BACKGROUND The current economic environment necessitates efforts to prevent avoidable losses in clinical revenue in academic cardiothoracic surgery programs. Inadequate documentation frequently results in delayed, denied, or reduced reimbursement. With the recent increase in integrated residency programs, documentation and compliance are becoming increasingly dependent on junior residents; howe...

Critical (or intensive) care medicine (CCM) is a branch of medicine concerned with the care of patients with potentially reversible life-threatening conditions. Numerous studies have demonstrated that adequate staffing is of crucial importance for patient outcome. Adequate staffing also showed favorable cost-effectiveness in terms of ICU stay, decreased use of resources, and lower re-admission ...

Executive Summary The electrodiagnostic medicine (EDX) evaluation is an important and useful extension of the clinical evaluation of patients with disorders of the peripheral and/or central nervous system. EDX tests are often crucial to evaluating symptoms, arriving at a proper diagnosis, and in following a disease process and its response to treatment in patients with neuromuscular (NM) disord...

BACKGROUND Most orphan drugs do not meet traditional standards of cost-effectiveness. Yet, most orphan drugs are reimbursed, which implies that other factors are taken into account at the time of reimbursement. To increase accountability of decision-makers, there is a need for more transparency in the factors that play a role in reimbursement decisions of orphan drugs. Therefore, the aim of thi...

to successfully defend a single claim of malpractice would likely exceed the annual premium for liability insurance, and this fact alone makes malpractice insurance a sound business expense. Unfortunately, it’s one that growing numbers of physicians can’t afford. Physicians and patients in 20 states are facing a “full-blown medical liability crisis” (up from 12 states two years ago), and at lea...

We use linked administrative data from program and earnings records to summarize the 2007 employment rates of Social Security disability program beneficiaries at the national and state levels, as well as changes in employment since 1996. The findings provide new information on the employment activities of beneficiaries that should be useful in assessing current agency policies and providing ben...

In "What Is the Problem With ThirdParty Prescription for School-Based Practice" (AjOT, Ocrober 1996, pp. 750-751), Royeen discusses the difficulties of third-party therapists involved in me evaluation of a child receiving school-based occupational therapy. I agree with the author that an evaluation void of the school environment is problematic. Frequently, third-party therapists have little awa...

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...

OBJECTIVES To compare third-party payor reimbursement for patients evaluated in a university-based pediatric weight management clinic in central Kentucky. STUDY DESIGN Demographic and reimbursement data were reviewed for 120 patients evaluated January to December 2004. Statistical analysis included Kruskal-Wallis test and Friedman's test. RESULTS Overall, median reimbursement was 60%. For n...

In this qualitative study of managed health care and occupational therapy practice, participants described how their practice had changed, suggested that students be educated to communicate the value of occupational therapy and to navigate corporate medicine, and expressed ethical concerns regarding reimbursement versus therapy goals. In-person, individual, focused interviews were conducted wit...