Answer:
Affordable Care Act
or Obamacare
Explanation:
Affordable Care Act
or Obamacare
10 categories of essential health benefits are
Ambulatory patient services (outpatient care)
Prescription drugs
Pediatric services (including dental and vision coverage)
Preventive care
Laboratory services
Emergency services
Hospitalization for surgery, overnight stays, and other conditions
Mental health coverage and substance use disorder services
Rehabilitative and habilitative services
Pregnancy, maternity, and newborn care
If you experience: Dial your doctor's number or visit the closest emergency room. a difficulty urinating following a cystoscopy. Nausea and soreness in the abdomen.
<h3>What is Nausea ?</h3>
The feeling of nausea is an uneasy feeling in the stomach that frequently precedes the desire to vomit but does not always result in vomiting. Vomiting is the act of forcing stomach contents up through the mouth, either voluntarily or involuntarily.
Schedule a visit with your doctor if: Vomiting lasts more than two days in adults, 24 hours in toddlers, and 12 hours in newborns. For more than a month, you've experienced episodes of nausea and vomiting.
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A Drug Trend report published in 2009 had predicted continued price increase among traditional branded and biotech drugs that lack generic competition. Now, further, CMS has reduced its Average Sales price (ASP) margin from 6 percent to 4 percent for non-pass-thorough. This has affected pharmacy reimbursement. However, there are certain other aspects of Pharmacy Billing that can affect reimbursement and thereby the Revenue Cycle Management (RCM) process if not well implemented.
1. Data Workflow:
Recognizing how the revenue cycle works in pharmacy is very essential. Procurement to Inventory, billing and reimbursement involves purchase of medications, their storage, and method of dispensing, how they are administered, way they are coded & billed, and finally reimbursed. If the drug is covered as a pharmacy benefit, or the payer needs that to be obtained via a specialty pharmacy as identified through patient-specific benefit verification, then here both the provider and the pharmacy are part of the reimbursement process. The physician writes a prescription and orders the drug. This is followed by the pharmacy that fills the order and issues the drug to the physician, CMHC, or hospital outpatient department. Here the pharmacy bills the insurance company for the drug. If any information is entered incorrectly into the pharmacy system in the initial phase of the cycle, errors can prove to be costly, impacting aspects of clinical and revenue cycle.
2. Procurement:
During this phase information is converted from purchased quantities and pricing to storage units of measure (UOM) and inventory costs. Manually entering the data is followed in most cases. UOM conversions, when data is uploaded from the wholesale distributor to the pharmacy system, are also checked and verified manually. Here too mistakes can lead to breakdown in the revenue cycle management (RCM) process.
3. The Charge master:
Critical & substantial revenue leakage can occur when separately reimbursable medications are either missing from or miscoded in the charge master. Conversion of pharmaceutical quantities is a must from purchased amounts to patient-administered amounts, and only then made billable. There is often a difference between dosage amounts required for patient use as from that purchased. Besides inventory, the clinician and pharmacist should convert dosage, strength, and delivery mechanism for each drug. Drug data must be correctly converted from the quantities residing in clinical systems into the payer-billable quantities appropriate for the financial system or charge master. The UOMs must be reconciled to avoid any under- or over-payments. More than often, missing or incorrect data in the charge master can result in negative financial consequences – denied claims, partial reimbursement, and compliance risks.
4. Linkages between Purchases & Billing:
Most hospitals have separate processes to order drugs, administer them, and process reimbursement. Without linkage between pharmacy expenditures for medications (i.e., spend data) and the charge master, ensuring proper charge capture and optimal reimbursement is a challenge. Besides hospitals should have automated tools to identify charge capture errors precisely, so as to pinpoint when and where their occurrence to decreasing revenue loss.
Risks of deep vein thrombosis (DVT) and pulmonary embolism (PE) in chronic pancreatitis (CP) are <u>unclear</u>.
The CP cohort showed a 2.95-fold greater adjusted hazard ratio (aHR) for DVT and a 4.51-fold greater aHR for PE than the non-CP cohort. Substantial risks of DVT and PE were evident in patients with CP aged < 55 years.
The CP cohort with comorbidities showed increased risks of DVT and PE as compared with the non-CP cohort.
Hence the risks of DVT and PE are significantly higher in CP patients than in the general population.
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The three different types of epidemiological nutrition studies: cross-sectional, case-control, and prospective cohort studies. The three basic types of nutrition research are randomized, animal and laboratory studies, and cohort studies.
Cross-sectional studies are used primarily to determine the prevalence of a problem, while cohort studies involve the study of a population that is both exposed and unexposed to the cause of the disease. Case control studies are used to study 2 groups of cases (diseased) and controls (non-diseased) and to identify risk factors between them. Randomized trials, researchers actually intervene to see how a particular behavior change or treatment, for example, will affect a health outcome. Animal and laboratory studies are studies carried out in laboratories on cells, tissues or animals. Laboratories provide tightly controlled conditions that have a broad impact on human health.
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