Answer:
irregular ovulation ( D )
Explanation:
Irregular ovulation is not one of the common causes of infertility. , The quality of the eggs in women/ size of the eggs affect the fertility status in women and this quality is affected by declining hormone levels that occur with age. while in the case of irregular ovulation the woman will have to put in more effort to determine her most fertile time but it won't affect her ability to conceive in general.
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.
Answer:
3 Monitor intake and output
Explanation:
This client is admitted for heart failure and acute pulmonary edema, which means that his/her heart is not pumping blood as it should, and that there's liquid in the lungs, causing the client symptoms such as dyspnea (shortness of breath).
IV Furosemide, a loop diuretic is prescribed. This drug increases renal excretion of water and electrolytes out of the body, resulting in the mobilization of excess fluid from the body and a decrease in blood pressure. The indication to give the client a second dose of furosemide in an hour is because of its delayed effect.
Since furosemide causes liquids to exit the body, it is important to monitor fluid balance in order to evaluate the effectiveness of this medication. Monitoring fluid balance refers to observing and registering all liquids that come in (IV, orally) and out (urine) of the body. For the client, being admitted to the hospital and receiving IV medication, the nursing personnel should be registering all the liquids the client is receiving (IV and orally) and voiding (urine).
