving forward.
"What we have is some in-house research from Ali and his team. I am delighted that they are using partners and academic institutions to increase the robustness of their research, but it's still very early days.
"I'm concerned about the hype surrounding this right now. We need to be cautious, we need to demand evidence because we have to be sure that anything we introduce is safe."
Despite this uncertainty in the delivery of Babylon services, they seem to attract a lot interest from investors and technology giants. The company recently partnered with Samsung to incorporate their Ask an Expert video doctor appointments to Samsung's Health app. It also signed a collaboration deal with Tencent, Chinese e-commerce and social networks leader, to deliver personal health assessments, treatment advice and individual record across mainland China.
Publishing its latest study and test results on the company website, Babylon Health's authors say the application may hold the promise of reduced costs and improve access to healthcare worldwide, but add that this would entail acquiring "greater levels of confidence from the medical community and the wider public". The researchers also conclude that "studies using larger, real-world cohorts will be required to demonstrate the relative performance of these systems to human doctors".
Comments
Post a Comment