IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for submission of accurate claims. This reimbursement policy is intended to ensure that you are reimbursed based on the code or codes that correctly describe the health care services provided. UnitedHealthcare Community Plan reimbursement policies uses Current Procedural Terminology (CPT ® *), Centers for Medicare and Medicaid S...

Radical changes to our nation’s healthcare system will affect remuneration for both hospitals and interventional cardiologists yet these very same directives may allow for specific areas of synergy and collaboration toward the common good, for hospitals, physicians and most importantly for the patients we serve. Accordingly, the Society for Cardiovascular Angiography and Interventions (SCAI) su...

to intervene inmiediately in crisis situations, and worked out a shorter and more practical technique of interviewing than social workers are traditionally taught. I suspect that many more social workers would do the same if given the chance. At present most of them can only be contacted during office hours and then only if the clerk in the social services department office chooses to tell them...

Few arenas of modern medicine have been more efficacious than regionalized perinatal and neonatal intensive care. Regionalized health care has been described as a coordinated system of care “to improve patient outcomes by directing patients to facilities with optimal capabilities for a given type of illness or injury.” The most complex infants are ideally born and cared for at regional high-ris...

health care debate. t is easy for physicians to be discouraged in today’s medical environment. Physicians strive to deliver quality care under increasing pressure to prove its quality. Tactics cloaked as being quality improvement are often designed to cut cost, reduce choices or patients, and promote the economic interest of payers and government. The practice of medicine is being squeezed betw...

State Medicaid reimbursement methods and rates are reported for the period 1978-86 for skilled nursing and intermediate care facilities. A cross-sectional time series regression analysis of Medicaid reimbursement rates on methods showed that States using prospective class reimbursement had significantly lower rates for the period 1982-86. States using prospective facility-specific reimbursement...

Introduction The Chinese National Reimbursement Drug List (NRDL) was established in the early 2000’s and includes drugs both fully partially covered by Basic Medicine Insurance. As China’s health system has been reformed over past decade, it is important for manufacturers to understand ever-changing reimbursement process its implications on newly launched drugs. This study provides an updated o...

BACKGROUND AND PURPOSE Thrombolysis for acute ischemic stroke saves societal costs, but hospitals that practice acute stroke care appear to shoulder the burden of the cost, which exceeds reimbursement. With creation of the diagnosis-related group (DRG) 559, the US Centers for Medicare and Medicaid Services pays hospitals approximately US $6000 more per case when thrombolysis is administered. We...

In the early years of the Medicare program, proportionally more whites than non-whites among the aged used Medicare services. This article examines the use and reimbursement of Medicare services by the aged between 1967 and 1976 to determine if racial differences still exist. To do so, three measures are studied. The first, the number of persons reimbursed for Medicare service per 1,000 enrolle...