Sampling of training program material for health care fraud, abuse and compliance training for health care providers. contact Chiropractic Compliance Consultants for more at 913-369-9000, or visit our website at cccpfc.com
Billing and Reimbursement for Surgical Assistants - How to startLuis F. Aragon
A basic guide of what you need to know if you are looking into going into private practice as a non-physician surgical assistant in regards to third party billing.
7 legal issues associated with telemedicine servicesmosmedicalreview
Like traditional medicine, telehealth also involves medical chart reviews and other investigations. There are certain legal issues related to telemedicine.
Billing and Reimbursement for Surgical Assistants - How to startLuis F. Aragon
A basic guide of what you need to know if you are looking into going into private practice as a non-physician surgical assistant in regards to third party billing.
7 legal issues associated with telemedicine servicesmosmedicalreview
Like traditional medicine, telehealth also involves medical chart reviews and other investigations. There are certain legal issues related to telemedicine.
Medical insurance fraud is generally defined as knowingly executing a treatment to render medically unnecessary or over-utilizing services that result in useless costs to the healthcare system, including health insurance providers
Louisiana medical psychologists telemedicine overview - the who, what, when, ...Conrad Meyer JD MHA FACHE
Louisiana Telemedicine Telehealth Law - Who, what, when, where and how. Everything you need to know about the current state of affairs with respect to Telemedicine and its application to Louisiana Regulatory Scheme. If you are a physician looking to setup a telemedicine practice in Louisiana or a Louisiana Physician or medical psychologist looking to expand your practice with telemedicine, this presentation can help you.
Healthcare Billing and Reimbursement: Starting from ScratchDale Sanders
The healthcare billing environment in the US is a disaster. It creates huge waste in care and cost. As presented at the Cayman Islands International Healthcare Conference in October 2010, this slide deck suggests what the billing system might look like, if we could start over.
Short presentation alerting physicians as to how the False Claims Act can affect their medical practice, including fines and exclusion from medicare and medicaid programs.
Health Care Fraud Investigations: What to Do When the Government KnocksEpstein Becker Green
Webinar with moderator Marcia Nusgart, R.Ph., of the Alliance of Wound Care Stakeholders, and attorneys George B. Breen, David E. Matyas, and Lynn Shapiro Snyder of Epstein Becker Green. August 17, 2016.
This webinar will provide insight into expanding government investigations and offer ways to enhance your compliance efforts including:
* High risk health care fraud issues
* How to manage a 'touch' by the government enforcement players such as the receipt of a subpoena, and
* The current enforcement climate
http://www.ebglaw.com/events/health-care-fraud-investigations-what-to-do-when-the-government-knocks/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Medical insurance fraud is generally defined as knowingly executing a treatment to render medically unnecessary or over-utilizing services that result in useless costs to the healthcare system, including health insurance providers
Louisiana medical psychologists telemedicine overview - the who, what, when, ...Conrad Meyer JD MHA FACHE
Louisiana Telemedicine Telehealth Law - Who, what, when, where and how. Everything you need to know about the current state of affairs with respect to Telemedicine and its application to Louisiana Regulatory Scheme. If you are a physician looking to setup a telemedicine practice in Louisiana or a Louisiana Physician or medical psychologist looking to expand your practice with telemedicine, this presentation can help you.
Healthcare Billing and Reimbursement: Starting from ScratchDale Sanders
The healthcare billing environment in the US is a disaster. It creates huge waste in care and cost. As presented at the Cayman Islands International Healthcare Conference in October 2010, this slide deck suggests what the billing system might look like, if we could start over.
Short presentation alerting physicians as to how the False Claims Act can affect their medical practice, including fines and exclusion from medicare and medicaid programs.
Health Care Fraud Investigations: What to Do When the Government KnocksEpstein Becker Green
Webinar with moderator Marcia Nusgart, R.Ph., of the Alliance of Wound Care Stakeholders, and attorneys George B. Breen, David E. Matyas, and Lynn Shapiro Snyder of Epstein Becker Green. August 17, 2016.
This webinar will provide insight into expanding government investigations and offer ways to enhance your compliance efforts including:
* High risk health care fraud issues
* How to manage a 'touch' by the government enforcement players such as the receipt of a subpoena, and
* The current enforcement climate
http://www.ebglaw.com/events/health-care-fraud-investigations-what-to-do-when-the-government-knocks/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Fico unleashes new analytics for fighting america's $700+ billion healthcare ...aldrencarlo
FICO Insurance Fraud Manager 3.3 adds link analysis, facility model to boost detection of fraud rings and suspicious providers
MINNEAPOLIS, Oct. 2, 2012 -- /PRNewswire/ -- FICO (NYSE:FICO), the leading provider of predictive analytics and decision management technology, today released the latest version of FICO® Insurance Fraud Manager, the most advanced system for detecting and preventing healthcare insurance fraud, waste and abuse. FICO® Insurance Fraud Manager 3.3 integrates link analysis with business rules and predictive analytics, and also adds a facility model for detecting fraud at a hospital or an outpatient provider.
"Fraud has always been a part of the insurance business, but the magnitude of insurance fraud today is startling," said Russ Schreiber, who leads FICO's insurance practice. "Experts estimate the annual cost of health care fraud, waste and abuse in the US to be upwards of $700 billion, and last May one Medicare fraud scam alone racked up $452 million. Now, with FICO Insurance Fraud Manager 3.3, insurers have a better way to fight back."
FICO Insurance Fraud Manager 3.3 boasts the first fully integrated link analysis capability with an insurance fraud application. Insurers who previously had to configure separate link analysis tools can now save time and improve results with an easy-to-use solution preconfigured to use health care claims data. With FICO Insurance Fraud Manager 3.3, insurers can investigate organized fraud rings using the visualization capabilities of a proven link analysis tool set, and easily create displays that reveal connections between disparate claims, patients and providers.
"Integrating link analysis with Insurance Fraud Manager's powerful analytics and our advanced business rules gives insurers three ways to combat fraud, waste and abuse," said James Evans, vice president of network and financial management at McKesson Health Solutions, which provides Insurance Fraud Manager's analytics to U.S. insurers via its InvestiClaim® solution. "This triple protection gives insurers a powerful tool for fighting fraud, waste and abuse."
The new facility model in FICO® Insurance Fraud Manager 3.3 scans enormous volumes of claims data for recurring, suspicious activity at a hospital or an outpatient provider. Telltale signs may include unusual scheduling with a single patient, unusually expensive procedures, and even such issues as patients being discharged and readmitted, which can indicate problems with quality of care.
Universal American, which piloted this model with FICO, received a 2012 FICO Decision Management Award this month for its use of FICO Insurance Fraud Manager to control costs and prevent fraud losses. Universal American, a leading provider of health benefits to people with Medicare, has implemented the FICO Insurance Fraud Manager solution into their claims workflow prior to payment, and integrated it with their claims platform, Facets.
What's the difference between fraud, waste and abuse when it comes to health care? What is the government doing to prevent fraud, waste and abuse from happening? Learn the definitions and differences in these legal terms and how CMS has worked to prevent these from happening since its inception in 1965.
The issue of fraud in health care has become a serious problem that every participant in the health delivery system must remain aware of in terms of potential and consequences. Managers in the health care system are tasked with ensuring that their staff members know the various fraud schemes as well as making sure that providers are not committing fraud themselves. A key way to accomplish this task is through education and training for fraud detection and prevention by and of health care stakeholders. The stakeholders in health care include providers, patients, organizations and institutions, the government, and the public. Also included are non-health care entities that may steal patient data for fraudulent claims and billing. Managers, therefore, are strongly advised to seek the services of health care compliance agencies to train staff, including doctors and nurses, on how to detect fraud and prevent fraud themselves. These agencies are also adept at helping to improve billing and payment functions to mitigate the risk of lost revenue through fraud and avoidance of criminal liability for the actions of providers and patients. The well-coordinated efforts of all stakeholders of health care assist in preserving the integrity of the system and make available quality services at reasonable prices for all.
Fraud is now the leading criminal conviction in OIG analysis charts. In FY 2013 there were 993 cases while 2014 saw a close 956 cases. How and why is this becoming a trend in the healthcare industry? What are its implications? See more informative infographics on http://streamlineverify.com/blog
Any healthcare reform short of Single Payer leaves the entire US system open to waste, fraud and duplication of effort. This short presentation describes a 'Best Practices' method of handling this area.
Government enforcement actions against health care companies are increasing. The Department of Justice has recovered more than $2 billion in health care false claims cases in each of the last five years. In 2014, the DOJ recovery was $2.3 billion. Health care fraud is an issue for any company that deals in health care, as well as for private equity firms, lenders, and underwriters.
Winston health care partners Tom Mills and Marion Goldberg led an informative eLunch on what you should be aware of if you are involved in health care. Topics included:
• Current government focus
• Recent enforcement actions
• What you should be alerted to if you are a health care company
• What to look for in the diligence process if you are investing, financing, or underwriting a health care company
Biological properties of dental materials /certified fixed orthodontic cours...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This is an overview of VoIP fraud, different types of fraud and what telecommunication carriers are doing to combat this issue. Types of fraud include International / Premium Number Fraud, Impersonation / Social Engineering, Service Degradation / Denial of service. Presented by Mark Magnusson at KazooCon 2015.
Potential factor of rising health care cost. Presentation will drive around introduction,facts, statistics, tactics and solutions regarding fraud & abuse. I would like to thank Imran Bhai for his suggestions
Urgent Care Billing Services, Revenue Cycle & EHR Serviceseverestar
Everest A/R is a Florida-based Medical Billing & Revenue Cycle Management Services Company, offers Urgent Care Medical Billing along with Free EHR Services.
Business Medical Identity Theft faq Health Care Health Plan- Mark - Fullbright
All product and company names mentioned herein are for identification and educational purposes only and are the property of, and may be trademarks of, their respective owners.
Medical billing denials are the bane of many practice existences. Here are the most common reasons for claim denials. https://www.mgsionline.com/healthcare-denial-management.html
Looking for reliable medical billing and insurance credentialing services? Look no further! Our team of experts specializes in providing excellent and efficient services to healthcare providers. Trust us with your credentialing needs and focus on what you do best - providing excellent healthcare,..
US Medical Billing A Comprehensive Overview for Healthcare Providers.pdfmedquikhelathsolutio
The intricate world of medical billing can feel like a labyrinth for healthcare providers. Between deciphering complex medical codes, navigating insurance regulations, and ensuring timely reimbursements, it's easy to get overwhelmed.
Medicare, Medicaid, and the Health Insurance Portability and Accou.docxbuffydtesurina
Medicare, Medicaid, and the Health Insurance Portability and Accountability Act (HIPAA) have had significant impacts on the healthcare industry. Consider the most significant benefits that Medicare, Medicaid, and (HIPAA) have brought to the healthcare industry and the most significant challenges they have presented to decision making in the industry.
Research Medicare, Medicaid and HIPAA. Identify two benefits as well as two challenges.
Peer Response 1:
Erika Corbett posted
CONS
Disclosure to relatives. This means that hospitals will not reveal information over the phone to relatives of admitted patients (U.S. Department of Health & Human services, n.d.). I do agree with this, however in cases where a patient may be out of state and is injured, unable to speak on their behalf, families are left to wonder where they are and what has happened to them. I agree that everyone has a right to privacy but if you look at it from a standpoint of an injured loved one and no way to contact them and find out what has happened, this can be a bad part of HIPAA laws in my opinion.
Victims of abuse, neglect, or domestic violence. While thissection of the HIPAA privacy rule is good, it could also be bad. If the allegation does not look to be in the favor of the person it was meant to protect, the worry of retaliation is of great concern to the patient. If CPS or Police do not have enough to deem neglect or abuse the child or person being abused may fear retaliation from their abuser. This puts them in a difficult position.
PROS
Right to access your PHI. I think this is great because it allows patients to review their conditions, labs, imaging, and treatment plans. It can help keep them on track with caring for themselves and participate fully in the provider’s care. Patients can also request that their records be transferred to someone else that is caring for them, keeping with continuity of care.
Victims of abuse, neglect, or domestic violence. The HIPAA privacy rule allows providers to disclose PHI to authorities regarding victims. By having this in place, it helps protect children of neglect and abuse as well as domestic violence victims who are unable to speak out for themselves. By allowing us to share healthcare information that can help get them to a safe place and/or protect them from their abuser.
PROS
Medicare/Medicaid: These health plans are regulated by the Government; therefore, certain standards of care must be met by the providers in order to be reimbursed. I think this is good for the patients because if they receive poor care, hospitals/Doctors are fined, and it makes them want to improve their standards. An example of this is hospital-acquired infection rates. If a patient is admitted and develops a bed sore, or pneumonia, that is the hospital’s cost not the patient’s insurance.
Medicare/Medicaid provides care to patients who may not be able to afford it. Seniors and American’s with disabilities do not have to go without insurance because.
Understanding and Overcoming Medical Billing Denials.pdfCosentus
Medical billing denials are the scrooge of the healthcare service industry. They have a negative impact on patients, healthcare practices, insurance companies and third party payers. Medical billing denials are not an unusual phenomenon, they affect almost all healthcare service providers of all sizes and specialities.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.