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japanologydiaries · 4 years

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Vocab from Shinzo Abe’s Twitter Thread, another procrastination measure by yours truly;

[https://twitter.com/AbeShinzo/status/1285877278346375168]

1. 新型コロナウイルス感染症 (しんがたコロナウイルスかんせんしょう): COVID-19. (新型 - しんがた: new type; new style; new model) , ( 感染症 - かんせんしょう: infectious disease; infection)

2. 現状 (げんじょう): present condition, status quo, current state

3. 専門家 (せんもんか): specialist; expert; professional; authority

4. 分析 (ぶんせき): analysis

5. 評価 (ひょうか): 1. valuation; appraisal; evaluation; assessment. 2. appreciation; recognition; acknowledgement, praising

6. 状況 (じょうきょう): state of affairs (around you); situation; circumstances

7. 拡大 (かくだい): magnification, enlargement, expansion, amplification.

8. 警戒 (けいかい): vigilance; caution; alertness; precaution..

9. 検査 (けんさ): inspection (e.g. customs, factory); examination; scan (e.g. MRI, PET, etc.) + 体制 ( たいせい): order; system; structure; set-up; organization; organisation

10. 拡充 (かくじゅう): expansion

11. 医療 (いりょう): medical care; medical treatment + 提供 (ていきょう): providing; supplying; making available; donating (blood, organs, etc.) (...) + 体制 (たいせい)

12. 整備 (せいび): 1. maintenance; servicing/ 2. putting in place; establishment; development; preparation; provision; outfitting...

13. 主に (おもに): mainly, primarily

14. 重症者 (じゅうしょうしゃ): the seriously ill

15. 踏まえる (ふまえる) 1. to be based on; to take into account; to build upon; to have origin in/ 2. to have one's feet firmly planted on; to plant oneself on

16. 緊急事態宣言 (きんきゅうじたいせんげん): declaration of a state of emergency

17. 異なる (ことなる): to differ; to vary; to disagree

18. 他方 (たほう): 1. one (esp. of two); the other; the other way; the other direction; the other party... 2. on the other hand

19. 足元 (あしもと): 1. at one's feet; underfoot; one's step (as in "watch your step") 2. most recent; current (see a dictionary for the rest)

20. 新規 (しんき): new, fresh + 感染者 (かんせんしゃ): infected person

21. 大規模 (だいきぼ): large-scale

22. 現在 (げんざい): now; current; present; present time; as of

23. 上限 (じょうげん): upper limit

24. 設定 (せってい): 1. establishment; creation; posing (a problem); setting (movie, novel, etc.); scene/ 2. options setting; preference settings; configuration; setup (Computer terminology)

25. 維持 (いじ): maintenance; preservation; improvement

26. その上で (そのうえで): moreover; in addition

27. 最も重要 (もっともじゅうよう): most important; central; matters most

28. 効果的 (こうかてき): effective; successful

29. 防止策 (ぼうしさく): preventive measures

30. 講じる (こうじる): 1. to take measures; to work out a plan/ 2. to lecture; to read aloud

31. 段階的 (だんかいてき): stepwise

32. 回復 ( かいふく): 1. restoration; rehabilitation; recovery; return; replevin; improvement/ 2. recovery (from an illness); recuperation; convalescence

33. 両立 (りょうりつ): compatibility; coexistence; standing together

34. 図る (はかる): 1. to plan; to attempt; to devise/ 2. to aim for; to strive for; to work towards; to seek.. (see a dictionary for the rest)

35. 都道府県 (とどうふけん): administrative divisions of Japan: Tokyo-to, Hokkai-do, Osaka-fu, Kyoto-fu and remaining prefectures

36. 連携 (れんけい): cooperation; coordination; link

37. 更なる (さらなる): even more; still more; further

38. 強化 (きょうか): strengthening; intensifying; reinforcement; enhancement...

39. 事業者 (じぎょうしゃ): 1. business person / 2. operator; carrier

40. 業種別ガイドライン (ぎょうしゅべつガイドライン): industry-classified guidelines (each industry has its own guideline type of a thing, from my humble understanding..)

41. 遵守 (じゅんしゅ): observance (of laws, rules, etc.); adherence; obeying; following; abiding by; compliance

42. 徹底 (てってい ): 1. thoroughness; completeness; consistency/ 2. thorough enforcement; seeing to it that a policy, etc. is carried out without exception

43. 同時に (どうじに): coincident with; while; simultaneously

44. 重症化 (じゅうしょうか): aggravation (of an illness); exacerbation; worsening

45. 高齢者 (こうれいしゃ): old person; old people

46. 基礎疾患 (きそしっかん): underlying disease; primary illness; underlying condition

47. 感染拡大 (かんせんかくだい): spread of infection

48. 何としても (なんとしても): no matter what it takes; by any means necessary; at all costs

49. 防ぐ (ふせぐ): 1. to defend against; to protect against/ 2. to prevent; to avert; to avoid

50. 医療機関 (いりょうきかん): medical institution

51. 施設 (しせつ): 1. institution; establishment; facility, 2. home (for elderly, orphans, etc.)

52. 速やか (すみやか): quick; speedy; prompt; rapid; swift

53. 出張 (しゅっちょう): business trip; official trip + 方式 (ほうしき): form; method; system; formula

54. 実施 (じっし): enforcement; implementation; putting into practice; carrying out; operation; enactment

55. 検討 (けんとう): consideration; examination; investigation; study; scrutiny; discussion; analysis; review

56. 連休 (れんきゅう): consecutive holidays

57. 回避 (かいひ): evasion; avoidance

58. 控える (ひかえる): to be temperate in; to refrain; to abstain; to hold back; to restrain oneself from excessive (...) [see a dictionary for the rest]

59. 消毒 (しょうどく): disinfection, sterilisation

60. 換気 (かんき): ventilation

61. 諸国 (しょこく): various countries; various regions; various provinces

62. 水際対策 (みずぎわたいさく): protection measures at ports and airports (against smuggling, disease, etc.)

63. 既存 (きそん): existing

64. 措置 (そち): measure; step; action

65. 延長 (えんちょう): extension; elongation; prolongation; lengthening

66. 入国 (にゅうこく): entry into a country + 拒否 (きょひ): refusal; rejection; denial; veto + 対象 (たいしょう): target; object (of worship, study, etc.); subject (of taxation, etc.) + 地域 (ちいき): area, region

67. 追加 (ついか): addition; supplement; appending; appendix

68. 流入 (りゅうにゅう): afflux, influx

69. 防止 (ぼうし): prevention; check

70. 万全を期す (ばんぜんをきす): to make absolutely sure; to make doubly sure (万全 - ばんぜん: perfection; flawlessness)

71. 国際的 (こくさいてき): international

72. 往来 (おうらい): 1. coming and going; traffic/ 2. road; street (..)

73. 再開 (さいかい): reopening; resumption; restarting

74. 順次 (じゅんじ): in order; sequential; seriatim

75. 重要 (じゅうよう): important; momentous; essential...

76. 再入国許可 (さいにゅうこくきょか): (immigration) re-entry permit

77. その際 (そのさい): in so doing; when you do so; in this regard; on this occasion; some time during that period

78. 観点 (かんてん): point of view

79. 居住 (きょじゅう): residence; abode; dwelling

80. ＰＣＲ検査 (ピーシーアールけんさ): polymerase chain reaction test + 証明 (しょうめい): proof; verification; certification

81. 取得 (しゅとく): acquisition; obtaining; gaining possession; purchase

82. 人材 (じんざい): 1. capable person; talented person/ 2. human resources; personnel

83. 協議 (きょうぎ): conference; consultation; discussion; negotiation

84. 調整 (ちょうせい): adjustment; regulation; coordination; reconciliation; tuning; fixing; tailoring

85. ニーズ : needs; demands; requests

86. 勘案 (かんあん): taking into consideration; giving consideration (to)

87. 防疫 (ぼうえき): communicable disease control (e.g. by quarantine, disinfection, etc.); prevention of epidemics

88. 要件 (ようけん): 1. important matter/ 2. requirement; requisite; necessary condition; sine qua non

89. 短期間 (たんきかん): short term; short time

90. 限定 (げんてい): limit; restriction

91. 枠組み (わくぐみ): 1. frame/ 2. framework; outline

92. 導入 (どうにゅう): introduction; bringing in; leading in; installation

93. 開催 (かいさい): holding (a conference, exhibition, etc.); opening; hosting (e.g. the Olympics)

94. 我が国 (わがくに): our country; our land; one's own country

95. 能力 (のうりょく): ability; faculty

96. 不可欠 (ふかけつ): indispensable; essential

97. 厚生労働省 (こうせいろうどうしょう): Ministry of Health, Labour and Welfare

98. 関係省庁 (かんけいしょうちょう): the concerned government agencies; the ministries and agencies that are relevant to the matter at hand; the relevant authorities

99. 早急 (そうきゅう): immediate; prompt; quick; rapid; urgent; pressing

100. 各位 (かくい): everyone; each and every one (of you); ladies and gentlemen

101. 抑え (おさえ): 1. keeping control; exercising authority/ 2. having self-control; exercising self-discipline/ 3. defense; guard; deterrence...

102. 地方自治体 (ちほうじちたい): local authority; local government; locality; local self-governing body; municipality

103. 対策 (たいさく): measure; step; countermeasure; counterplan; countermove; strategy; preparation (e.g. for a test)

104. 首相官邸 (しゅしょうかんてい): prime minister's official residence

#learning japanese #japanese vocabulary #long post #also I'm shadow-banned or something as my posts don't show up in the tags #ah well

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sqursol · 4 years

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Mental Health and Covid-19

Introduction:

The current pandemic due to the novel Coronavirus (SARS-COV-2), COVID-19, has resulted in considerable stress to the health systems throughout the world. COVID-19 pandemic has left in its wake an unprecedented challenge for mental health services across the world. With almost all affected, mental health service delivery to address the psychological consequences at the individual level has become near impossible. Pandemics, like other natural disasters, negatively affect the mental health of the community in general and those with pre-existing mental illness in particular. While natural disasters also result in significant stress and strain to the health systems, the relative non-involvement of other regions allows one to divert the health resources from other regions.

As the focus during a disaster is on stress and anxiety-related disorders, there needs to be literature on the specific needs of people with severe mental illness during pandemics. Considering that a considerable proportion of patients with severe mental illness require continued management even during a pandemic, strategies to continue the care need to be developed. Otherwise, disruption to or absence of access to care can have serious negative consequences in patients with severe mental illness.

Different aspects:

The existing health services are at its breakpoint to control the spread and reduce the mortality of COVID-19. Policymakers though aware of the mental health consequences are prioritizing the capacity building of the health services and attempting to reduce the socio-economic hardships of communities following COVID-19.

Mental health issues noted in (biological) disaster zones including COVID-19 can be classified into an acute phase during the outbreak (approximately 2-6 months) and long-term phase after the control of the outbreak (>6 months).

a) Acute Phase (during the outbreak) – Issues to be dealt with include immediate mental health impacts such as fear, denial, anxiety, insomnia, dissociative symptoms, depressive symptoms, suicidal ideas/attempts, substance withdrawal, and relapse of pre-existing mental health problems. Besides, stress-related issues of the health care providers and frontline personnel need to be addressed.

b) Long-term phase (after the control of the outbreak) – Issues commonly presenting include grief, survivors’ guilt, depression, substance use, relapses of pre-existing mental illness, PTSD, and somatization disorders. The major stressor during this period will be the direct and indirect socio-economic impact of COVID-19. Along with the diagnosable mental health issues, the affected community also harbors a large number of the worried well. Mental health professionals should be aware of this phenomenon and restrain themselves from labeling this population with mental disorder and treating them aggressively with medications.

In addition, all health care and frontline personnel should be aware that mental health issues post-COVID-19 (or any disaster), represent the emotional reactions of normal people in abnormal situations and for a majority these symptoms are self-limiting.

Case Finding:

There are possibly three streams for case-detection/identification of mental health issues that need to be focused in the acute phase of COVID-19.

1. Case Identification by front-line medical and non-medical personnel (including police officers, Members of Local Self Government, Community/health workers)

- Points of entry into the country/state –Airport/Railway Station/State borders etc.

- Home quarantine visits

- Other Medical Emergencies

2. Case Identification by health care professionals (non-psychiatric)

- Hospital quarantine/isolation

- Routine out-patient assessment for other illness

3. Self-referral/Walk-ins to mental health professionals

4. Identification of frontline medical and non-medical personnel in need of help/support for stress management or burnout

5. Screening of the high-risk (vulnerable) population once Community Transmission is established

Who are the most Vulnerable?

· Children

· Senior citizens

· Pregnant women

· Persons with disability

· Homeless individuals, Poor social support & lower economic status

· Marginalized communities

· Life-threatening chronic medical conditions like cancer, chronic renal failure, liver diseases, asthma/COPD, immunocompromised patients

· History of severe mental illness and wandering mentally ill

Mental Health Issues:

1. Mental Health Issues of Home Quarantine:

Quarantine is defined as the separation of people who have been exposed to a contagious disease to ascertain whether they become sick, thereby reducing the risk of them infecting others. Presently governments across the world and in India are using a combination of measures to stop the spread of the COVID-19 pandemic. While considered essential under the present circumstances, quarantine can be a taxing and distressing experience for many. Based on studies from previous epidemics/ pandemics we shall identify some of the mental health concerns which people in quarantine face and propose solutions/remedial measures for the same. It must be acknowledged at the outset that we could not find any intervention studies which have examined the effectiveness of the various remedial measures. Rather, these measures are proposed based on the problems people in quarantine had faced in previous epidemics.

2. Mental Health Issues in Hospital Quarantine/Isolation:

Quarantine is done for the larger interest of the community by curtailing the right of the individual. The quarantine can lead to physical, psychological, emotional, and financial stress due to fear of contracting the illness, boredom, loneliness, loss of personal freedom, a new set of daily routine, and lack of social togetherness.

The mental health issues following the hospital quarantine period can be

a. New-onset mental health problems

b. Exacerbation of pre-existing mental health problems.

3. Mental Health Issues in Children and Adolescents Children:

All of us, children included, are trying to make sense of the overwhelming uncertainty in front of us due to the global pandemic caused by the Coronavirus (COVID-19). Children and adolescents have already been at home – with schools being shut early – for over three months in several parts of India. Their regular schedules have been disrupted, with no clear idea of when they will be restored. Children may experience a range of psychological issues such as anxiety, fear, worry, depression, difficulty sleeping, and loss of appetite.Quarantine and isolation may also lead to an acute stress disorder, PTSD, and grief in many children. Children with various physical and mental disabilities – and especially mental health disorders – are more vulnerable during this trying time.

Social isolation may worsen the living situation of children in abusive environments as well as children with special needs. Children may even go through loss and grief at this time.

4. Addressing Mental Health Issues among Pregnant and Postpartum Women during COVID-19:

Positive mental health is particularly important during pregnancy and postpartum. Currently, available literature has consistently shown an association between depression, anxiety during pregnancy, and small for gestational age, low birth weight, and preterm delivery. During the postpartum period around 10-15% of women experience depression and anxiety.

It has also been observed that postpartum depression is one of the reasons for poor bonding with their babies. In the current period of COVID-19 pandemic, even routine visits to health care facilities for antenatal care and infant immunization are likely to create a great sense of anxiety in mothers about their health and that of their unborn or newborn baby. It is thus a matter of priority to address these concerns to ensure positive mental health and early interventions for perinatal mental health issues.

Ø Symptoms of anxiety and psychological distress during the perinatal period related to COVID-19:

· Excessive worry about getting the infection even when all precautions are being taken and even after reassurance

· Lack of sleep because of anxiety

· Focusing excessively on social media messages about COVID-19

· Getting anxious about infection control procedures in family members

· Excessive worrying about missing work

· Feeling sad and angry because of isolation and not being able to meet family and friends

· Feeling nervous, anxious, or on edge

· Not being able to stop or control worrying

· Trouble relaxing

· Being so restless that it's hard to sit still

· Becoming easily annoyed or irritable

· Feeling afraid as if something awful might happen

5. Suicidality in the context of COVID-19 Pandemic:

The ongoing COVID-19 pandemic worldwide has been increasingly associated with suicides. Instances of suicide in the context of the pandemic have been reported among individuals who have tested positive for COVID-19 infection, those who have suffered severe financial setbacks. The COVID-19 pandemic has led to significantly increased levels of stress at the community, family, and individual levels with a consequently increased vulnerability to suicide.

6. Counseling for home quarantined using telephone helplines and telepsychiatry:

For subject’s in-home quarantine, supportive counseling can be provided by telephone helplines and telepsychiatry platforms. These have an important advantage over the face to face counseling, as they provide specialist services, which can be accessed from the convenience of peoples' homes without endangering the health personnel and the larger community.

Telepsychiatry Video Consultations (VC)

In the background of the COVID-19 pandemic, advancements in digital communication (telepsychiatry) has meant that there are means to overcome this to a great extent. During the ongoing COVID-19 pandemic, it may be a safer alternative to provide infection-proof consultations from both the user (patients and their family) and the provider (psychiatrists).

What is telepsychiatry?

It means that patient care is provided by the psychiatrist to the service users employing digital technology.

Conclusion:

In conclusion, considering the possible higher risk of contracting the infection, patients with severe mental illness requires special attention. Continuation of community-based treatment is essential to prevent relapse or worsening of the severe mental illness which can add additional burden to the stressed health infrastructure. Technology platforms need to be widely used for teleconsultations to achieve the same.

Quarantine, isolation, and social distancing in the times of a raging pandemic can be psychologically distressing for many people. However, there are simple and effective actions that you can take as a health care provider. Psychological issues following the pandemic are likely to be common. Most affected will require only brief assessments and immediate support. Given the lack of knowledge base, a clinical decision needs to be made and treatment for COVID-19 needs to be individualized in patients with severe mental illness.

#mentalheathawareness #mental health #assignment #covidー19 #staysafestayhealthy #staysafe #stayhealthy

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not-your-prisoner-anymore · 4 years

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A Reminder That...

While the Coronavirus disease is very dangerous; panic, negligence, denial, and social stigmas can kill far more people in a much shorter time.

More tips below the cut...

Remember:

Wash your hands and face regularly.

Clean your living/workspaces regularly.

Use hand-sanitizer whenever you come across it.

Keep your distance from others you believe are sick or are vulnerable to becoming sick soon.

Avoid using your hands for things if you don’t have to.

If you believe you’re experiencing symptoms, do your very best to avoid contact with others.

Make a call to a medical center before you plan on visiting for help.

Avoid large gatherings.

Avoid contact with the elderly and small children/babies unless necessary.

Talk with those you know to spread information and remind them to keep calm and play their part in preventing its spread.

Only buy food, supplies, etc., you legitimately need to avoid taking them away from those who need them more. ( i.e., medical professionals, caretakers, minimum wage workers, immunocompromised people, etc.)

The virus is referred to professionally as "COVID-19", "2019-nCov", or "2019 Novel Coronavirus".

#coronavirus #corona outbreak #coronavirus disease #covid-19 #tumblr

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daniels09stuff · 2 years

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Medical Billing Services In 2022 – Changes To Expect

Due to the COVID pandemic, hospitals had to operate on tight margins and extract the maximum out of the revenue cycle more than ever. The pandemic highlighted the importance of medical billing services all the more as it had become a struggle to keep up with the testing and immunization records. The post-COVID healthcare industry will be much more complex than earlier. In the coming year of 2022, this will result in the introduction of key technologies and process innovations to improve business outcomes.

There have been a few recent changes that have impacted the medical coding and billing industry significantly. Let’s understand these changes and how they might affect 2022.

Adding COVID-19 Codes

The sudden pandemic and its effects forced the healthcare industry to make some changes in their system, to cope up with the situation. A few codes had to be added for streamlining and tracking the procedures, medical tests for COVID detection, treatment, and immunization related to it. These changes will be an important part of the medical billing system, specifically in 2022.

Transitioning to New ICD Systems

The medical billing industry has already made a major shift to ICD-10 from ICD-9. It is a global system used to classify and code symptoms, diseases, and medical procedures. Though ICD-10 was implemented as early as 1999 for reporting mortality, it was very recently implemented by medical providers and insurance companies. The new system made way to more than 140,000 new diagnostic codes and procedures.

The World Health Organisation (WHO) has already approved the usage of ICD-11 from January 2022. Hence, the new system will come with more changes; for which all professionals need to be trained to keep up with the new codes, rules, etc. This will also shed light on the importance of continual training that goes beyond certification credits or continuing education units (CEUs).

Replacing Medicare Physician Fee Schedule

This recent major change enacted by the Centers for Medicare and Medicaid Services (CMS) in 2021, is one of the first implemented in more than 10 years. Hence, reimbursements and fee schedules in the future will be changing. This will also require professionals to get additional training to keep following the new changes.

Increased Automation

Automation has proved to be a boon in the healthcare industry by helping to reduce physician burnout, increasing accuracy, and streamlining workflow. It has efficiently boosted productivity for various professionals through processes like automated appointment reminders, online scheduling, or patient check-ins. Not only for saving time, but automation has also helped in reducing delays and denials during reimbursements.

The next year and the future look promising on this front. Increased automation can provide for more thorough documentation and completion of tasks in less time.

Increase in Use of Artificial Intelligence

With the other industries, healthcare has also adopted AI and machine learning as its part. It has helped to cut costs and increase patient satisfaction by integrating billing workflows and creating work queues for claim re-submissions. It has also been used to correct and verify the demographic information of patients and customize billing statement releases.

It’s a myth that AI being a part of Computer-Assisted coding (CAC) will reduce human jobs, but it has been proven that the software has been less accurate without the help of a professional human coder. The technology is perfectly designed to enhance the capabilities and increase the productivity of medical billing professionals.

Aligning EHR Software

Almost 86% of office-based physicians already use the EHR software and it has many proven advantages. This feature never stops expanding and surely won’t in the coming year too. It ensures robust reporting and helps perform digital payment processing via patient portals. It also helps in reducing the need to photocopy each billing sheet, using cleaner claims to reduce coding errors, accessing data from a single location, and keeping manually filling forms at the minimum.

Changes in Medical Billing Industry Statistics and Outlook

According to the Bureau of Labour Statistics, employment in the field of medical billing is expected to grow by 8% on a national level in 10 years, from 2019 to 2029.

Family healthcare insurance plans have moved to a higher-deductible model and consumers will be able to use their Health Savings Accounts (HSAs) for covering the costs.

Patients have become more aware of their payment responsibilities and generally want to know their bills upfront considering the growth of electronic payments. Unfortunately, traditional medical billing may delay the collection process by as much as 30 days. The industry is coming up with new payment models such as Revenue Cycle Management (RCM) which can help manage patient payments easily and streamline the whole process.

Some other upcoming changes in 2022:

CMS has come up with a few provisions related to the Affordable Care Act (ACA) coming into effect in 2022. It will help in better medical access for U.S. residents.

The European Commission has proposed an AI-based framework for Europe, which might be the first legal framework and might come into effect in 2022.

The No Surprise Act coming in 2022 for Americans will make health providers treat out-of-network services as in-network services, except ground ambulance transportation.

Even if it is the most crucial part, selecting the proper code and accuracy continues to be challenging in this constantly evolving field. It is integral for efficient working of bill payments and preventing fraud at the same time. Educating all the professionals periodically about billing system changes, insurance regulations, Medicare policies, and medical privacy laws.

Outsourcing Medical Billing Services to the Rescue!

Outsourcing medical billing to another company helps providers focus more on patients, increase productivity, and reduce burnouts. It enables providers to allocate their resources in other aspects of their business. Plus, these companies who take up the outsourced work are compliant with the current healthcare regulations and strive to ensure steady growth. Outsourcing help businesses lessen their burden as they take care of all aspects of revenue cycle management, manage the accounts receivable, and timely submission of claims for reimbursements.

Consider choosing 24/7 Medical Billing Services for all your needs. Simplification of your billing, dedicating resources to payer reimbursements, and ensuring the accuracy of claims; everything will be taken care of!

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yoursmithjorden · 2 years

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Medical Billing Services In 2022 – Changes To Expect

There have been a few recent changes that have impacted the medical coding and billing industry significantly. Let’s understand these changes and how they might affect 2022.

Adding COVID-19 Codes

Transitioning to New ICD Systems

Replacing Medicare Physician Fee Schedule

Increased Automation

The next year and the future look promising on this front. Increased automation can provide for more thorough documentation and completion of tasks in less time.

Increase in Use of Artificial Intelligence

Aligning EHR Software

Changes in Medical Billing Industry Statistics and Outlook

According to the Bureau of Labour Statistics, employment in the field of medical billing is expected to grow by 8% on a national level in 10 years, from 2019 to 2029.

Family healthcare insurance plans have moved to a higher-deductible model and consumers will be able to use their Health Savings Accounts (HSAs) for covering the costs.

Some other upcoming changes in 2022:

CMS has come up with a few provisions related to the Affordable Care Act (ACA) coming into effect in 2022. It will help in better medical access for U.S. residents.

The European Commission has proposed an AI-based framework for Europe, which might be the first legal framework and might come into effect in 2022.

The No Surprise Act coming in 2022 for Americans will make health providers treat out-of-network services as in-network services, except ground ambulance transportation.

Outsourcing Medical Billing Services to the Rescue!

Read more: How To Find The Right Medical Billing Outsourcing Company?

#medical billing #medical billing and coding #medical billing company #medical billing specialist #medical billing services #outsourced medical billing and coding

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astronehs · 3 years

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Challenges of Talent Shortage in Healthcare Revenue Cycle Management

The lack of sufficient healthcare professionals as well as revenue cycle management staff, mounting losses and spiraling account receivables have burdened the healthcare sector that is struggling to cope due to shortage of talent at every step.

As healthcare institutes in US scramble to navigate through the widening gap of population vs resources, let us look at the challenges posed and some reasons for the crisis.

Growing Cost of Healthcare

The US is known for one of the highest healthcare costs in the world. In 2018, healthcare costs increased from 5% of GDP to 18%. CMS (Centers for Medicare and Medicaid Services) projects the increase to 20% by 2028 which is roughly $6.2 trillion or $18,000 per person. This does not even include the pandemic related costs of testing, treatment and short- or long-term impacts.

- Aging population: The American Association of Medical Colleges (AAMC) observed that the 65+ population in the country will grow as much as 48% by 2032 leading to an intense scarcity of physicians, nurses and other healthcare professionals.

- Key drivers of healthcare costs: Cost of healthcare services rises faster than the inflation in the economy. Other factors include new technology leading to more expensive procedures, provider-payer technologies causing administrative waste, branded hospital experiences, monopolies, etc.

Impact of COVID-19 on Hospital Margins

Some factors driving negative margins for hospital operations during the pandemic are recovery rates of hospital volumes (degree and speed at which inpatient, outpatient and emergency department volumes return), COVID-19 vaccination process and decline in COVID-19 cases.

As found by Kaufman Hall, a resurgence of COVID-19 is also impacting physician practices. They experienced increased expenses in second half of 2021 and high level of physician investments.

CARES Act Funding

The Coronavirus Aid, Relief and Economic Security Act, was passed by the Congress in March 2020 to provide immediate and quick economic relief to American people impacted by the pandemic. The American Hospital Association reported that the CARES Act allotted $178 billion to providers, of which $148.4 was disbursed. Only $70 billion has reached the hospitals.

The funds have not proven enough to mitigate the losses faced due to a reduction in inpatient volumes, which means hospitals may experience the financial impact beyond 2021.

State of Accounts Receivable Numbers

With an already bad cash flow situation at practices, the federal government’s mandate for vaccination of all healthcare workers has led to hasty work from home adaptation in organizations.

As workers show reluctance to return to office-based model, or the lack of software or training for streamlined remote RCM services like payment posting, claim submission, patient registration, etc., it is increasingly difficult to recover the accounts receivables that keep piling up.

Shortage of Revenue Cycle Management Staff

There is no denying the short supply of expert medical billers, coders, accounts receivables and denial management specialists, front office and patient experience representatives. It existed before the pandemic and has worsened during the pandemic, mainly due to burn out, increased workload and latest vaccination mandate.

As demand for elective surgeries is rising and inpatient volume is increasing, the demand is intensifying. The mammoth task of handling backlog of accounts receivables is also an issue. Looks like the problem of shortage of staff trained in HIPAA compliance, latest billing and coding techniques and software has finally caught up with practices.

While providers look for solutions to expand their care and treatment services, the financial and administrative aspect can be handled to a great extent with the following strategy!

A Strategy to Start With – Outsourcing RCM

With reliable medical and dental billing companies like Astron EHS, key functional areas of revenue cycle management like patient registration, eligibility & insurance verification, claims filing & submission, credentialing & provider enrollment, accounts receivables, payment posting, denial management and more can be handled seamlessly.

The manpower issue faced by practices at this end can be quickly eliminated, leading to an increase in revenue and overcoming the AR backlog.

With latest technology, teams trained in billing, updated ICD codes and denial management, such companies are the answer to faster and efficient medical billing services. Astron EHS also offers additional services such as medical answering service, patient statements and secondary claims submission.

Have questions? Get in touch with Astron EHS today!

#account receivables #RCM services #payment posting #medical and dental billing companies #medical billing services

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pinkobservationwizard · 3 years

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A Guide On Durable Medical Equipment Billing

Medicines or other medical equipment’s can be readily available from a pharmacist, or any resources. But the pharmaceutical industry does not only rely on medications, right? Often the patient’s health deteriorates to the extent that they have to rely on life-saving resources. But what exactly is a Durable Medical Equipment?

Durable Medical Equipment is the abbreviated form of DME. It is an item that is prescribed to patients who suffer from some severe medical conditions. Some medical conditions may weaken the body to such an extent, and they need a source to support their life. Such resources are termed as DME’s.

Durable Medical Equipment Billing is managing the overall activities that are taken place to claim for the equipment you rent. The documentation and every minor detail have to be clearly monitored as any misplaced document, or incorrect information can directly lead you to higher chances of denial for claims.

Durable Medical Equipment Industry:

DME Industry is necessary, in all regards. When you look at medical history, so many patients suffer from chronic, life-threatening diseases. For instance, the entire world is right now shaken by the Covid-19 virus. There is an utmost need for the DME’s. When a patient is dying out there, is it necessary to treat them first or to have the documents sorted?

For such instances, there’s a dedicated group of companies that will work on the complete management of renting or purchasing such equipment and helping the individuals gather the relevant data and papers which can help them to claim for such a tremendous amount.

Also, it is your responsibility to look after your dear ones in such times and not indulge in some secondary affairs. These companies take up all your worry and liberate you from any possible issues. At the same time, making sure you’re not denied from the financial help you deserve.

There are a lot of devices and equipment that fall under the Durable Medical Equipment. Few of the common and commonly heard are – Walkers, Crutches, Wheelchair, Hospital Beds, Oxygen related equipment, blood sugar monitoring, braces, mobility devices, ventilators, etc. While these are equipment that may not necessarily be purchased but rented for a specific amount, then, in scenarios like this- the billing and the proper coding is to be made sure. The claims will help the patient pay those massive heap amount.

Durable Medical Equipment Coding and Durable Medical Equipment Billing

Healthcare Common Procedure Coding System (HCPCS) is a standard code build for providers in the medical industry for health insurances and Medicare. The DME is a complicated procedure as compared to the other medical billing issues. This type of situations falls under HCPCS Level II codes.

The Durable Medical Equipmentbilling is a procedure, and hence every step must be taken care of, failing, which can lead to a lesser chance of reimbursement. The code should be formulated perfectly, and the entities must be clearly and precisely defined. The information must be on point, and there is no space for any sort of ambiguity.

Multiple people come into picture while DME coding and billing process takes place. From doctors to the patient’s side, Durable Medical Equipment supplier and the coder to the insurance company. All must meet the ends to ensure that the patient is not incurred in debts or losses, the insurance company extends its support.

The entire procedure needs to be done in the proper flow. There is an algorithm that is usually followed for such systems.

Once the doctor finds a requirement of any DME for a patient’s medical condition, the documents must be made which will help for claims submission.

Upon a request risen for DME, the patient’s end will reach out to a DME supplier. The coder here needs to provide the proper prescription and also collect the patient’s insurance company.

The insurance company may also expect a check from their end. The use of the equipment and the agreement on paying for the equipment as the claim, all these sorts of business are settled here.

Upon finishing the necessary paperwork, the material is handed to the patient.

The medical coding is then done, the proper use of codes and the correct information is to be made.

The entire procedure is encrypted in the code and handed to the insurance company. The appropriate authorization and billing are needed to ensure the insurance company is liable to pay the claim amount to the patient

There are a lot of services offered, like medical billing companies. They keep a record and check if all the documents are on point, and no incomplete or fake information is handed. The process is much complicated and tedious than expected.

The services obtained from a reliable medical billing company is utmost necessary in such regards. They take care and make sure all the documents are genuine, and all the paperwork is on point.

What Are Modifiers in Durable Medical Equipment Billing?

There is so much information related to any particular item. Any single code may not be sufficient to point out all the features and information. Hence, to have some extra information regarding the subject, modifiers are something to rely on.

From encrypting the information to giving the details needed for any particular Durable Medical Equipment, modifiers can be used with the HCPCS code. A modifier is used to provide more information. There are many keywords that are used but below mentioned are some of the widely observed modifiers.

RR – Rental

NU – New Equipment purchase

UE – Old Equipment Purchase

Even digging deeper, there are few other keywords that point out at the Rental period. For instance,

KH – First-month rental

KI – Second and third-month rental

KJ – Fourth to 13th-month rental

Outsourcing of Durable Medical Equipment Billing:

It is beneficial in all regards to outsourcing DME billing and coding as it eliminates a lot of headaches and is a plethora of time-saving and cost-saving techniques. Instead of rubbing your heads on the documents and other sources, the doctors and health practitioners can concentrate more on the treatment of the patients.

The dedicated team is already skilled enough to deal with this and hence the time to train your staff or hire people to take care of these billing requirements.

The revenue can also be increased in terms of infrastructure and staff. With no need to hire more people and train them, this surely can be your brownie point.

The DME billing is time-consuming and tedious. It can end up taking a lot of your considerable time. This time can be productively used in taking care of the patients.

The billing stuff is trained and upgraded with the latest take in the market. They’ll be smart enough to tackle all the happenings in the market.

The reliable third-party sources will also make sure that the proper codes and accurate information is handed and nullifies the possibilities of generating errors. The work is done precisely and in the stipulated time period.

There is a lot of popular software available in the market that handles the task of DME billing. While the number may go on increasing, some very popular ones have been gaining a reputed position and are reliable for all sorts of DME Billing procedures.

Brightree is one of the most renowned and trusted software solutions for all your queries on Durable Medical Equipment’s Medical Billing. Helping you with all the steps, they have helped a handsome amount of people get their claims. From assisting you in generating revenues, they are one of the leading solutions.

Other widely used options are – Practice Suites, Provider Suite, Bflow Solutions. They are one of the most reliable and widely used software available in the market for billing of the durable medical equipment. They are used by professionals who ensure the complete management of billing these types of equipment and its uses.

Most Common ICD 1O codes used with Durable Medical Equipment Billing

There are few frequently used ICD 10 codes which target the problems coming under the Durable Medical Equipment Billing. Some of the commonly used ones are: –

E0100-E0159 – Walking Aids and Attachments

E0163-E0175 – Commode Chair and Supplies

E0181-E0199 – Pressure Mattresses, Pads, and Other Supplies

E0250-E0373 – Hospital Beds and Associated Supplies

E0424-E0487 – Oxygen Delivery Systems and Related Supplies

E0621-E0642 – Patient Lifts and Support Systems

E0950-E1036 – Wheelchair Accessories

In a nutshell

Durable Medical Equipment is used by healthcare professionals when there is a need for the patient to rely on some external sources to support his health and body. Such items bare a cost even if rented, hence there is a complete procedure to undergo for the perfect documentation and other paperwork.

Durable Medical Equipment Billing is often taken as a different department and several experts make the whole process by themselves. When the need arises for a specific Durable Medical Equipment, the prescription is taken to the Durable Medical Equipment supplier. This is coded in the proper format and presented to the insurance company. Proper authorization check, if needed is done and the insurance company checks from their end. The entire documentation and paperwork are then handed to the insurance company and the claim can be generated.

A Durable Medical Equipment Billing is a tough task and hence the software or companies make sure to not indulge in any false or inappropriate information. Clear and concise data is to be given. These types of services should not be constrained in any timeframes. The services should be made available 24*7 for fellow patients. After all, the need for a medical emergency arises at any odd hour. There is no advance notice or time limit for such cases.

Thus a dedicated team can take over these tasks to ensure that the work is done precisely and with no loss for the doctor in terms of time and money. Outsourcing the Durable Medical Equipment Billing & Coding is a suitable and well-chosen option.

Also, Credentialing services are time-consuming and may cost you high? Well, we are here to ease your troubles. Free Credentialing will be provided by us to cater all your needs and the services will not have you bang your head on the tiresome work. We are here to take care of the minute things that might have troubled you. Rely on our services as we offer you the best we can!

#dme billing #billing services #healthcare professionals #icd-10

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lupine-publishers-sjpbs · 4 years

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Lupine Publishers | Insights About a Pandemic: Clinical Approach

Lupine Publishers | Scholarly Journal Of Psychology And Behavioral Sciences

Abstract

Many changes have occurred in our world in so many little time, as a novel situation that we all have had to cope with such as a sudden and unexpected pandemic. Psychological approaches such as skepticism, uncontrollability, new emotions to new stimuli, irrational thoughts or behaviors are some common consequences of the situation and we will elaborate them briefly in this text. Some basic clinical and medical explanations about the intermediate specie, common symptoms or possible brain affection are described in the text. With the perspective of a healthy future without viruses attacks, based on Scientific knowledge and the experience of producing laboratory experimental results.

Introduction

The global pandemic year 2020 has been a humanitarian challenge that affected everybody and has changed our lives and routines. Because of the sudden appearance, there is very few experts on Pandemic in the general population. Fear of disease has been daily present in our thoughts and worries in a much higher percentage: ten percent of patients infected with the SARS-CoV-2 generates a severe acute respiratory syndrome and becomes critical, requiring special care from the intensive care unit (UCI). The autoimmune response to this virus in the fight for self-cure might be disproportionate some cases, causing excessive swelling in vital organs which leads to incompatibilities to life. Skepticism and disbelief were common false friends present at the beginning of the spread of the plague. Uncertain or the complete absence of knowledge about its origin, its nature, its spreading behavior, how the metabolism might react, its effects over the organism, medicines to prevent (vaccine) or to cure, etc., were adding panic and fears to the situation, creating the ideal environment for corrupted approaches, faked information, shamanic cures, discrimination or unhealthy unsupportive responses. Government control measures meant in some cases extreme surveillance and complaints from neighbors without much evidence about other people behavior. An infected person could be forcibly examined and quarantined against his/her will. Scientific and clinical teams have worked hard together and improved our contrastable information about the virus and disease: a) the spread ration (R0 = basic reproduction number) of this virus is higher than a normal flu (R0 = 2.5 vs R0 = 1.3), b) the spread mechanism is so aggressive and long lasting (saliva which might remains over superficies for up several days). Coronaviruses over inanimate surfaces like metal plastic, metal or glass had been observed for up 9 days, being the minimal contact time for contagious of 30 seconds [1]. Some cases its effects over organism are of a considerable damage and harm for human life. Mean for incubation period is 5.2 days with the 95th percentile of the distribution at 12.5 days [1], having the 80% of patient’s mild symptoms but the amount of virus enough to spread it.

Intermediate Specie

The host creature for the virus was the bat, because of zoonoses, since this winged creature is the only mammal capable of powered flight for migration and having a longer range to spread the virus very rapidly, compared to land mammals. The most likely path of contaminations would be from the bat to the humans through saliva onto fomites or surfaces or through virus-laden aerosolized urine and faeces, with another intermediate specie (Figure 1) [2, 3]. Bats are able to maintain virus CoVs long-term without showing clinical symptoms or diseases [2]. Common spreader of diseases, the bat has been the inspiration for horror stories such as Dracula and vampires which needs to find new blood to drink for spreading the undead course. Many previous diseases such as Black Death, Spanish influenza, and HIV/AIDS, were caused by zoonoses Lloyd- Smith [4]. Civets, horses, and great apes have been found to be intermediate species for several coronaviruses spreading and amplifying the virus, to subsequently infect humans [2,3].

However, where the fist bat was infected to spill it over to humans remains unclear. How the virus survived outside of it reservoir host to contaminate the recipient host is known yet. The virus exposition had to be in sufficient quantity and time for generating an infection and disease in some intermediate specie. Health authorities are not able yet to accurately find and describe the Patient Zero in the Northern Italian outbreak [3, 5]. Progresses in understanding and combating zoonoses from Science would need a new generation of research schemas that addresses a broader approach of research with including several animals host species to study and several scientific disciplines all together [4].

Skepticism or Denialism

Cognitive skepticism is “an attitude of doubt or a disposition to incredulity either in general or in a particular object” . In 1980 Bertram Brookes published his pseudo-mathematical equation which he was working on for several years:

K (S ) + ΔI = K (S + ΔS )

Where K (S ) means knowledge structure to be known and ΔI the increase of information about the structure. In his own words, the equation “states in its very general way that the knowledge structure K (S )is changed to the new modified structure K (S + ΔS ) by the information ΔI, the is indication the effect of the modification” [6, 7]. According to the formula, the bigger amount of information about the structure, the bigger change over the new knowledge compared to its original. Skepticism might be happening with a small bit of knowledge (ΔI ) which remains the original and new structure almost identical. Concerning to the virus, skepticism might have happened at some point, when curative resources were aimed at the beginning for exaggerated cares to only a few first cases, without a clear perception of coming or priority risks [8].

In Spain there has been 27.135 deceases (6-6-2020), 52 were professionals caregivers (Physicians, Nurses, Psychologist, etc.) from whom 40.961 have been infected (data Red Nacional de Vigilancia Epodemiológica 05-29-2020) (Figure 2). In the Netherlands due to the COVID-19 there was an excess of mortality of about 8,600 people in the period March 9 - May 10 according to the Central Bureau of Statistics (CBS). On the same day, RIVM announced that up to 28% of all registered contamination cases were healthcare workers, or about 8,000 cases. The risk of infection depends not only on personal risks factors, but also upon the general state of the other individuals in the population [4]. During first period and concurrently, different tests for diagnoses where made: positive antibodies tests (light green bars) and PCR, IgM (dark green bars). Second period only PCR and IgM were apply (dark green bars). From Centro de Coordinación de Alertas y Emergencias Sanitarias. Ministerio de Sanidad. Gobierno de España. So many Scientific publications are in the air and some has been published without time to contrast: experimental results are published within only 10 days of revision, being this way of information more similar to the daily News reports than to the rigorously procedure for Scientific texts. Publications based only in N=1 patient have been accepted when that would be unthinkable for Journals in any other circumstances, when life is not under risk. Controlled experiments with manipulated variables compared to control groups and reviewers work would be desirable but were practically inexistent. However, difficulties of working with any sort of mammalian virus hinders such experimentation [3]. That causes contradictive information in a number of Scientific publications during pandemic time, without a calm or quiet study and reading other papers published. However, Science still goes on and a promising treatment with a monoclonal antibody compound against COVID-19 Figure 3 has been experimentally checked in vitro with therapeutically efficacy in Thailand and Holland (Utrecht and Rotterdam) [9,10]. Neutralizing antibodies can alter the course of infection or protect against the virus [10], however large production of monoclonal antibodies might not be affordable in labor intensity, expenses and time consuming [9].

Likely a vaccine is going to be available in 2021 or earlier, because not only massive disease has to be prevented, but also some consequences for health and psychological sequels which are happening in patients after the disease. Inappropriate perception of the facts, worries about well-being of their families and irrational believes are some facts which are causing excessive stress response [11,12]. Parallel clinical diseases have been concurrently diagnosed in COVID-19 patients in relation to the stress, anxiety, immune-depression and also related to disseminated intravascular coagulation and blood coagulation alterations, leading to acral ischemia or dry gangrene [1, 13]. Autoimmune diseases concomitant to the disease COVID-19 or even to the lockout have been found: dermatological no specific reactions in children and adult were described, being unknown yet or remaining unclear whether they come up in response to an infection for the virus or to an emotional/hypersensible reaction [1, 13], in some cases without hospitalization required. To an accurate diagnose, a number of reverse transcription polymerase chain reaction (RTPCR) kits with different primers and probes have been designed to detect SARS-CoV-2 presence genetically. Thermocyclers, incubation temperatures and times have been optimized to get the faster results: in the one-step assay, reverse transcription of SARS-CoV-2 and PCR amplification are happening into one unique simultaneously reaction [14].

Circulation of blood and changes in its coagulation pattern (thrombus, skin deceleration) were found, but no clarity whether they were a cause concurring with the infection or a consequence for the medication. Urticaria, morbilliform rash, vesicular eruptions, acral lesions (“COVID toes”), livedoid eruptions appeared in patients infected. Further microscopically analysis of the skin reveals groups of apoptotic keratinocytes in the epidermis, suggesting a viral exanthema [15]. Symptoms related to the loss of olfaction and taste during the infection COVID-19 (anosmia or hyposmia) were found in a few patients, likely due to the lower respiratory track diseases in uncomplicated early stage (fever, dry cough, weakness) [16-18].

A majority of Androgenetic Alopecia (79%) in male patients and 42% in female patients has been coincident among patients hospitalized due to severe COVID-19 (“Gabrin sign”), suggesting a possible influence of the Androgen Receptor through its effect over the enzyme angiotensin-converting enzyme 2 (ACE2), both genes (AR, ACE2) located in chromosome X [17,18]. Some patients infected with SARS-CoV-2 showed neurological signs such as headache (about 8%), nausea and vomiting (1%) and in severe patients, acute cerebrovascular diseases and impaired consciousness. Patients with acute SARS-CoV illness had evidences of the virus in their cerebrospinal fluid (Figure 4) [16]. In this brief revision we are exploring new emotions caused by several unpredictable situations due to the pandemic, irrational thoughts and we are including one psychological test for a better approach to a relocation of the locus of control.

New Emotions

Ideas and believes might have a really huge impact over our health and metabolism: for instance, consumption of meat of wild animals has become a sign of social status in some areas of the world [22] and it seems the COVID-19 has been mainly caused for that rare habit. Education on these ideas with empirical data and contrasted information might be of great necessity to avoid further zoonoses. The strategies for preventing spread of outbreaks are mitigation (isolation plus quarantined plus social distancing) and suppression (isolation plus quarantined plus social distancing and closing schools, Universities and businesses). Those measures of isolation of confirmed and suspected cases and the rapid and effective contacts tracing of clinical cases have been succeeded for the majority of scenarios: with a R0 = 2.5 the 70 % of contacts were possible to be traced and isolation was assumed to be 100 % effective at preventing further transmission [23]. The word quarantine was firstly used in Venice, year 1127, when leprosy and later on with Black Death happened [24]. United Kingdom 300 years later established the quarantine as an imposition in response to a plague. All these measures imply a serious restriction for people´s free will and their personal decisions, imposing the necessity of changing their routines, habits and lives till that moment. Some keys to deal with these hyper-protective measures to the subdued population were provided to the population, especially in order to prevent rebellions and for controlling the intensity of relief of de-escalated measures. Stigmatization and negative feelings, some of them negative against affected persons, also happened before in History (Spanish flu, bubonic plague, etc.). Even health care workers have suffered from a greater stigmatization and rejection from people in their local neighborhoods than the general public [24]. Post-traumatic stress symptoms, confusion, anger, exhaustion, mass hysteria, obsession of contamination, detachment from others, anxiety, indignation, irritability, frustration, boredom, financial loss, annoyance, fear, isolation, helplessness, loneliness, less happiness, etc. are some consequences described which have an impact over our psychological state and the general population [11, 24, 25]. Stigmatizations causes damage in psychological health and common coexistence, that is why the World Health Organization (WHO) have tried to prevent it from the very beginning, renaming on February the 11th the disease as COVID-19 [16], with no link to the area or region where it firstly showed up to avoid discrimination against Chinese population. The enemy is the virus, but many unreasonable behaviors might have happened because our inertial reactions to blame something else and because our psychological necessity of visualizing the hated target. Worries of people changed to be mainly focus on their health and family instead of in leisure and friends [11]. Victimization is an approach that patients with severe sequels might apply themselves, because in some cases posterior to the infection a long time has to be dedicated to rehabilitation therapies. Social distancing together with barrier methods (facial masks) and respiratory hygiene (washing hands and good breathing habits) are some keys suggested to avoid disease and improve general health [25]. In children a relative resistance to SARS-CoV-2 has been described, however the reason why is not clear yet [26].

But as human spirit uses to do, also good emotions and feelings happened: for instance an increase in faith for Science and its curative labor during these months, because a vaccine would be a very efficient measure and perhaps the only one, to reduce anxiety and fears on general population. Messages about death and religion became salient to comfort tense moods and bring more positive emotions, after January 20th when Dr. Zhong Nan Shan made a public announcement of this virus in CCTV [11, 18]. Music, routine games, allowed recreational activities and generous musical and artistic performances have been shared between common people and neighborhoods every day. King of the Netherlands Willem- Allexander comforted and warned people to avoid loneliness: “Alertness, solidarity and warmth: as long as we keep those three, we can handle this crisis together, even if it takes a little longer.” King said. In Spain admiration and respect have been shown everyday with applauses toward the caregivers and their current difficult work. As Sir Ludwig Guttmann said, “this is especially the time we need to “love our paraplegics” [27].

Irrational Thoughts And Behaviors

Our common enemy is a virus which is a target not visible. Understanding about that fact is not an easy goal. The lockout has reduced social interactions or hobbies to be distracted, then an increase in bad, harmful, and toxic habits (alcohol, drugs) and thoughts through rumination has happened. Under these unexpected circumstances with any or few psychological tools to deal, people are more likely to develop negative emotions (aversion, anxiety) and negative cognitive assessment about self-protection, life satisfaction or social risks, which may result in excessive avoidance behaviors and blind conformity [11]. Some behaviors as repeated washing hands like an obsessivecompulsive disorder (OCD) might be “normalized” and even socially rewarded in the middle of the pandemic [25]. The OCD and specifically its compulsive nature is clinically defined by the DSM-5 (300.3) as: “1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.” However, the temporal criteria makes the diagnoses more restrictive: B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day). About the prevalence: The 12-month prevalence of OCD in the United States is 1.2%, with a similar prevalence internationally (1.1%-1.8%). The frustration related to quarantine goes to several psychological problems including depression and post-traumatic stress disorder. Post-traumatic stress disorder is typified by recurrent, extremely vivid memories of traumatic events and the avoidance of everything that brings them to mind, along with depression, addiction, increased watchfulness, aggression, shame, nightmares, flashbacks, feelings of guilt, raised heart-rate, shallow sleep, frequented waking and excessive irritability (“having a short fuse”) [28, 29]. Moreover this environment pushes people to consume high sugar foods (chocolate, soft drinks, saturated fats) to boost their mood and release dopamine in the brain, which increases obesity. Sleep disturbances also increases food intake and physical activities has been reduced because to the lockdown, to the point some countries should be prepared for the upcoming epidemic of “depreobessed patients” [30]. Anxiety, depression, indignation and other negative cognitive indicators were wildly described in an affected population [11]. Physical exercises might be a good solution to prevent obesity, to a better sleep and healthy breathing space habits and for our immune system [31, 32].

Locus of Control Internal Vs External

The concept of locus of control was firstly described by Julian B. Rotter in 1954, referring to a personality trait based on the degree that people believe to have about their own control over the outcome of events vs the power of external forces beyond their particular influence (Figure 5). Attributional styles and self-efficacy concepts are built upon this trait, which may lead to neuroticism, poor self-efficacy or low self-esteem. In Figure 5: Metaphorical representation of an external locus of control, being the subject unable to freely move or to think without instructions coming from their ties. In order to restore our confidence and start new fresh acting on our internal locus of control areas and to learn from our mistakes, we suggest to read and answer this inventory elaborated by Rotter, to improve our knowledge about differences in loci of control and to get a better perspective of our own power over the events [26-31]. Many external places are suggested in this questionnaire as “common areas to blame” as responsible for our own decisions and paths taken: politicians, teachers, leaders, mates, friends, parents, genes, conflicts, luck, accidents, few trials, etc (Table 1).

During the lockout and because of pandemic restrictions, locus of control of people has been dramatically changed to be almost completely external to their will, with the sudden imposition of new rules which changed their control over their routines and lives. No chance of choosing about where to be or what to do, because suppression measures closed every places people used to go. Under this extremes circumstances, the locus of control might be relocated and focused on smaller areas where the person has a real control, such as the time of their days, the space of their homes, the few indoor activities, etc. Much more creativity and imagination are required from population, who is asked to keep calm and be patient while their range of maneuvering is considerable limited and restricted. Uncomfortable forced coexistence might lead to many conflicts that might be avoid: confusion about who is the enemy, the easily spread of fake news, rumors or even magic cures about the disease, passive and victimizes attitudes in healthy people, personalization of the information given by media or newspapers about the pandemic.

Conclusion

With this virus and at a very high cost we have learned several important lessons. Among them, the humble assumption that a tiny creature without superior intelligence or brain is capable of putting us in check and making us tremble at the foundations of our civilization. For the virus itself it is not a matter of ideology or power, or right or wrong, or races nor colors, or amount of military arsenal. Another lesson would be the fact that every person has its own immune system and reacts differently to the same virus. Every disease each people has suffered makes the history of his/her immune system which allows a particular fight against the virus. Among all our immune systems, the virus is mutating and we are working in a team against the common enemy. We, as a specie with brain and higher intelligence, will find hopefully soon safe vaccines for everybody according to their body weights and metabolism

https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000185.pdf

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adhikarilawpllc · 4 years

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NATIONAL INTEREST EXCEPTIONS TO EXECUTIVE ORDERS WHICH SUSPENDED THE ENTRY OF IMMIGRANTS AND NONIMMIGRANTS

On June 22, the President signed Presidential Proclamation (P.P.) 10052, which extends P.P. 10014, which suspended the entry to the United States of certain immigrant visa applicants, through December 31, 2020. Reuters News reports that the President has issued Proclamation on Dec 31, 2020 extending suspension till March 31, 2020. P.P. 10052 also suspends the entry to the United States of certain additional foreign nationals who present a risk to the U.S. labor market during the economic recovery following the 2019 novel coronavirus outbreak. Specifically, the suspension applies to applicants for H-1B, H-2B, and L-1 visas; J-1 visa applicants participating in the intern, trainee, teacher, camp counselor, au pair, or summer work travel programs; and any spouses or children of covered applicants applying for H-4, L-2, or J-2 visas.

The Proclamation does not apply to applicants who were in the United States on the effective date of the Proclamation (June 24), or who had a valid visa in the classifications mentioned above (and plans to enter the United States on that visa), or who had another official travel document valid on the effective date of the Proclamation. If an H-1B, H-2B, L-1, or J-1 non-immigrant is not subject to the Proclamation, then neither that individual nor the individual’s spouse or children will be prevented from obtaining a visa due to the Proclamation. The Department of State is committed to implementing this Proclamation in an orderly fashion in conjunction with the Department of Homeland Security and interagency partners and in accordance with all applicable laws and regulations.

Both P.P. 10014 and 10052 include exceptions, including an exception for individuals whose travel would be in the national interest, as determined by the Secretary of State, the Secretary of Homeland Security, or their respective designees. The list below is a non-exclusive list of the types of travel that may be considered to be in the national interest, based on determinations made by the Assistant Secretary of State for Consular Affairs, exercising the authority delegated to him by the Secretary of State under Section 2(b)(iv) of P.P. 10014 and 3(b)(iv) of P.P. 10052.

Until complete resumption of routine visa services, applicants who appear to be subject to entry restrictions under P.P. 10014, P.P. 10052, and/or regional-focused Presidential Proclamations related to COVID-19 (P.P. 9984, 9992, 9993, 9996, and/ or 10041) might not be processed for a visa interview appointment unless the applicant also appears to be eligible for an exception under the applicable Proclamation(s). Applicants who are subject to any of these Proclamations, but who believe they may qualify for a national interest exception or other exception, should follow the instructions on the nearest U.S. Embassy or Consulate’s website regarding procedures necessary to request an emergency appointment and should provide specific details as to why they believe they may qualify for an exception. While a visa applicant subject to one or more Proclamations might meet an exception, the applicant must first be approved for an emergency appointment request and a final determination regarding visa eligibility will be made at the time of visa interview. Please note that U.S. Embassies and Consulates may only be able to offer limited visa services due to the COVID-19 pandemic, in which case they may not be able to accommodate your request unless the proposed travel is deemed emergency or mission critical. Prospective visa applicants should visit the website for Embassy or Consulate where they intend to apply for a visa to get updates on current operating status. Travelers who are subject to a regional COVID-19 Proclamation but who do not require a visa, such as ESTA travelers (i.e., those traveling on the Visa Waiver Program), should also follow the guidance on the nearest Embassy or Consulate’s website for how to request consideration for a national interest exception.

Exceptions under P.P. 10052 for certain travel in the national interest by nonimmigrants may include the following:

H-1B applicants:

For travel as a public health or healthcare professional, or researcher to alleviate the effects of the COVID-19 pandemic, or to conduct ongoing medical research in an area with a substantial public health benefit (e.g. cancer or communicable disease research). This includes those traveling to alleviate effects of the COVID-19 pandemic that may be a secondary effect of the pandemic (e.g., travel by a public health or healthcare professional, or researcher in an area of public health or healthcare that is not directly related to COVID-19, but which has been adversely impacted by the COVID-19 pandemic).

Travel supported by a request from a U.S. government agency or entity to meet critical U.S. foreign policy objectives or to satisfy treaty or contractual obligations. This would include individuals, identified by the Department of Defense or another U.S. government agency, performing research, providing IT support/services, or engaging other similar projects essential to a U.S. government agency.

Travel by applicants seeking to resume ongoing employment in the United States in the same position with the same employer and visa classification. Forcing employers to replace employees in this situation may cause financial hardship. Consular officers can refer to Part II, Question 2 of the approved Form I-129 to determine if the applicant is continuing in “previously approved employment without change with the same employer.”

Travel by technical specialists, senior level managers, and other workers whose travel is necessary to facilitate the immediate and continued economic recovery of the United States. Consular officers may determine that an H-1B applicant falls into this category when at least TWO (2) of the following five (5) indicators are present:

The petitioning employer has a continued need for the services or labor to be performed by the H-1B nonimmigrant in the United States. Labor Condition Applications (LCAs) approved by DOL during or after July 2020 are more likely to account for the effects of the COVID-19 pandemic on the U.S. labor market and the petitioner’s business; therefore, this indicator is only present for cases with an LCA approved during or after July 2020 as there is an indication that the petitioner still has a need for the H-1B worker. For LCAs approved by DOL before July 2020, this indicator is only met if the consular officer is able to determine from the visa application the continuing need of petitioned workers with the U.S. employer. Regardless of when the LCA was approved, if an applicant is currently performing or is able to perform the essential functions of the position for the prospective employer remotely from outside the United States, then this indicator is not present.

The applicant’s proposed job duties or position within the petitioning company indicate the individual will provide significant and unique contributions to an employer meeting a critical infrastructure need. Critical infrastructure sectors are chemical, communications, dams, defense industrial base, emergency services, energy, financial services, food and agriculture, government facilities, healthcare and public health, information technology, nuclear reactors, transportation, and water systems. Employment in a critical infrastructure sector alone is not sufficient; the consular officers must establish that the applicant holds one of the two types of positions noted below: a.) Senior level placement within the petitioning organization or job duties reflecting performance of functions that are both unique and vital to the management and success of the overall business enterprise; OR b.) The applicant’s proposed job duties and specialized qualifications indicate the individual will provide significant and unique contributions to the petitioning company.

The wage rate paid to the H-1B applicant meaningfully exceeds the prevailing wage rate by at least 15 percent (see Part F, Questions 10 and 11 of the LCA) by at least 15 percent. When an H-1B applicant will receive a wage that meaningfully exceeds the prevailing wage, it suggests that the employee fills an important business need where an American worker is not available.

The H-1B applicant’s education, training and/or experience demonstrate unusual expertise in the specialty occupation in which the applicant will be employed. For example, an H-1B applicant with a doctorate or professional degree, or many years of relevant work experience, may have such advanced expertise in the relevant occupation as to make it more likely that he or she will perform critically important work for the petitioning employer.

Denial of the visa pursuant to P.P. 10052 will cause financial hardship to the U.S. employer. The following examples, to be assessed based on information from the visa application, are illustrative of what may constitute a financial hardship for an employer if a visa is denied: the employer’s inability to meet financial or contractual obligations; the employer’s inability to continue its business; or a delay or other impediment to the employer’s ability to return to its pre-COVID-19 level of operations.

H-2B applicants

Travel based on a request from a U.S. government agency or entity to meet critical foreign policy objectives or to satisfy treaty or contractual obligations. An example of this would be supporting U.S. military base construction (e.g. associated with the National Defense Authorization Act) or IT infrastructure.

Travel necessary to facilitate the immediate and continued economic recovery of the United States (e.g. those working in forestry and conservation, nonfarm animal caretakers, etc). Consular officers may determine that an H-2B applicant falls into this category when at least two of the following three indicators are present:

The applicant was previously employed and trained by the petitioning U.S. employer. The applicant must have previously worked for the petitioning U.S. employer under two or more H-2B (named or unnamed) petitions. U.S. employers dedicate substantial time and resources to training seasonal/temporary staff, and denying visas to the most experienced returning workers may cause financial hardship to the U.S. business.

The applicant is traveling based on a temporary labor certification (TLC) that reflects continued need for the worker. TLCs approved by DOL during or after July 2020 are more likely to account for the effects of the COVID-19 pandemic on the U.S. labor market and the petitioner’s business, and therefore this indicator is only present for cases with a TLC approved during or after July 2020 as there is an indication that the petitioner still has a need for the H-2B worker. For TLCs approved by DOL before July 2020, this indicator is only met if the consular officer is able to determine from the visa application the continuing need of petitioned workers with the U.S. employer.

J-1 applicants

Travel to provide care for a minor U.S. citizen, LPR, or nonimmigrant in lawful status by an au pair possessing special skills required for a child with particular needs (e.g., medical, special education, or sign language). Childcare services provided for a child with medical issues diagnosed by a qualified medical professional by an individual who possesses skills to care for such child will be considered to be in the national interest.

Travel by an au pair that prevents a U.S. citizen, lawful permanent resident, or other nonimmigrant in lawful status from becoming a public health charge or ward of the state of a medical or other public funded institution.

Childcare services provided for a child whose parents are involved with the provision of medical care to individuals who have contracted COVID-19 or medical research at United States facilities to help the United States combat COVID-19.

An exchange program conducted pursuant to an MOU, Statement of Intent, or other valid agreement or arrangement between a foreign government and any federal, state, or local government entity in the United States that is designed to promote U.S. national interests if the agreement or arrangement with the foreign government was in effect prior to the effective date of the Presidential Proclamation.

Interns and Trainees on U.S. government agency-sponsored programs (those with a program number beginning with “G-3” on Form DS-2019): An exchange visitor participating in an exchange visitor program in which he or she will be hosted by a U.S. government agency and the program supports the immediate and continued economic recovery of the United States.

Specialized Teachers in Accredited Educational Institutions with a program number beginning with “G-5” on Form DS-2019: An exchange visitor participating in an exchange program in which he or she will teach full-time, including a substantial portion that is in person, in a publicly or privately operated primary or secondary accredited educational institution where the applicant demonstrates ability to make a specialized contribution to the education of students in the United States. A “specialized teacher” applicant must demonstrate native or near-native foreign language proficiency and the ability to teach his/her assigned subject(s) in that language.

Critical foreign policy objectives: This only includes programs where an exchange visitor participating in an exchange program that fulfills critical and time sensitive foreign policy objectives.

L-1A applicants

Travel as a public health or healthcare professional, or researcher to alleviate the effects of the COVID-19 pandemic, or to conduct ongoing medical research in an area with a substantial public health benefit. This includes those traveling to alleviate effects of the COVID-19 pandemic that may be a secondary effect of the pandemic.

Travel based on a request from a U.S. government agency or entity to meet critical foreign policy objectives or satisfy treaty or contractual obligations. An example of this would be supporting U.S. military base construction or IT infrastructure.

Travel by a senior level executive or manager filling a critical business need of an employer meeting a critical infrastructure need. Critical infrastructure sectors include chemical, communications, dams, defense industrial base, emergency services, energy, financial services, food and agriculture, government facilities, healthcare and public health, information technology, nuclear reactors, transportation, and water systems. An L-1A applicant falls into this category when at least two of the following three indicators are present AND the L-1A applicant is not seeking to establish a new office in the United States:

Will be a senior-level executive or manager;

Has spent multiple years with the company overseas, indicating a substantial knowledge and expertise within the organization that can only be replicated by a new employee within the company following extensive training that would cause the employer financial hardship; or

Will fill a critical business need for a company meeting a critical infrastructure need.

L-1A applicants seeking to establish a new office in the United States likely do NOT fall into this category, unless two of the three criteria are met AND the new office will employ, directly or indirectly, five or more U.S. workers.

L-1B applicants

Travel as a technical expert or specialist meeting a critical infrastructure need. The consular officer may determine that an L-1B applicant falls into this category if all three of the following indicators are present:

The applicant’s proposed job duties and specialized knowledge indicate the individual will provide significant and unique contributions to the petitioning company;

The applicant’s specialized knowledge is specifically related to a critical infrastructure need; AND

The applicant has spent multiple years with the company overseas, indicating a substantial knowledge and expertise within the organization that can only be replicated by a new employee within the company following extensive training that would cause the employer financial hardship.

H-4, L-2, and J-2 applicants

National interest exceptions are available for those who will accompany or follow to join a principal applicant who is a spouse or parent and who has been granted a national interest exception to P.P. 10052. Note, a national interest exception is not required if the principal applicant is not subject to P.P. 10052 (e.g. if the principal was in the United States on the effective date, June 24, or has a valid visa that the principal will use to seek entry to the United States). In the case of a principal visa applicant who is not subject to P.P. 10052, the derivative will not be subject to the proclamation either.

Exceptions under P.P. 10014 for certain travel in the national interest by immigrants may include the following:

Applicants who are subject to aging out of their current immigrant visa classification before P.P. 10014 expires or within two weeks thereafter.

Travelers who believe their travel falls into one of these categories or is otherwise in the national interest may request a visa application appointment at the closest Embassy or Consulate and a decision will be made at the time of interview as to whether the traveler has established that they are eligible for a visa pursuant to an exception. Travelers are encouraged to refer to the Embassy/Consulate website for detailed instructions on what services are currently available and how to request an appointment.

Applicants for immigrant visas covered by Presidential Proclamation 10014, as extended by P.P. 10052, including Diversity Visa 2020 (DV-2020) applicants, who have not been issued an immigrant visa as of April 23, are subject to the proclamation’s restrictions unless they can establish that they are eligible for an exception. No valid visas will be revoked under this proclamation.

[Last updated Dec 21, 2020]

Note: This is a blog post by Adhikari Law PLLC and should NOT be construed as a legal advice.

Please contact us at (+1) 202 600 7742, or email us at [email protected] if you will have any question on this topic. You can also reach us to learn about our legal services.

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jennyvergeese · 4 years

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Most Common ICD 1O codes used with Durable Medical Equipment Billing

What exactly is a Durable Medical Equipment?

But Durable Medical Equipment is the abbreviated form of DME. It is an item that is prescribed to patients who suffer from some severe medical conditions. Some medical conditions may weaken the body to such an extent, and they need a source to support their life. Such resources are termed as DME’s.

This Durable Medical Equipment is not cheap for many patients to buy. There is a considerable sum to be paid for even renting the item for a limited time, forget buying! Thus, for the patient to get some relief from the financial crisis, the insurance companies/payers may step in. The insurance company pays a certain amount of claim, provided all the documentation and protocols set in place. Durable Medical Equipment Billing is managing the overall activities that are taken place to claim for the equipment you rent. The documentation and every minor detail have to be clearly monitored as any misplaced document, or incorrect information can directly lead you to higher chances of denial for claims.

Durable Medical Equipment Industry:

Durable Medical Equipment Coding and Durable Medical Equipment Billing

The Durable Medical Equipment billing is a procedure, and hence every step must be taken care of, failing, which can lead to a lesser chance of reimbursement. The code should be formulated perfectly, and the entities must be clearly and precisely defined. The information must be on point, and there is no space for any sort of ambiguity.

The entire procedure needs to be done in the proper flow. There is an algorithm that is usually followed for such systems.

· Once the doctor finds a requirement of any DME for a patient’s medical condition, the documents must be made which will help for claims submission.

· Upon a request risen for DME, the patient’s end will reach out to a DME supplier. The coder here needs to provide the proper prescription and also collect the patient’s insurance company.

· The insurance company may also expect a check from their end. The use of the equipment and the agreement on paying for the equipment as the claim, all these sorts of business are settled here.

· Upon finishing the necessary paperwork, the material is handed to the patient.

· The medical coding is then done, the proper use of codes and the correct information is to be made.

· The entire procedure is encrypted in the code and handed to the insurance company. The appropriate authorization and billing are needed to ensure the insurance company is liable to pay the claim amount to the patient

The services obtained from a reliable medical billing company is utmost necessary in such regards. They take care and make sure all the documents are genuine, and all the paperwork is on point.

What Are Modifiers in Durable Medical Equipment Billing?

· RR – Rental

· NU – New Equipment purchase

· UE – Old Equipment Purchase

Even digging deeper, there are few other keywords that point out at the Rental period. For instance,

· KH – First-month rental

· KI – Second and third-month rental

· KJ – Fourth to 13th-month rental

Outsourcing of Durable Medical Equipment Billing:

· The dedicated team is already skilled enough to deal with this and hence the time to train your staff or hire people to take care of these billing requirements.

· The revenue can also be increased in terms of infrastructure and staff. With no need to hire more people and train them, this surely can be your brownie point.

· The DME billing is time-consuming and tedious. It can end up taking a lot of your considerable time. This time can be productively used in taking care of the patients.

· The billing stuff is trained and upgraded with the latest take in the market. They’ll be smart enough to tackle all the happenings in the market.

· The reliable third-party sources will also make sure that the proper codes and accurate information is handed and nullifies the possibilities of generating errors. The work is done precisely and in the stipulated time period.

· There is a lot of popular software available in the market that handles the task of DME billing. While the number may go on increasing, some very popular ones have been gaining a reputed position and are reliable for all sorts of DME Billing procedures.

Most Common ICD 1O codes used with Durable Medical Equipment Billing

There are few frequently used ICD 10 codes which target the problems coming under the Durable Medical Equipment Billing. Some of the commonly used ones are: –

· E0100-E0159 – Walking Aids and Attachments

· E0163-E0175 – Commode Chair and Supplies

· E0181-E0199 – Pressure Mattresses, Pads, and Other Supplies

· E0250-E0373 – Hospital Beds and Associated Supplies

· E0424-E0487 – Oxygen Delivery Systems and Related Supplies

· E0621-E0642 – Patient Lifts and Support Systems

· E0950-E1036 – Wheelchair Accessories

In a nutshell

Durable Medical Equipment Billing is often taken as a different department and several experts make the whole process by themselves. When the need arises for a specific Durable Medical Equipment, the prescription is taken to the Durable Medical Equipment supplier. This is coded in the proper format and presented to the insurance company. Proper authorization checks, if needed is done and the insurance company checks from their end. The entire documentation and paperwork are then handed to the insurance company and the claim can be generated.

About 24/7 Medical Billing Services

24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%. Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.

Media Contact –

Hari Sudan, Media Relations,

24/7 Medical Billing Services,

16192 Coastal Hwy,

Lewes, DE – 19958

Tel: + 1 -888-502-0537

Email - [email protected]

Website – www.247medicalbillingservices.com

#ICD-10 Coding #Outsourcing Medical Equipment Billing #Medical Devices Billing #Medical Equipment Billing Services #Durable Medical Equipment Billing #DME Billing

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newscheckz · 4 years

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WHAT TO DO WHEN YOU LOSE YOUR JOB

New Post has been published on https://newscheckz.com/what-to-do-when-you-lose-your-job/

WHAT TO DO WHEN YOU LOSE YOUR JOB

By Terryanne Chebet

On the 26th of October 2016, my then boss called me into her office and informed me that I had been affected in a restructuring exercise. It was 2.00pm on a Wednesday, I had been preparing for my evening TV show, The Business Centre. In a matter of minutes I had lost a very well paying and prestigious job as a TV host in the country’s leading media house.

It was a difficult time and I cried every night, wallwing in self -pity and anxiety.

I realised that even though I was emotionally broken I needed to face the truth and needed to quickly deal with the feelings of betrayal, rejection, denial, and the anger that I felt. I had no choice but to focus on what the future held for me and my family.

As a sole breadwinner, I was completely anxious about the future. I had a bank loan, school fees, rent etc that I needed to take care of. I was scared! That was the first time I truly understood what insomnia was. I couldn’t sleep well , I stayed up crying and wondering how I was going to make it without a salary.