insurance claim reporting

Summary

Summary: The design, completion, and filing of forms with the insurer.

Top Publications

  1. ncbi Focused physician coding audits: using modifier 25
    Mary H Stanfill
    J AHIMA 75:62-4. 2004
  2. ncbi Making sense of preventive medicine coding
    Emily Hill
    Hill and Associates, Wilmington, N C, USA
    Fam Pract Manag 11:49-54. 2004
  3. ncbi Accuracy of administrative data for identifying patients with pneumonia
    Dominik Aronsky
    Department of Biomedical Informatics and Emergency Medicine, Vanderbilt University, 2209 Garland Avenue, Nashville, TN 37232, USA
    Am J Med Qual 20:319-28. 2005
  4. ncbi Are claims data accurate enough to identify patients for performance measures or quality improvement? The case of diabetes, heart disease, and depression
    Leif I Solberg
    HealthPartners Research Foundation, Minneapolis, Minnesota 55440, USA
    Am J Med Qual 21:238-45. 2006
  5. ncbi Prospective validation of eight different adherence measures for use with administrative claims data among patients with schizophrenia
    Sudeep Karve
    Department of Pharmacy Administration, College of Pharmacy, The Ohio State University, Columbus, OH, USA
    Value Health 12:989-95. 2009
  6. pmc The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited
    Donald H Taylor
    Center for Health Policy, Sanford Duke School of Public Policy, Duke University, Durham, NC 27708, USA
    J Alzheimers Dis 17:807-15. 2009
  7. ncbi Agreement of diagnosis and its date for hematologic malignancies and solid tumors between medicare claims and cancer registry data
    Soko Setoguchi
    Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA, USA
    Cancer Causes Control 18:561-9. 2007
  8. ncbi Estimation of disease-specific costs in health insurance claims: a comparison of three methods
    Etsuji Okamoto
    National Institute of Public Health, Department of Management Sciences, 2 3 6, Minami, Wako Shi, Saitama 351 0197, Japan
    Nihon Koshu Eisei Zasshi 51:926-37. 2004
  9. ncbi Risk of diabetes mellitus associated with atypical antipsychotic use among patients with bipolar disorder: A retrospective, population-based, case-control study
    Jeff J Guo
    College of Pharmacy, University of Cincinnati Medical Center, Cincinnati, Ohio 45267 0004, USA
    J Clin Psychiatry 67:1055-61. 2006
  10. ncbi Refined method for estimating medical expenditures for liver disease using the patient survey and claim data in Japan
    Satoshi Toyokawai
    Department of Public Health, Graduate School of Medicine, University of Tokyo, Japan
    Nihon Koshu Eisei Zasshi 52:957-61. 2005

Research Grants

Detail Information

Publications238 found, 100 shown here

  1. ncbi Focused physician coding audits: using modifier 25
    Mary H Stanfill
    J AHIMA 75:62-4. 2004
  2. ncbi Making sense of preventive medicine coding
    Emily Hill
    Hill and Associates, Wilmington, N C, USA
    Fam Pract Manag 11:49-54. 2004
  3. ncbi Accuracy of administrative data for identifying patients with pneumonia
    Dominik Aronsky
    Department of Biomedical Informatics and Emergency Medicine, Vanderbilt University, 2209 Garland Avenue, Nashville, TN 37232, USA
    Am J Med Qual 20:319-28. 2005
    ..ICD-9-based algorithms did not influence patient variables in our population. Identifying pneumonia patients with DRG codes is significantly less precise...
  4. ncbi Are claims data accurate enough to identify patients for performance measures or quality improvement? The case of diabetes, heart disease, and depression
    Leif I Solberg
    HealthPartners Research Foundation, Minneapolis, Minnesota 55440, USA
    Am J Med Qual 21:238-45. 2006
    ..97, 0.95, and 0.95. This approach is feasible and necessary for those wanting to use administrative data for case identification for performance measurement or quality improvement...
  5. ncbi Prospective validation of eight different adherence measures for use with administrative claims data among patients with schizophrenia
    Sudeep Karve
    Department of Pharmacy Administration, College of Pharmacy, The Ohio State University, Columbus, OH, USA
    Value Health 12:989-95. 2009
    ....
  6. pmc The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited
    Donald H Taylor
    Center for Health Policy, Sanford Duke School of Public Policy, Duke University, Durham, NC 27708, USA
    J Alzheimers Dis 17:807-15. 2009
    ..The use of Medicare claims to identify dementia results in an overstatement of the increase in Medicare costs that are due to dementia...
  7. ncbi Agreement of diagnosis and its date for hematologic malignancies and solid tumors between medicare claims and cancer registry data
    Soko Setoguchi
    Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA, USA
    Cancer Causes Control 18:561-9. 2007
    ..However, linkage between cancer registry and claims data including pharmacy-dispensing information is not always available. We examined the accuracy of claims-based definitions of incident cancers and their date of diagnosis...
  8. ncbi Estimation of disease-specific costs in health insurance claims: a comparison of three methods
    Etsuji Okamoto
    National Institute of Public Health, Department of Management Sciences, 2 3 6, Minami, Wako Shi, Saitama 351 0197, Japan
    Nihon Koshu Eisei Zasshi 51:926-37. 2004
    ....
  9. ncbi Risk of diabetes mellitus associated with atypical antipsychotic use among patients with bipolar disorder: A retrospective, population-based, case-control study
    Jeff J Guo
    College of Pharmacy, University of Cincinnati Medical Center, Cincinnati, Ohio 45267 0004, USA
    J Clin Psychiatry 67:1055-61. 2006
    ..Drug-induced diabetes onset has not been adequately quantified in patients with bipolar disorder, although atypical antipsychotics have been widely used as new mood stabilizers...
  10. ncbi Refined method for estimating medical expenditures for liver disease using the patient survey and claim data in Japan
    Satoshi Toyokawai
    Department of Public Health, Graduate School of Medicine, University of Tokyo, Japan
    Nihon Koshu Eisei Zasshi 52:957-61. 2005
    ..This study was performed to develop a estimation method for medical expenditures based on detailed data for the various kinds of liver disease...
  11. ncbi More than code revisions in the 2004 changes to ICD-9-CM
    Kathy Giannangelo
    J AHIMA 75:94-6. 2004
  12. ncbi The 15 most common coding/billing errors
    Robin Linker
    National AAPC Advisory Board Officer Local Chapter Relations, Aurora, CO, USA
    J Med Pract Manage 20:327-31. 2005
  13. ncbi Clarifying today's coding and compliance issues. Treatment delivery clarification
    Cindy C Parman
    Coding Strategies, Inc, Atlanta, GA, USA
    J Oncol Manag 12:5-6. 2003
  14. ncbi Medicare maximization by state Medicaid programs: effects on Medicare home care utilization
    Wayne L Anderson
    Med Care Res Rev 60:201-22. 2003
    ....
  15. ncbi APCs: lack of knowledge can hurt your bottom line
    Caral Edelberg
    Medical Management Resources Team Health, Jacksonville, FL, USA
    ED Manag 15:53-5. 2003
  16. ncbi The power of paperwork: how Philip Morris neutralized the medical code for secondhand smoke
    Daniel M Cook
    Center for Tobacco Control Research and Education, University of California, San Francisco UCSF, USA
    Health Aff (Millwood) 24:994-1004. 2005
    ..Philip Morris's reaction reveals the importance of policy decisions related to data collection and paperwork...
  17. ncbi Bolstering bottom lines. Claims and coding
    Richard R Rogoski
    Health Manag Technol 26:10, 12, 14-5. 2005
  18. ncbi Improve compliance and financial performance at the same time
    Jeff Sinaiko
    HPEN, Inc, 11777 San Vicente Boulevard, Suite 777, Los Angeles, CA, USA
    J Med Pract Manage 18:155-8. 2002
    ..The lesson for medical practice managers is that if you improve compliance, you should actually improve your bottom line, not harm it...
  19. ncbi Medicare cost controls and program compliance: the rationale of physician claims edits
    Darren Carter
    J Med Pract Manage 18:115-9. 2002
    ..Many resources are available to aid physicians, including computerized tools, new CMS initiatives, and Internet materials...
  20. ncbi Variation in coding influence across the USA. Risk and reward in reimbursement optimization
    Daniel P Lorence
    Department of Health Policy and Administration, Pennsylvania State University, State College, Pennsylvania, USA
    J Manag Med 16:422-35. 2002
    ..Implications for reimbursement programs and evidence-based health care are discussed...
  21. ncbi 2003 OIG Work Plan highlights aberrant coding patterns. Plan puts new spin on 2002 work plans, introduces new projects
    Sue Prophet-Bowman
    J AHIMA 74:76-9. 2003
  22. ncbi Emergency department coding and billing
    Caral Edelberg
    Medical Management Resources, Inc Team Health, 8001 Belfort Parkway, Suite 200, Jacksonville, FL 32256, USA
    Emerg Med Clin North Am 22:131-51. 2004
    ..Minimizing the risk for submitting fraudulent claims is critical, because it assures the efficient and timely billing of all ED services. For the practice to thrive, each is necessary...
  23. ncbi Observation services present compliance challenges
    Sue Prophet-Bowman
    J AHIMA 74:60-5. 2003
  24. ncbi The False Claims Act: the courts move toward a rule of reason
    Michael M Mustokoff
    Partner, Duane Morris, LLP, One Liberty Place, Philadelphia, PA 19103 7396, USA
    J Med Pract Manage 20:317-22. 2005
    ..It indicates the limitations that are imposed on prosecutors, as well as the liability that providers do incur under current statues...
  25. ncbi Make sense of wound care billing: turn your cents into reimbursement dollars
    Deanna M Vargo
    Department of Ambulatory Care Wound Care, Summa Health System, Barberton Citizens Hospital, Barberton, Ohio 44203, USA
    J Wound Ostomy Continence Nurs 35:186-96; quiz 197-8. 2008
    ..Therefore, investing the time to check the site for the latest updates can make a critical difference in your success with reimbursement for wound care services...
  26. ncbi Keeping internal chart reviews from being used against you: 11 useful strategies
    David M Glaser
    Fredrikson and Byron, 200 South Sixth Street, Minneapolis, MN, USA
    J Med Pract Manage 20:32-5. 2004
    ..This article provides some guidance to help practitioners realize the fuller value of chart reviews in terms of over- and under-coding, adequacy of documentation, and attorney-client privilege...
  27. ncbi Coding for split visits for Medicare patients: preventive medicine and office visit on the same day
    Betsy Nicoletti
    Medical Practice Consulting, PO Box 946, Springfield, VT 05156, USA
    J Med Pract Manage 20:97-9. 2004
  28. ncbi An MS-DRG journey. How one hospital joined together to successfully implement MS-DRGs
    Ginny Martin
    SwedishAmerican Hospital, Rockford, IL, USA
    J AHIMA 79:70-2. 2008
  29. ncbi Insurance billing and coding
    Rebecca H Napier
    Department of Surgery, University of Kentucky, College of Dentistry, D 508, 800 Rose Street, Lexington, KY 40536 0297, USA
    Dent Clin North Am 52:507-27, viii. 2008
    ..Claim submissions for care provided can be completed electronically or by means of paper forms...
  30. ncbi Coding for effective denial management
    Jackie Miller
    Per Se Technologies, Atlanta, GA, USA
    Radiol Manage 26:18-21. 2004
    ..Some radiologists may lack the funding or human resources needed to implement truly effective coding programs for their staff members. In these circumstances, radiology business managers should consider outsourcing their coding...
  31. ncbi Keep your billing on target
    Gail Garfinkel Weiss
    Med Econ 81:60-1. 2004
  32. ncbi CPT new patient vs. established patient guidelines
    Deborah Grider
    Medical Professionals Inc, 7098 N Shadeland Ave, Suite D, Indianapolis, IN 46220, USA
    J Med Pract Manage 19:159-60. 2003
  33. ncbi Making your encounter form work for you
    Crystal S Reeves
    Coker Group, 11660 Alpharetta Highway, Suite 710, Roswell, Georgia 30076, USA
    J Med Pract Manage 19:150-3. 2003
    ..A well-designed encounter form is one key to enhance the process. This article provides some practical guidelines for making the encounter form more effective...
  34. ncbi CPT coding for hospice in long-term care
    Ronald J Crossno
    American Board of Hospice and Palliative Medicine, 1904 Sager Road, Rockdale, TX 76567, USA
    J Am Med Dir Assoc 5:50-4. 2004
  35. ncbi Claims denials--don't take no for an answer
    Betsy Nicoletti
    Med Econ 82:41-2. 2005
  36. ncbi How to get a good night's sleep: adhere to correct billing practices
    Betsy Nicoletti
    Medical Practice Consulting, P O Box 946, Springfield, VT 05156, USA
    J Med Pract Manage 20:314-6. 2005
  37. ncbi Obtaining advance beneficiary notices for Medicare physician providers
    Darren Carter
    Provistas, Incorporated, 12 Dongan Place, Suite 203, New York, NY 10040 1592, USA
    J Med Pract Manage 19:10-8. 2003
    ..The author also presents special applications of the ABN regulations as they apply to the EMTALA rules, anti-kickback, and other statutes. Samples of the official ABN forms are illustrated...
  38. ncbi 10 tips for avoiding APC traps
    Julie A Micheletti
    HSS, Inc, Hamden, Connecticut, USA
    Healthc Financ Manage 56:64-8. 2002
    ..Transitional pass-through items should be audited routinely; associated coding should be kept current. Consideration should be given to meeting medical necessity requirements, particularly for mental health services...
  39. ncbi Don't get burned coding common skin procedures
    Keith Millette
    University of North Dakota School of Medicine and Health Sciences, USA
    Fam Pract Manag 12:47-50. 2005
  40. ncbi Ambulance services move to a new payment method
    Richard L Gundling
    HFMA, Washington, D C, USA
    Healthc Financ Manage 56:80-1. 2002
    ..Of particular interest is the development of a new coding system for ambulance claims reports and payment increases for ambulance service in rural areas...
  41. ncbi Remember to report changes
    Duane C Abbey
    Abbey and Abbey, Consultants, Inc, Ames, Iowa, USA
    Revenue-cycle Strateg 4:3. 2007
  42. ncbi Corporate integrity agreements: making the best of a tough situation
    Robert B Ramsey
    Healthcare Group of Buchanan Ingersoil, Pittsburgh, Pennsylvania, USA
    Healthc Financ Manage 56:58-62. 2002
    ..Effective negotiations can help minimize the organization's costs of compliance with the agreement and facilitate its ongoing implementation of the agreement...
  43. ncbi Ensuring timely reimbursement
    Lisa L Spoden
    Strategic Health Care Company, Columbus, OH, USA
    Dermatol Nurs 19:280, 285, 288. 2007
  44. ncbi Are you committing health care fraud under the False Claims Act? The answer may not be as simple as you think
    Michael K Goldberg
    Goldberg and Frankenstein, LLC, 222 South Riverside Plaza, Suite 810, Chicago, IL 60606, USA
    J Med Pract Manage 17:206-9. 2002
    ..In addition, it characterizes the concept of qui tam that allows whistleblowers to share in any financial awards. Finally, it highlights the importance of proper coding as a means of reducing the suspicion of fraud or abuse...
  45. ncbi Coding changes for 2006
    Theresa Powers
    DoctorsManagement, Knoxville, USA
    Tenn Med 99:33-4. 2006
  46. pmc Perceived, actual, and desired knowledge regarding Medicare billing and reimbursement. A national needs assessment survey of internal medicine residents
    Kenna Adiga
    Department of Medicine, University of Missouri, Kansas City, MO, USA
    J Gen Intern Med 21:466-70. 2006
    ..Economics and reimbursement have become a daily part of practicing physicians' lives. Yet, few internal medicine (IM) programs have offered formal curricula during residency about practice management or economics...
  47. ncbi Evaluation and management and modifiers: you too can find comfort in using them
    Suzan Hvizdash
    University of Pittsburgh Medical Center, UPP Department of Surgery, USA
    J Med Pract Manage 22:60-1. 2006
  48. ncbi The deficit reduction act of 2005: policy, politics, and impact on radiologists
    James W Moser
    American College of Radiology, Reston, VA 20191, USA
    J Am Coll Radiol 3:744-50. 2006
    ..Although the DRA cuts payments for certain imaging services, it does nothing to control utilization, which is the prime mover driving spending...
  49. ncbi Nursing homes face quality-of-care scrutiny under the False Claims Act
    B S Landsberg
    Litigation and Employment Business Unit, Manatt, Phelps and Phillips, LLP, Los Angeles, California, USA
    Healthc Financ Manage 55:54-8. 2001
    ..In a recent case, however, a Federal judge refused to grant the defendant facility's motion to dismiss and permitted the government's case to proceed...
  50. ncbi CPT coding by interventional radiologists: a multi-institutional evaluation of accuracy and its economic implications
    Richard Duszak
    West Reading Radiology Associates, Department of Radiology, Reading, Pennsylvania 19612 6052, USA
    J Am Coll Radiol 1:734-40. 2004
    ..To evaluate the accuracy of Current Procedural Terminology (CPT) coding for interventional radiology procedures and the associated professional economic impact when coding is performed by operating physicians...
  51. ncbi Coding and reimbursement
    Claudia P Barone
    University of Arkansas for Medical Sciences in Little Rock, 72205, USA
    AACN Adv Crit Care 17:116-8. 2006
  52. ncbi From concept to CPT code to compensation: how the payment system works
    William T Thorwarth
    Catawba Radiological Associates, Hickory, NC 28603, USA
    J Am Coll Radiol 1:48-53. 2004
    ....
  53. ncbi "This might sting a bit": policing skin care in nursing facilities by litigating fraud
    Michael Stockham
    Cornell Law Rev 87:1041-77. 2002
  54. ncbi The pitfalls of overcoding evaluation and management services
    Vickie Balistreri
    J Med Pract Manage 17:234-6. 2002
  55. ncbi Payback
    Ken Ortolon
    Tex Med 101:43-5. 2005
  56. ncbi Hospitals' code blues. MS-DRG switch may initially delay pay
    Cinda Becker
    Mod Healthc 37:18-9. 2007
  57. ncbi Medicare fraud-busters target patient transfer reporting
    Stephen G Sozio
    Trustee 55:46-7. 2002
  58. ncbi CODE your way to better reimbursement
    Robert Lowes
    Med Econ 84:48-50, 52-4. 2007
  59. ncbi The codes to watch: identifying the DRGs most prone to payment error
    Kimberly Hrehor
    Texas Medical Foundation, Austin, TX, USA
    J AHIMA 76:36-40. 2005
  60. ncbi Coding level-IV visits without fear
    Thomas A Waller
    Department of Family Medicine, Mayo Clinic, Jacksonville, Fla, USA
    Fam Pract Manag 13:34-8. 2006
  61. ncbi OASIS coding, your license, and your reputation
    Elizabeth A Madigan
    Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106 4904, USA
    Home Healthc Nurse 24:190. 2006
  62. pmc Using administrative data to study persons with disabilities
    Lisa I Iezzoni
    Harvard University, USA
    Milbank Q 80:347-79. 2002
    ..Linking administrative data to survey or other data sources enhances the utility of administrative data for disability studies...
  63. ncbi Coding, coverage, and compensation for pathology and laboratory medicine services
    Ronald L Weiss
    ARUP Laboratories, University of Utah School of Medicine, 500 Chipeta Way, Salt Lake City, UT 84108, USA
    Clin Lab Med 27:875-91, viii. 2007
    ..CMS uses a Physician Fee Schedule and a separate Clinical Laboratory Fee Schedule, whose designs and annual updates differ...
  64. ncbi Medical necessity and level-IV visits
    Jeffrey J Sourbeer
    Fam Pract Manag 13:26. 2006
  65. pmc Validation of a method for identifying nursing home admissions using administrative claims
    Ilene H Zuckerman
    Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
    BMC Health Serv Res 7:202. 2007
    ..Our objective was to develop and validate an algorithm that identifies nursing home admissions at the resident-month level using the MarketScan Medicare Supplemental and Coordination of Benefit (COB) database...
  66. ncbi [Interspinous decompression as treatment for lumbar spinal stenosis]
    U M√ľnnich
    Abteilung Medizinische Beratung der Deutschen Krankenversicherung, Koln
    Versicherungsmedizin 59:176-8. 2007
    ..There are reports of implanting these devices in certain cases under local anaesthetic. A prospective randomised trial has shown promising results for up to two years postoperatively. There are no long-term results available...
  67. ncbi Impact of managed care on physicians' decisions to manipulate reimbursement rules: an explanatory model
    Jonathan VanGeest
    WellStar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144 5591, USA
    J Health Serv Res Policy 12:147-52. 2007
    ..To develop and test an explanatory model of the impact of managed care on physicians' decisions to manipulate reimbursement rules for patients...
  68. ncbi Use of pharmacy claims databases to determine rates of medication adherence
    David Day
    Clinical Applications, Pfizer Pharmaceuticals Group, New York, New York 10017, USA
    Adv Ther 20:164-76. 2003
    ....
  69. ncbi Real-time payment: what's holding it back?
    Ken Terry
    Med Econ 84:44, 47-8, 51. 2007
  70. ncbi Asthma disease management: regression to the mean or better?
    David Tinkelman
    National Jewish Medical and Research Center, Denver, CO 80206, USA
    Am J Manag Care 10:948-54. 2004
    ....
  71. ncbi Stratified random sampling for estimating billing accuracy in health care systems
    Jirachai Buddhakulsomsiri
    Sirindhorn International Institute of Technology, Thammasat University, P O Box 22, Thammasat Rangsit Center, Pathumthani 12121, Thailand
    Health Care Manag Sci 11:41-54. 2008
    ..Computational study results show effectiveness of the proposed sampling plan...
  72. ncbi Computers, coding, and change
    Chris Dimick
    J AHIMA 79:46-9; quiz 51-2. 2008
  73. ncbi Managing medical necessity denials
    Carl Bertrams
    Compliance Solutions, 3M Health Information Systems, Chicago, USA
    Healthc Financ Manage 59:95-100. 2005
  74. ncbi Factors associated with back problems among emergency medical technicians
    Jonathan R Studnek
    National Registry of Emergency Medical Technicians, Columbus, OH 43230, USA
    Am J Ind Med 50:464-9. 2007
    ..It is hypothesized that the likelihood of reporting back problems will be associated with the individual and work-related characteristics of a national sample of EMTs...
  75. ncbi Eight reasons payer interoperability and data sharing are essential in ACOs. Interoperability standards could be a prerequisite to measuring care
    Shefali Mookencherry
    Hayes Management Consulting, USA
    Health Manag Technol 33:16-9. 2012
    ..It is in the interest of ACOs to work collaboratively with payers early on to develop reasonable and effective performance benchmarks. Hence, it is essential to have payer interoperability and data sharing integrated in an ACO model...
  76. ncbi New codes, new rules and new opportunities
    Cindy Hughes
    Fam Pract Manag 14:27-8. 2007
  77. pmc Economic burden of acute coronary syndrome in South Korea: a national survey
    Jinhyun Kim
    College of Nursing The Research Institute of Nursing Science, Seoul National University, 28 Yeongeon dong, Jongro Gu, Seoul, Republic of Korea
    BMC Cardiovasc Disord 13:55. 2013
    ..This study examined the economic effect of ACS on the Korean population during the period 2004 to 2009...
  78. pmc Medicare part B claims for chiropractic spinal manipulation, 1998 to 2004
    James M Whedon
    Health Services Research, The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA
    J Manipulative Physiol Ther 33:558-61. 2010
    ..The objective of this study was to examine the volume and rate of Medicare Part B claims for chiropractic spinal manipulation longitudinally from 1998 to 2004...
  79. ncbi Straight talk: new approaches in healthcare. Are you ready to send HIPPA-compliant transactions? Your cash flow is at stake. Panel discussion
    Lee B Barrett
    Mod Healthc 32:37-40. 2002
    ..If you can't send a compliant transaction, the Centers for Medicare and Medicaid Services could reject your claims, drying up a big percentage of your cash flow...
  80. ncbi The effect of zanamivir treatment on influenza complications: a retrospective cohort study
    J Alexander Cole
    Epidemiology and Safety Research Division, Riverside Center, Ingenix, Inc, Auburndale, Massachusetts 02466, USA
    Clin Ther 24:1824-39. 2002
    ..Complications of influenza are a major cause of morbidity and mortality during the influenza season. Clinical trials of zanamivir have reported a reduced incidence of influenza complications among high-risk patients...
  81. ncbi Regulatory and medical-legal aspects of intraoperative monitoring
    Marc R Nuwer
    Department of Neurology, School of Medicine, University of California at Los Angeles UCLA, California, USA
    J Clin Neurophysiol 19:387-95. 2002
    ..Various billing codes for intraoperative monitoring are reviewed along with the circumstances in which they are to be used. Policy on the use of non-approved devices is also presented...
  82. ncbi How physicians can steer clear of fraud charges
    Jeffrey J Denning
    Manag Care 11:26. 2002
  83. ncbi Revascularization in the new year
    Melody W Mulaik
    Coding Strategies, Inc, USA
    Radiol Manage 33:25-8. 2011
    ..New codes bring new guidelines for the lower revascularization procedures. It is important that all staff members responsible for coding and charge capture understand how to properly assign correct codes for these procedures...
  84. ncbi Update on standardized nursing data sets and terminologies
    Judith J Warren
    University of Kansas School of Nursing, USA
    J AHIMA 73:78-83; quiz 85-6. 2002
  85. ncbi Electronic 'superbills'
    Steven F Isenberg
    Ear Nose Throat J 81:439. 2002
  86. ncbi CPT code recommendations for nuclear medicine therapy
    Kenneth A McKusick
    J Nucl Med 43:27N-28N. 2002
  87. ncbi Get a grip on billing and reimbursement
    Diana S Contino
    Emergency Management Systems, Inc, Laguna Niguel, California, USA
    Nurs Manage 33:10-3. 2002
    ..Managing Medicare outpatient reimbursement has ballooned into a complex, full-time job. Here's an overview of upcoming initiatives that require changes to your financial procedures...
  88. ncbi Costs and resources associated with the treatment of overactive bladder using retrospective medical care claims data
    J A Hall
    Ingenix Pharmaceutical Services, Eden Prairie, Minnesota, USA
    Manag Care Interface 14:69-75. 2001
    ..Although the adjusted percent change in PPPM pharmacy costs was significantly higher within the tolterodine group, medical and total PPPM costs were not...
  89. ncbi Dental benefits--expanding access to dental care
    E F Ireland
    National Association of Dental Plans, Dallas, Texas, USA
    J Am Coll Dent 68:18-23. 2001
    ..Current issues include dental workforce, the economy, human resources policies, and regulation. The issue of quality oral health care is identified as needing consensus definition by the entire dental industry...
  90. ncbi Diagnostic imaging studies performed in children over a nine-year period
    Trevor Tompane
    Department of Pediatrics, University of California, San Diego, La Jolla, California 92093 0984, USA
    Pediatrics 131:e45-52. 2013
    ..Our objective was to determine the prevalence and characteristics of DIPs ordered by physicians in an independent physicians association treating a general pediatric population...
  91. ncbi Using Medicaid data to estimate state- and county-level prevalence of asthma among low-income children
    P A Buescher
    State Center for Health Statistics, North Carolina Department of Health and Human Services, Raleigh 27699 1908, USA
    Matern Child Health J 3:211-6. 1999
    ..This study examines the prevalence of asthma among low-income children in North Carolina using Medicaid paid claims and enrollment data...
  92. ncbi Epidemiology of recurrent cerebral infarction: a medicare claims-based comparison of first and recurrent strokes on 2-year survival and cost
    G P Samsa
    Center for Clinical Health Policy Research, and the Departments of Community and Family Medicine and Medicine, Duke University School of Medicine Durham, NC, USA
    Stroke 30:338-49. 1999
    ..The extent of this difference has, however, not yet been estimated with precision...
  93. pmc Predictive value of Medicare claims data for identifying revision of index hip replacement was modest
    Jeffrey N Katz
    Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women s Hospital, Harvard Medical School, Boston 02115, MA, USA
    J Clin Epidemiol 64:543-6. 2011
    ..To determine the positive predictive value of Medicare claims for identifying revision of total hip replacement (THR), a frequent marker of THR quality and outcome...
  94. ncbi A case study of population health improvement at a Midwest regional hospital employer
    D Adam Long
    Department of Research and Infomatics, Onlife Health, Franklin, Tennessee 37067, USA
    Popul Health Manag 13:163-73. 2010
    ..Participants averaged $40.65 PMPM savings over the control population. Program return on investment, including incentive costs and vendor fees, was 2.87:1...
  95. ncbi Characteristics of medical professional liability claims in patients with cardiovascular diseases
    William J Oetgen
    Division of Cardiology, Georgetown University School of Medicine, Washington, District of Columbia, USA
    Am J Cardiol 105:745-52. 2010
    ..Detailed knowledge of risks associated with liability claims should assist practicing cardiologists in improving the quality of care, reducing patient injury, and reducing the incidence of claims...
  96. pmc Increasing short-stay unplanned hospital admissions among children in England; time trends analysis '97-'06
    Sonia Saxena
    Department of Primary Care and Social Medicine, Imperial College London, London, United Kingdom
    PLoS ONE 4:e7484. 2009
    ..We hypothesised that any increase in isolated short stay admissions for childhood illness might reflect failure to manage these cases in the community over a 10 year period spanning these changes...
  97. ncbi Managing workers' compensation costs in the military setting: the Army's story
    Marianne Cloeren
    US Army Center for Health Promotion and Preventive Medicine, Building E 1570, Stark Road, Aberdeen Proving Grounds, MD 21010 5403, USA
    Clin Occup Environ Med 4:vii, 323-39. 2004
    ..Front-line managers bear the responsibility for educating the workforce and providing safe workplaces. Employees become the beneficiaries, not of medical and compensation benefits but of safe and healthy work environments...
  98. ncbi Relationship of lumbar strength in shipyard workers to workplace injury claims
    V Mooney
    University of California at San Diego, USA
    Spine (Phila Pa 1976) 21:2001-5. 1996
    ..All but two had higher-than-average strength. CONCLUSIONS: There is no evidence that preplacement back strength testing would predict workplace claims of injury...
  99. ncbi Direct health care costs of 4 common skin ulcers in New Mexico Medicaid fee-for-service patients
    Ritesh N Kumar
    College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
    Adv Skin Wound Care 17:143-9. 2004
    ..To determine health care costs associated with pressure ulcers, ulcers of the lower limbs, other chronic ulcers, and venous leg ulcers from the New Mexico Medicaid fee-for-service program perspective...
  100. ncbi The science of compliance. CMS is enlisting hospitals for pilot program to help determine why some billing-compliance programs work while others don't
    Mark Taylor
    Mod Healthc 34:6-7, 1. 2004
    ..The plan is already winning praise. "The burning question is which components of compliance programs are the most effective," says Roy Snell, left, of the Health Care Compliance Association...
  101. ncbi Coding for NP care
    Dorothy L Pennachio
    Med Econ 81:45-7. 2004

Research Grants64

  1. The Secondary Prevention of Melanoma
    Susan Oliveria; Fiscal Year: 2007
    ..abstract_text> ..
  2. Use of Complementary and Alternative Medical (CAM) Providers by Cancer Patients
    Paula Diehr; Fiscal Year: 2007
    ..This study will increase the understanding of the role CAM should play in providing supportive care for cancer patients. ..
  3. Race and Herbal Medications Among Medicare Recipients
    William Lafferty; Fiscal Year: 2004
    ..African- Americans already report lower satisfaction with their medical care and frequently leave the doctor's office with unanswered questions, therefore, special educational programs may be useful. ..
  4. Competitive Continuation of Insurance Financing of Integrative Medicine
    Paula Diehr; Fiscal Year: 2007
    ..Since the United States is the world's number one consumer of medical care, this study on the addition of new CAM benefits and the consequences is important. [unreadable] [unreadable]..
  5. The Development of a Health Numeracy Measure
    Marilyn Schapira; Fiscal Year: 2009
    ..d. Criterion validity will be tested by evaluating the association of scores on the NUMi with the Medical Data Interpretation Test, the adoption of health protective behaviors, and perceived health. ..
  6. Breast Density, IGF-I, & Prolactin, in Four Populations
    Gertraud Maskarinec; Fiscal Year: 2004
    ..The statistical analysis will include mixed models to explore the relation between hormone levels and breast density while controlling for confounders and for clustering by study location. ..
  7. Arkansas Consortium for Health Services Research
    Bradley Martin; Fiscal Year: 2007
    ..unreadable] [unreadable] [unreadable]..
  8. EVALUATING MAMMOGRAPHY CLAIMS DATA
    Jean Freeman; Fiscal Year: 2006
    ..S. radiologists. [unreadable] [unreadable]..
  9. Health Services Research in Under-Served Populations
    Jean Freeman; Fiscal Year: 2006
    ..unreadable] b. Develop and implement a Health Services Research selective to introduce School of [unreadable] Medicine students to this area of research. [unreadable] [unreadable] [unreadable]..
  10. Soy Consumption and Breast Tissue Proliferation
    Gertraud Maskarinec; Fiscal Year: 2006
    ....
  11. Until Death Do Us Part: Careers of Caregiving Wives
    Donald Taylor; Fiscal Year: 2006
    ..abstract_text> ..
  12. Use of Claims Data to Study Quality of Cancer Care
    James Goodwin; Fiscal Year: 2007
    ..We will then explore the reliability of the provider-level data in order to assess its potential utility in assessing quality of care for individual providers. ..
  13. In-Depth Examination of Disparities in Cancer Outcomes
    Cathy Bradley; Fiscal Year: 2007
    ..abstract_text> ..
  14. Effects of Soy on Estrogens in Breast Fluid and Urine
    Gertraud Maskarinec; Fiscal Year: 2010
    ..The NAF approach is the only way to learn more about the beneficial and adverse effects of soy directly in the female breast without applying invasive procedures to women without breast disease or surgery. ..
  15. Intervention Effectiveness in Finnish Agriculture
    Risto Rautiainen; Fiscal Year: 2007
    ..The results have great importance for similar efforts in Iowa and elsewhere. This study addresses three NORA priority areas and four Healthy People 2010 priority areas. ..
  16. Promoting Postpartum Weight Loss in Overweight Women
    Truls Ostbye; Fiscal Year: 2007
    ..In addition, extended follow-up will enable evaluation of long-term benefits of the intervention for weight loss and maintenance. ..
  17. Nutritional Risk Factors for Type 2 Diabetes in the Multiethnic Cohort
    Gertraud Maskarinec; Fiscal Year: 2008
    ..unreadable] [unreadable] [unreadable] [unreadable]..
  18. The effect of physical activity on metabolic syndrome in pregnancy and fetal outc
    Cynthia Ko; Fiscal Year: 2008
    ..It may offer a safe and readily available method to control weight and improve infant health during and after pregnancy. [unreadable] [unreadable] [unreadable]..
  19. Tracking Hospital Readmissions for Assessing Quality of Care: Methodological and
    Denise Love; Fiscal Year: 2008
    ..unreadable] [unreadable] [unreadable]..
  20. Colonoscopy quality and outcomes in clinical practice
    Cynthia W Ko; Fiscal Year: 2010
    ..The various algorithms we develop will be tested in a second, validation subset of our database to find the algorithm with optimal performance characteristics. ..
  21. COST AND OUTCOMES OF TWO PROTOCOLS FOR DENTAL SEALANTS
    Stephen Eklund; Fiscal Year: 2001
    ..A total of 1,000 children are being enrolled over a three-year period, and will be followed for an additional two years, in order to evaluate the clinical outcomes and resource requirements for the two alternatives. ..
  22. Welfare Reform, Fertility and Reproductive Behavior
    Robert Kaestner; Fiscal Year: 2003
    ....
  23. Outcomes of ICU Working Conditions
    Patricia Stone; Fiscal Year: 2003
    ..In addition, obtaining NNIS and Medicare data creates an opportunity to explore the sensitivity and specificity of identifying NI through claims data. ..
  24. Children with Chronic Health Conditions: Family Impact
    KAREN KUHLTAHU; Fiscal Year: 2002
    ....
  25. COST EFFECTIVENESS OF GENETIC SCREENING FOR COLON CANCER
    Scott Ramsey; Fiscal Year: 2002
    ....
  26. HLTH LIT, SOC SUPPORT,& HLTH: SURVEY OF MEDICARE ENROLLE
    Shoou Yih Lee; Fiscal Year: 2003
    ..abstract_text> ..
  27. NIMH TRAINEE CONFERENCE ON MENTAL HEALTH SERVICES RESEAR
    David Salkever; Fiscal Year: 2004
    ..In Year 1, the conference will be held with the annual meeting of the Association for Health Services Research; alternative sites will be considered for subsequent years. ..
  28. Mental Disorders, Private Insurance, and SSDI Benefits
    David Salkever; Fiscal Year: 2001
    ..abstract_text> ..
  29. Pilot to Evaluate Second Primary Cancers in the Elderly
    Lynne Penberthy; Fiscal Year: 2002
    ..abstract_text> ..
  30. INTERVENTION EFFECTIVENESS IN NURSING HOMES
    Barbara Silverstein; Fiscal Year: 2001
    ....
  31. Nursing Effort and Quality in Long-Term Care Facilities
    Robert Kane; Fiscal Year: 2004
    ..The database consists of 3125 residents in 98 nursing units from 62 facilities. Results should shed light on the current policy debate over nursing home staffing standards. ..
  32. RCT of Arthroscopic Partial Meniscectomy in OA
    Jeffrey Katz; Fiscal Year: 2004
    ..If funded, these planning activities would enable us initiate the full trial with minimal delay. ..
  33. PERCEPTION OF RISK AND BEHAVIOR IN THE ELDERLY
    Donald Taylor; Fiscal Year: 2001
    ....
  34. IMMUNOMODULATION IN INFLAMMATORY BOWEL DISEASE
    BRUCE SANDS; Fiscal Year: 2004
    ..The principal investigator seeks to become an independent clinical investigator by completing the didactic and scientific portions of this proposal. ..
  35. Economic Evaluations of Emerging Genomic Tests for Early Stage Breast Cancer
    YA CHEN SHIH; Fiscal Year: 2008
    ..To estimate the budgetary impact of the emerging pharmacogenomic prognostic and/or predictive tests [unreadable] [unreadable] [unreadable]..
  36. UTMB Center for Population Health and Health Disparities
    James Goodwin; Fiscal Year: 2008
    ..unreadable] [unreadable]..
  37. Youth Alcohol, Tobacco and Marijuana Use: Effects of Hours of Work and Wages
    Robert Kaestner; Fiscal Year: 2009
    ..The proposed research will identify the importance of employment and earned income on youth substance use and produce information that can be used to design effective public health policy to address this problem. ..
  38. OUTCOMES OF OLDER WOMEN WITH EARLY STAGE BREAST CANCER
    ANN NATTINGER; Fiscal Year: 2008
    ..The results will be critical to informing policy initiatives, including determination of how to best reduce socioeconomic disparities in breast cancer outcomes. ..
  39. KAN-DO: A Family-Based Intervention to Prevent Childhood Obesity
    Truls Ostbye; Fiscal Year: 2010
    ..Participants will be surveyed at baseline (3 months postpartum), 12 and 24 months post-baseline. Extended follow-up will enable evaluation of long-term benefits, and if effective, the KAN-DO intervention can be disseminated broadly. ..
  40. Inflammatory Markers in a 2-Year Soy Intervention among Premenopausal Women
    Gertraud Maskarinec; Fiscal Year: 2008
    ..The statistical analysis will apply general linear models to compare the levels of inflammatory markers by soy intake, while taking into account the repeated measurement design. [unreadable] [unreadable] [unreadable] [unreadable]..
  41. TRUCKING FIRM CHARACTERISTICS, DRIVER INJURY AND OUTCOME
    Arthur Oleinick; Fiscal Year: 2003
    ..Predictive value is evaluated by ROC curves, the Bayes Information Criteria or other recommended approaches. ..
  42. A Genetic Screening Policy Model for Colorectal Cancer
    Scott Ramsey; Fiscal Year: 2006
    ..The model will incorporate QOL information from Aim 2, along with family history, clinical, and screening information from the Seattle CFR. ..
  43. IMURAN Dose Ranging Study in Crohn's Disease
    BRUCE SANDS; Fiscal Year: 2005
    ..Abstract Not Provided ..
  44. Epidemiology of hepatocellular carcinoma
    Cynthia Ko; Fiscal Year: 2006
    ....
  45. Linking Performance Measures to Treatment Outcomes
    Deborah Garnick; Fiscal Year: 2004
    ..Our goal is to develop a data set rich enough to support testing the WCG performance measures and their relationship to outcomes in states that represent larger and more diverse populations. ..
  46. ESTABLISHING A LINK BETWEEN NUMERACY AND HEALTH
    Marilyn Schapira; Fiscal Year: 2005
    ..The findings will have implications for the role of mathematics in education and the potential role of interventions to improve numeracy among adults. ..
  47. LABOR MARKET OUTCOMES OF LONG TERM CANCER SURVIVORS
    Cathy Bradley; Fiscal Year: 2004
    ....
  48. SCHOOL ENVIRONMENT: EFFECT ON SUICIDE PREVENTION PROGRAM
    Bradley Stein; Fiscal Year: 2004
    ....
  49. Diabetes and Drug-Associated Hyperkalemia: Effect of Laboratory Monitoring
    Marsha Raebel; Fiscal Year: 2008
    ..The findings will also assist in developing a framework for future studies to evaluate the effects and costs of medication-laboratory monitoring among patients with diabetes. [unreadable] [unreadable] [unreadable] [unreadable]..
  50. PRIVATE AND SOCIAL COST OF SMOKING
    Frank Sloan; Fiscal Year: 2001
    ..We will examine implications of our empirical analysis for tort claims brought against tobacco companies and the evolution of legal theories underlying tobacco tort litigation in a law review article. ..
  51. Economic and Policy Analyses in Geriatric Disease
    EKATERINA NOYES; Fiscal Year: 2006
    ..The model and analytical approaches acquired by the candidate during her training will be used later to develop a decision analytical model describing geriatric depression. ..
  52. LINKING OCCUPATIONAL INJURY AND ILLNESS DATA BASES
    Kenneth Rosenman; Fiscal Year: 2002
    ..We have assembled an interdisciplinary team consisting of an occupational health physician, epidemiologists, a biostatistician and a computer programmer. We have arranged access to all nine data systems. ..
  53. Visual Impairment, Treatment and Effects on the Elderly
    Frank Sloan; Fiscal Year: 2008
    ..Ten papers are anticipated for this four-year study. [unreadable] [unreadable]..
  54. Utility of a New Database to Study Drug Safety during Pregnancy
    SOKO SETOGUCHI IWATA; Fiscal Year: 2008
    ..This database based on large population-based follow-up data with linkable clinical birth data has the potential to enhance the safety of prescription drug use in pregnant women and their children. [unreadable] [unreadable] [unreadable]..
  55. Medication Management Decisions in Schizophrenia
    Mark Olfson; Fiscal Year: 2003
    ..The results will inform quality improvement programs by identifying key modifiable determinants of the quality of medication management in the community treatment of schizophrenia. ..
  56. A PRESCRIPTION FOR ENHANCING RESIDENT QUALITY OF LIFE
    Ann Kolanowski; Fiscal Year: 2008
    ..This study holds promise for improving quality of life for nursing home residents with dementia by using theoretically based activities to respond to their needs. ..
  57. Predicting Transitions Among Community-Dwelling Elders
    Ilene Zuckerman; Fiscal Year: 2008
    ....
  58. Determinants and Consequences of Alcohol Consumption
    Frank Sloan; Fiscal Year: 2008
    ..abstract_text> ..
  59. CYTOKINE MODULATION IN PROLIFERATIVE VITREORETINOPATHY
    GLENN JAFFE; Fiscal Year: 2005
    ..Density-dependent effects of IL-1, TNFalpha, and specific NF-kappaB inhibitors on NF-kappaB-mediated RPE apoptosis will be quantified. IV) To determine whether specific in vivo NF-kappaB blockade inhibits PVR. ..
  60. OSCCAR: A Novel, Population-based Prospective Inception Cohort of Inflammatory Bo
    BRUCE SANDS; Fiscal Year: 2008
    ..unreadable] [unreadable] [unreadable]..