PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “billing”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources

Proximate and ultimate causes of adoption in ring-billed gulls.

From 1987 to 1994, the annual frequency of adoption by breeding pairs at a Lake Erie ring-billed gull, Larus delawarensis, colony ranged from 3 to 37% (average 8%/year, N=7 years) and, on average, foster parents raised 0.5 fewer of their own chicks to fledging than pairs that did not adopt. The key evolutionary question is: why do some individuals apparently suffer the costs associated with a behaviour that appears to enhance the fitness of others? From 1992 to 1995, I investigated the proximate and ultimate causes of adoption in ring-billed gulls from the perspectives of both the foster parents and adopted chicks, and tested predictions that differentiated between various competing adaptive and nonadaptive hypotheses that have been proposed to explain it. While I was able to demonstrate a breeding cost, I failed to identify any benefits to foster parents. Thus, the adaptive hypotheses that rely on the foster parents benefiting were not supported (e.g. kin selection, reciprocal altruism, acquisition of parenting experience). From the foster parent's perspective, adoption was mediated through errors in parent-offspring recognition. Under natural conditions, most fostering pairs were tending small chicks (<6 days old) at the time of adoptions; in chick-transfer experiments, resident parents did not discriminate against foreign chicks until their own chicks were 7-9 days old. Chicks (N=25) that subsequently abandoned their natal nests were lighter, and grew at a slower rate, than chicks that survived to fledging in their home broods. Thus, departing chicks were at a survival disadvantage in their home broods. Chicks that gained acceptance into foreign broods where they were older/larger than the resident chicks realized high survival at the expense of their foster siblings and parents. Based upon individual growth rates and the corresponding survival probabilities, disadvantaged chicks approximately doubled their survival chances through foster care. Why has selection not eliminated adoption? I argue that adoption is an evolutionary arms race between the two principle actor groups; disadvantaged chicks, which benefit through foster care, and host parents, which avoid providing foster care (e.g. infanticide). In ring-billed gulls, selection has failed to eliminate adoption because the long-term reproductive cost (estimated at 4%, this study) of an occasional adoption is probably offset by the relatively higher costs associated with stricter kin discrimination mechanisms (e.g. parental infanticide). (c) 1998 The Association for the Study of Animal Behaviour.

Journal Article↗

Billings natural family planning in Shanghai, China.

With cervical mucus, or Billings, method of family planning, a woman learns to recognize the characteristics of her cervical mucus that identify the fertile phase in her menstrual cycle. She and her partner abstain from sexual activity during a period from the first indication of mucus until four days after the mucus peak day, which includes ovulation. They also abstain during menses, because mucus can be confused with menstrual bleeding. This method of family planning is used widely, worldwide, by couples seeking a natural, reliable method of family planning. Between July 1988 and May 1990, 688 couples of child-bearing age, most of whom were parous, used the Billings method for contraception. Five hundred and fifty of these couples used the method for more than 12 months. Efficacy, continuation rates, and discontinuation rates were analyzed using life-table analysis for 10,175 woman-months of data collected. The net cumulative discontinuation rates per 100 women at 12 and 18 months were 19.85 and 34.58, respectively, resulting in continuation rates of 80.15 and 65.42. The discontinuation rates per 100 women for method-related reasons at 12 and 18 months were 1.61 and 2.84, respectively, while the discontinuation rates for unintended pregnancy were 1.02 and 1.18. During the study, 67 subjects volunteered to have vaginal smears taken from the upper part of the vaginal wall for cytologic examinations, and among them serum and urine LH levels were measured in 10 subjects and urinary estrogen and progesterone were assayed in 35 cases. These tests related other indications of the menstrual cycle to the ability of the women to judge ovulation by cervical mucus. Our research suggests that further investigation of the Billings method is warranted and that careful planning and organization are needed to disseminate the method more broadly.

Cervix Mucus↗

Thyroid and annual gonad development, body weight, plumage pigmentation, and bill color cycles of lal munia, Estrilda amandava.

Long-term administration of L-thyroxine (T4) in the wax bill (lal munia) inhibited the current gonad development cycle, and the increase in gonadal volume in the second cycle was suppressed only by higher concentrations. Gonadal inhibition by high but not by low doses of L-T4 was associated with a failure in the development of LH-dependent pigmented nuptial plumage. This suggests that L-T4 depresses FSH secretion more readily than LH secretion. The results indicate that the effects of L-T4 administration on the body weight cycle depends upon the physiological and/or gonadal status of the bird at the start of the experiment and that the juvenile hypothalamo-hypophysial-gonadal axis is more sensitive to L-T4 than that of the adult birds. The bill color, like plumage pigmentation, appears to be LH controlled. It is suggested that while thyroid hormone, acting by way of the hypothalamo-hypophysial complex and/or by direct action on the feather papillae, modulates the annual cycles of plumage pigmentation, bill color, gonad development, and body weight of lal munia, the finch has an endogenous mechanism which enables it to adapt to chronic hyperthyroidism in such a way that breeding occurs at the normal time of the year.

Animals↗

Using OHIP physician billing claims to ascertain individual influenza vaccination status.

The objective of this study was to validate physician billing claims against self-reported influenza vaccination to assess individual-level vaccination status. We compared responses to the Canadian Community Health Survey 1.1 (CCHS) and Ontario Health Insurance Plan (OHIP) physician billing claims and found moderate agreement. Using self-report as the gold standard, OHIP claims based on using both influenza-specific and general vaccination codes have high specificity and positive predictive value (PPV), reasonable negative predictive value (NPV), but only fair sensitivity. OHIP physician billing claims are suboptimal for ascertaining the vaccination status of individuals because many individuals receive their vaccinations outside doctor's offices, but may be used as the backbone for the creation of an immunization registry.

Adolescent↗

Follow-up consultation billing and documentation.

Frequently, bills are not submitted for follow-up visits for patients who have been evaluated psychiatrically on medical-surgical services. There often is confusion regarding which procedure codes are most appropriate to use in billing. To help the consultant understand the documentation requirements for various procedure codes, information from several sources was synthesized and distilled. This paper should help minimize documentation errors and maximize reimbursement for clinical services. The authors have reviewed available billing choices, and clarified the documentation requirements for different procedure codes according to Medicare regulations.

Accounting↗

Lack of genetic and plumage differentiation in the red-billed quelea Quelea quelea across a migratory divide in southern Africa.

A migratory divide usually signals the presence of a geographical region over which other traits, such as morphology and genotypes, also undergo rapid change. A migratory divide has been hypothesized in central southern Africa for the abundant migratory weaver, the red-billed quelea Quelea quelea. The positioning of the divide in the region is based on the patterns of rainfall in the region that stimulate the annual migrations of queleas. Evidence indicates that premigratory queleas near the divide show two distinct preferred directions for migration. We used eight polymorphic microsatellite loci and a range of plumage characters to determine whether there was population structure among red-billed queleas in southern Africa, and specifically whether this structure coincided with the location of the migratory divide. There was no evidence of population genetic structure. An amova revealed no significant differences between samples taken either side of the migratory divide. Similarly, there was no geographical variation in plumage patterns across southern Africa. For both microsatellites and plumage characteristics, the variation that does exist occurs within each sampled site, with little differentiation between sites. We were therefore unable to find any evidence that either plumage or microsatellite genotypes varied in a similar way to migratory direction preference in red-billed queleas in southern Africa. This is perhaps because the migratory divide does not act to separate individuals into populations within which genetic and plumage differentiation can be maintained.

Africa, Southern↗

Management of Information in Radiation Oncology: An Integrated System for Scheduling, Treatment, Billing, and Verification.

An effective information system is an essential prerequisite to delivering quality patient care at competitive costs. From scheduling and billing to complex treatment machine control and verification, the quality of the information system strongly affects the efficiency and accuracy with which patient care is delivered. The standard paper-based information system used in many clinics suffers form inefficiencies and incompleteness in scheduling and billing, no centralized database and the inability to generate routine reports and communicate with other information systems. Many of these problems are resolved by the introduction of an electronic information system. The implementation, gains, and limitations of two electronic information systems are discussed. While limitations such as the lack of complete seamless integration of all information still exist, major improvements have been made in efficiency, accuracy, data integrity, and reporting and billing completeness.

Journal Article↗

Using billing data to improve hospital drug use.

All hospitals, both in the United States and abroad, have a critical need to ensure the appropriateness and safety of the drugs prescribed and administered to their patients. The sources of data to support this effort are typically patient charts or automated pharmacy information data bases. Patient charts allow the capture of all information relevant to the patient, but are laborious to review in detail. Pharmacy information systems provide much information on drugs prescribed, but lack information on laboratory values and patient diseases. A third source of data, namely billing data, is a byproduct of the automated order entry process in US hospitals, but is seldom used for research or quality management. By standardizing the individual charge codes used by the hospitals for billing for drugs, the billing data becomes more accessible, comparable to other institutions, and more valuable as a source of research, quality assurance and quality improvement.

Abstracting and Indexing↗

Nursing intensity billing.

UNLABELLED: Hospital nursing care has traditionally been billed using a fixed daily room and board rate. This approach hides the variability of nursing care within and across nursing units and does not align nursing costs with daily charges for actual patient care. Anew nursing intensity billing (NIB) model for assigning hospital daily room charges is proposed, and initial results are reported. METHODS: Two charge methods, one using traditional room and board daily billing and another using an NIB approach, were developed for 12 adult medical or surgical units at the Medical University of South Carolina (MUSC) Medical Center using retrospective data from January 1 to May 31, 2005. The room and board charge was assigned as private room or intermediate care based primarily on patient location. The NIB model added an additional focused care charge between private and intermediate care, and the charge for the 3 levels was based on daily nursing intensity entered as actual hours of nursing care delivered. The mean and sum of charges were compared between the 2 methods. Charge rates were simulated at $700, $950, and $1,200 for the 3 levels, which correlated with the existing proprietary room rates. Nursing cost-to-charge ratios were calculated for room and board and NIB methods. RESULTS: The NIB model resulted in a 32.2% increase in charges or a total sum of $4,870,250 for the 12 nursing units over the 5-month period. The variability of nursing cost-to-charge ratio was reduced from 0.34 to 0.80 for room and board to 0.33 to 0.45 for the NIB method. CONCLUSION: The NIB method of assigning charges based on nursing intensity rather than on patient location increased overall charges and more evenly distributed direct nursing costs to daily charges. Assigning charges based on nursing intensity is appealing as it reflects actual care given in the acute care environment. The NIB provides evidence to support higher charge rates and has the ability to redistribute hospital charges based on nursing care. The relationship between increased daily hospital charges and actual reimbursement is unknown.

Hospital Charges↗

Mid-Pleistocene divergence of Cuban and North American ivory-billed woodpeckers.

We used ancient DNA analysis of seven museum specimens of the endangered North American ivory-billed woodpecker (Campephilus principalis) and three specimens of the species from Cuba to document their degree of differentiation and their relationships to other Campephilus woodpeckers. Analysis of these mtDNA sequences reveals that the Cuban and North American ivory bills, along with the imperial woodpecker (Campephilus imperialis) of Mexico, are a monophyletic group and are roughly equidistant genetically, suggesting each lineage may be a separate species. Application of both internal and external rate calibrations indicates that the three lineages split more than one million years ago, in the Mid-Pleistocene. We thus can exclude the hypothesis that Native Americans introduced North American ivory-billed woodpeckers to Cuba. Our sequences of all three woodpeckers also provide an important DNA barcoding resource for identification of non-invasive samples or remains of these critically endangered and charismatic woodpeckers.

Animals↗

Distribution and putative function of autonomic nerve fibres in the bill skin of the platypus (Ornithorhynchus anatinus).

The electroreceptors located in the bill skin of the platypus are modified secretory glands. The electroreceptive nerve terminals form bare endings in close proximity to the duct of these glands. In this study, we describe the autonomic innervation of the glands and a separate specialized autonomic innervation of the epidermal portion of the glandular duct. A range of immunohistochemical labels showed that the gland cells of the electroreceptors have a non-noradrenergic (putative parasympathetic) innervation. Phalloidin labelling revealed a 'sphincter' of epidermal luminal cells that labelled strongly for actin. These actin-dense keratinocytes were seen to have a noradrenergic (putative sympathetic) innervation. Fine-diameter sensory fibres containing substance P (presumably C-fibre thermoreceptors or polymodal nociceptors) were observed to terminate in the superficial epidermis surrounding the pore of the gland. When the bill of the platypus is dry these pores were closed. However, when room temperature water was washed over the bill, the pores opened. It is proposed that this autonomic and sensory innervation, along with the actin sphincter, mediates the opening and closing of the pores. By doing this, the platypus prevents the desiccation of the bare electrosensory nerve terminals when it is out of the water, and it may also be a way to regulate the impedance of the internal electrical circuit presented to the water at the pores.

Actins↗

An analysis of California Assembly Bill 2185: mandating coverage of pediatric asthma self-management training and education.

OBJECTIVE: To summarize for the California Legislature the evidence on the medical effectiveness of pediatric asthma self-management training and education (PASMTE), including the use of peak flow meters, spacers, and nebulizers and the impact that mandated coverage of these services and devices under Assembly Bill (AB) 2185 would have on total health care expenditures, monthly premiums, health services utilization, and the public's health. MEDICAL EFFECTIVENESS FINDINGS: The review of the literature finds that PASMTE is medically effective and has favorable effects on the health of children with symptomatic asthma, as well as reduces asthma-related emergency room visits and hospitalizations. There was inadequate evidence to assess the effectiveness of the three medical devices independently of PASMTE. COST AND UTILIZATION FINDINGS: One-hundred percent of children in health maintenance organization (HMO) plans in California are already covered for PASMTE, with fewer having coverage for the specific medical devices. However, despite full coverage of PASMTE in HMOs, these services are underutilized. We expect that the enactment of AB 2185 would increase utilization of PASMTE among children who are currently covered by 10 percent as a result of increased awareness of current coverage by all HMOs and increased awareness of the importance of these services. We estimate that this increased utilization by children who are already covered may result in a total statewide premiums increase of $170,000 or 0.006 percent, equal to one to two cents per member per month (PMPM). PUBLIC HEALTH FINDINGS: It is estimated that the public health impact of the mandate, as a result of new utilization of PASMTE by 10 percent of children who are already covered, would reduce the number of school days missed because of asthma per year by 158,000; the number of children reporting restricted activity days by 6,020; the number of emergency department visits by 350; and the number of hospitalizations by 1,105. LEGISLATIVE ACTION: AB 2185 passed the legislature after being amended six times. The bill as it was signed into law did not mandate coverage for PASMTE, as all HMOs in California presently reported covering these services. However, the bill retained the mandate for coverage of the three medical devices, as their coverage was not as universal across health plans.

Asthma↗

Nonreimbursed home health care: beyond the bills.

The unprecedented growth in the home care industry over the past decade has produced a highly competitive environment for care delivery. To survive, most agencies are implementing strategies to maximize reimbursable care. This focus, while likely to improve an agency's financial situation, is fraught with potential problems. Reimbursed care represents only a small portion of the care that is required and delivered. Still, aside from anecdotes, little reporting has been done to document such additional service, much less to consider the consequences of reducing or deleting it. We selected a sample of 350 public health home care episodes throughout Virginia, and reviewed billing records to determine the number of billed home visits attached to them. We then reviewed home health records for the matching episodes and recorded all visits and other care-related activities (e.g., telephone calls, conferences, laboratory trips). Total home visits increased, with an average of 1.5 unbilled home visits per episode. In addition, 10 additional care-related activities take place per patient, none of which is billed. These findings represent one of the first attempts to quantify the amounts and types of nonbilled care delivered by nurses. This care consumes significant nursing resources and, as a result, may be destined to be reduced or totally eliminated.

Home Care Services↗

Payment of emergency department bills by Medicaid patients.

OBJECTIVE: To analyze ED services used by and payment received from patients who request to stay and assume responsibility for their bills after being denied emergency care payment by their Medicaid providers. METHODS: A retrospective chart review over an 18-month period was conducted. Charges for these visits were obtained from the physician billing service and hospital finance records. RESULTS: Of 193 patient visits identified, 192 charts were located and reviewed for chief complaint, diagnostic tests, and interventions performed. In total, the visits resulted in $18,120 in physician charges and $28,126 in hospital charges. Three payments amounting to $134 were collected, leaving $46,246 in nonreimbursed charges. CONCLUSIONS: Nearly all patients who elect to be seen in this pediatric ED after being denied by their Medicaid managed care providers do not pay their bills. ED resources, including laboratory studies, radiographs, and consultations, are used to evaluate and treat these patients without compensation. The cost of this nonreimbursed care must be recovered from other patient care charges.

Adolescent↗

Comment on "Ivory-billed woodpecker (Campephilus principalis) persists in continental North America".

We reanalyzed video presented as confirmation that an ivory-billed woodpecker (Campephilus principalis) persists in Arkansas (Fitzpatrick et al., Reports, 3 June 2005, p. 1460). None of the features described as diagnostic of the ivory-billed woodpecker eliminate a normal pileated woodpecker (Dryocopus pileatus). Although we support efforts to find and protect ivory-billed woodpeckers, the video evidence does not demonstrate that the species persists in the United States.

Animals↗

Spectral reflectance of gull's bill: physiological and evolutionary implications for animal communication.

The newly hatched laughing gull chick (Larus atricilla) begs food by pecking at the parent's dark red bill. The spectral reflectance of the bill over a range of 300 to 1200 nanometers reflects increasingly more with wavelength beginning about 575 nanometers. Because the chick shows a bimodal, true color preference in pecking, with modes at about 625 and 450 nanometers; the latter, blue peak in the spectral response curve is apparently not adapted to the natural stimulus of the parent's bill. The blue peak might thus be the result of limitations in the neural coding of color information in the chick's visual system.

Animal Communication↗

Concordance between childhood injury diagnoses from two sources: an injury surveillance system and a physician billing claims database.

OBJECTIVES: (1) To determine the concordance between injury diagnoses (head injury (HI), probable HI, or orthopedic injury) for children visiting an emergency department for an injury using two DATA SOURCES: an injury surveillance system (Canadian Hospitals Injury Research and Prevention Program, CHIRPP) and a physician billing claims database (Regie de l'assurance maladie de Quebec, RAMQ), and (2) to determine the sensitivity and specificity of diagnostic and procedure codes in billing claims for identifying HI and orthopedic injury among children. DESIGN: In this cross sectional cohort, data for 3049 children who sought care for an injury (2000-01) were obtained from both sources and linked using the child's personal health insurance number. METHODS: The physician recorded diagnostic codes from CHIRPP were used to categorize the children into three groups (HI, probable HI, and orthopedic), while an algorithm, using ICD-9-CM diagnostic and procedures codes from the RAMQ, was used to classify children into the same three groups. RESULTS: Concordance between the data sources was "substantial" (weighted Kappa 0.66; 95% CI 0.63 to 0.69). The sensitivity of diagnostic and procedure codes in the RAMQ database for identifying HI and for orthopedic injury were 0.61 (95% CI 0.57 to 0.64) and 0.97 (95% CI 0.96 to 0.98), respectively. The specificity for identifying HI and for orthopedic injury were 0.97 (95% CI 0.96 to 0.98) and 0.58 (95% CI 0.56 to 0.63), respectively. CONCLUSION: Combining diagnostic and procedures codes in a physician billing claims database (the RAMQ database) may be a valid method of estimating injury occurrence among children.

Adolescent↗

Political realities of statewide smoking legislation: the passage of California's Assembly Bill 13.

OBJECTIVE: To prepare a history of the enactment of California Assembly Bill 13 (AB 13), a state law prohibiting smoking in most workplaces passed in 1994, and to discuss its initial impacts. METHODS: Data were gathered from open ended interviews with representatives of voluntary health organisations, local government organisations, and principal legislators involved in the process, as well as observers around the state who could provide insight into the legislative process. Information was also obtained from legislative hearings and debates, public documents, letters and personal communications, internal memoranda, and news reports. RESULTS: The success of local tobacco control legislation in California led to a situation in which some health groups were willing to accept state preemption in order to attract the support of the state restaurant association for a bill. The decision to accept this preemption compromise was made by the state level offices of the voluntary health agencies without consulting the broader tobacco control community within California. In contrast, local tobacco control advocates did not accept this compromise, in part because of their belief that local legislation was a better device to educate the public, generate media coverage, and build community support for enforcement and implementation of clean indoor air and other tobacco control laws. Enactment of AB 13 was associated with a slowing of all local tobacco control legislation, including youth oriented laws. CONCLUSIONS: Because its supporters initially doubted that AB 13 would pass, there was never an effort to reconcile the policy differences between state oriented and locally oriented tobacco control policies. This lack of consensus, combined with the political realities inherent in passing any state legislation, led to a bill with ambiguous preemption language which replaced the "patchwork of local laws" with a "patchwork of local enforcement."

California↗