March 8th, 2009 at 10:07pm
Under Uncategorized
California small employers are creating a hurricane of lawsuits for themselves. With the elimination of vocational rehabilitation under California workers’ compensation and after the Raine v. City of Burbank decision in January 2006, Employers’ are misinterpreting the law and are refusing to accommodate employees, which is causing a massive flood of claims. Raine is an instructive opinion in that it gives the employer a step by step approach in finding whether an employee’s request is reasonable in order to accommodate after a work related injury. Raine teaches employers’ how to avoid the eye of the Hurricane.
Recently, I mediated and litigated claims where the employee, permanently disabled from a work related injury, was terminated following the finality of the workers’ compensation claim. The problem stemmed from the misinterpretation of Raine v. City of Burbank decision. Raine stood for the proposition that an employer does not have the duty to convert a temporary accommodation into a permanent job assignment when so doing would create a new position for the disabled employee. Employers are taking the holding to the extreme and arguing that any accommodation in the permanent job position of an employee is creating a new position. Unfortunately, employers are missing the vital component in analyzing whether a new position is being created, whether or not it is a reasonable accommodation.
Employers still become very confused on how to handle an accommodation under a worker’s compensation claim that turns into a FEHA/ADA accommodation. Employers’ understand that in a work related injury that they should provide light duty’ positions in order to reduce their workers’ compensation costs and liability. Usually these light duty’ positions are a requirement of the employer’s workers’ compensation insurance carrier. But once the employee’s workers’ compensation injury is found permanent and stationary, and results in the employee being rated with a permanent disability, what does an employer do? Raine is an instructive opinion in that it gives the employer a step by step approach in finding whether an employee’s request is reasonable in order to accommodate. Raine teaches employers’ how to avoid the eye of the Hurricane by following a process in accommodating a work related injury: 1. During the employees workers’ compensation claim, offering temporary duty or light duty , 2. After completion of the workers’ compensation claim, employee is permanent and stationary, and the employee’s injuries are rendered permanent: perform an interactive job analysis, and 3. If reassignment is requested, find available alternative employment opportunities.
When it begins to rain, we are never certain whether it will pour. At least with the weather satellites and meteorological forecasting, we can be prepared for a storm, and attempt to prevent any damage the storm may cause. If a small does not seek advice of legal counsel, to help them gain shelter from the storm, the small will be washed away. The Raine decision is our weather satellite and gives us three valuable storm warnings to prevent a hurricane of disability discrimination claims.
Disclaimer: This article reflects the author’s opinions and views on an employment issue; these opinions and views do not constitute a guarantee, warranty or prediction regarding the outcome of your legal matter; application of these views or opinions to any matter requires legal advice.
California small employers are creating a hurricane of lawsuits for themselves. With the elimination of vocational rehabilitation under California workers compensation and after the Raine v. City of Burbank decision in January 2006, employers are not offering accomodations to injured employees. If a small does not seek advice of legal counsel, to help them gain shelter from the storm, the small will be washed away.
Author: Elizabeth Moreno
Keywords: small
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By admin
March 8th, 2009 at 10:07pm
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Suppose you have a technology company and a technology (which may be a trade secret or in the stage of patenting), you need to meet an investor (whether its a venture capitalist or business angel). How do you protect yourself from the investor stealing the idea? A partial solution is the use of a legal document called the Non Disclosure Agreement (NDA). What does this agreement entails? Notice that I use the word partial, because not all investors like NDAs. I will discuss the possible situations where it may be or may not be appropriate to use it and provide a template for those in Singapore who might need it.
In short, A non-disclosure agreement (NDA), is a legal contract between at least two parties which outlines confidential materials or knowledge the parties wish to share with one another for certain purposes, but wish to restrict from generalized use (Source: Wikipedia). In short, it is just a piece of paper to ensure that two parties have agreed not to reveal any information covered by an agreement. If you are selling a particular product that requires protection to deal with the risk of replication by other competitors, this agreement is an essential piece of paper for you. Other terms of the same nature include a confidential disclosure agreement (CDA), confidentiality agreement or secrecy agreement.
In the case of the startups, NDAs are signed when two companies or individuals are considering the creation of a business enterprise, an investment proposal or a partnership agreement. It is required for evaluation of a business relationship as well. NDAs can also mean the following situation: either that both parties are restricted in their use of the materials provided, or they can only restrict a single party. In the case of large companies or even universities and research institutes, NDAs are required to protect privileged information that are disclosed to the employees.
Here are a couple of questions which I often encounter when an entrepreneur asks about the NDA:
Where can I find a template of an NDA that details such an agreement?: Basically, the entrepreneur needs to find an example on how to draft an NDA. You can find this URL from Enterprise One where sample NDA templates are provided. Note that it is a sample and you need to modify it to suit your purpose.
I hear from my lecturer or from some VCs that they dont accept NDAs: From the investors viewpoint particularly, the venture capitalists, there are two schools of thoughts. Some VCs are alright with signing one and some of them are not. There is no hard and fast rule. So, why is it that some venture capitalists or business angels dont like to sign an NDA? There are two reasons: first, they dont want to be tied down because they might encounter an alternate party sharing similar technology or idea like yours and second, the arrogance that since they are receiving a hundred plans per day, what makes your plan that unique that they should sign one?Let me give you my personal experience. In the UK and Europe in general, NDAs are common, and whether you are a startup or an established company, when you need to divulge something regarding technology, a NDA is required. You can imagine my shock when I hear some local investors (but they are trained in the US) telling me that they dont need that. So, NDA signings can be cultural in another perspective but it is an universally acceptable practice to request the other party to sign an NDA if you feel uncomfortable. You dont lose brownie points if you ask and they reject signing it. When I do consulting or fundraising for a biotech company who needs to divulge their technology so that I can do a valuation of how much they are worth, I usually ask for a NDA so that my client will trust me to look at their company.
Why do I need a NDA?: The answer is obvious. You need to protect your company. Actually, if you listen long enough to successful entrepreneurs, the real strategy is never to protect your technology, but rather, protect your markets, i.e. create barriers of entry for your competitors so that they need a lot of time and effort to roll out an alternative product to match yours.
In practice, its good to have one sample NDA with you when you go out and pitch your product. Usually, some people place a few NDA papers in their brief case, so that it comes in handy when meeting investors, business partners and even clients.
Bernard Leong is currently an adjunct assistant professor at the National University of Singapore (NUS). He sits on the steering committee for the Start-Up@Singapore business plan competition, and also teaches business and entrepreneurship. To learn more about the Start-Up@Singapore business plan competition, please visit www.startup.org.sg
Author: Bernard Leong
Keywords: startups, entrepreneurship, non-disclosure agreements, business, start-ups, entrepreneurs
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March 8th, 2009 at 10:07pm
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Let There Be Light!
Lighting for your store can never be too perfect. Never choose lighting to be the expense you skip out on because light is one of the most quintessential properties of your store. It communicates to your customer the value of your products as well as the value you place on your business. Consider the lighting you would find in a museum displaying valuable artifacts or rare works of art. You probably will not find cheap light bulbs accenting the workings of Van Gogh. The value of objects will always reflect in the lighting selected to display them. Understanding different lighting options and requirements will put you well on your way to a more effective store display.
Dimmers are usually an essential part to the lighting ensemble. These adjust lighting for variables you may have from season to season or product to product. This will insure you are ready to light your products in most situations. Dimmers are also helpful in balancing the general lighting and accent lighting used in your store. They can actually create an ambiance on their own. Dimmer switches are especially important to have on the down lighting of your store. Down lights provide general illuminations when used with incandescent flood lamps. The deeper and darker the light fixtures in this case, the better. This will hid the light source more effectively and lower the amount of glare that the flood lamps produce. Black baffle trim is even an option for this purpose. Swivel down fixtures may also provide a more directional soft light for whatever display needs you may have.
Emergency lights and exit signs are required by code. No store should go without these safety precautions. Emergency lights release a back-up light supply using batteries. This prevents chaos when the power goes out. Not only are they required, but your customers will be less likely to become frightened in the event of a power outage. Exit signs are also required by the life safety building codes to allow people to easily locate the nearest exit. This can save lives in the event of fire, earthquake, or criminal attack. LED exit signs require no lamp replacement for 25 years and use very little electricity, so exit signs do not have to be a large expense. Manufacturers now design a combination of exit signs and emergency lights so that they come in one unit. This can save on installation and maintenance costs.
Although they are not always the most appealing light source, fluorescent light fixtures are extremely energy efficient and give off a very even brightness. Lay-in fixtures are appropriate for hung ceilings and wraparounds for surface mounting. Fluorescents can also provide fantastic indirect lighting by positioning fluorescent fixtures behind soffits or coves in the store. To take a step up, track lighting is the premium product for dramatic accents. Customers will notice luxurious highlights on your products or display items such as furniture or artwork. Lunar light fixtures are an industry leader for great results in track lighting displays.
While track lighting really brings the store to a new level of display, surface mounted spotlights and other directional lights will provide some finishing touches. These are perfect for any sort of decorative lighting effects where track lighting may not work. Those hard to reach corners or high ceilings may prevent traditional track lighting while spotlights or other directional fixtures will serve well. Spotlights may also be used to highlight architectural elements of your shopping environment.
Whatever you provide the public in your retail store, your displays are far more effective with proficient lighting. Not all owners and managers realize that attention to this simple detail can change the flow of traffic in your store and produce an environment that customers choose to shop in. You can bring life to your store with the right kind of light.
Ron Maier is the Vice President of S & L Store Fixtures, a leading online vendor of mannequins, mannequin torso, and retail store displays. For more information, please visit http://www.slstoredisplays.com .
Author: Ron Maier Jr.
Keywords: store, displays, lighting, light, track, accent, decorate, decor, design
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By admin
March 8th, 2009 at 10:07pm
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The most recent NexusEQ Conference included delegates from over 100 disciplines and 37 nations gathered in Holland to see how emotional intelligence improves leadership. On EQ.org, more and more practitioners are appearing from all over the world. Google News has stories about EQ every day. It all goes to show that emotional Intelligence is of interest to a wide and growing audience. But what do we mean by emotional intelligence — is it just a nice way of talking about concepts that have been popular for decades? Or is there really a new concept to explore?
Part of the vision of these world conferences is to find a shared understanding, a common vision, which is challenging in an emerging science. There are many different theorists, many different practitioners, and many different models. So rather than choosing one specific model, the NexusEQ conferences work to bring out research and practice that values the power of emotions as a driving force in our capacity for wisdom. In this view, Emotional intelligence is different from emotional, different from humanism, different from openness, different from caring, different from consciousness, and even different from emotional literacy. While there are many forms of psychology, self-awareness, and personal growth that deal with emotions, that does not mean they are informed by the science of emotional intelligence. One key differentiator is how people define the role and function of emotions. In most of psychology emotions are identified as a symptom, an artifact, an aberration, or a coincidence (even in emotion-friendly disciplines such as Positive Psychology, Neuro-Linguistic Programming, Emotional Freedom Technique, Constellation Therapy, and Transactional Analysis). Emotion is seen as secondary, sometimes even as dysfunction. Generally speaking, psychological approaches say, Thinking is King, and emotion is a byproduct (as is behavior). Perhaps this is most clearly visible in Rational Emotive Therapy, which deals with emotions but treats them as artifacts of mistaken beliefs.
Another whole school of thought focuses on Behavior is King. This paradigm is almost insidious in the way it creeps into management, parenting, and education. In this view, all we need to focus on is behavior - and if we can pull the right levers (rewards and punishments), we can change any behavior.
At the other extreme, some approaches arising from the self-esteem movement treat positive emotions and feeling good as something magical or transcendental. Somewhere along the road, the current incarnations of EST, Forum, Tea Groups, and Essalon still act like emotions are a barrier that must be broken through with intense feeling and catharsis to arrive at true understanding.
Part of the revolutionary value of EQ is a new perspective on emotions that’s truly different from other views. From the EQ perspective, emotions are a functional, adaptive source of information and energy - they are understandable, measurable, and practical. Thinking and feeling are two notes of the same chord. Perhaps behavior is a third note. In this view, emotions are part of intelligence - part of cognition. Both are biological processes and inseparable from our physical selves.
As far back as Darwin (and maybe before), scholars have proposed that emotions help us survive. Going several steps further, we now know emotions are a basis for group interaction, they give us critical information about others and about ourselves, they influence thinking and even create our very consciousness. They cannot be meaningfully isolated from thinking, and it’s meaningless to say one comes first and the other is a result. There are no bad or irrational emotions, though there are emotions we don’t understand and many we express inappropriately. To be intelligent with our emotions, we must recognize and attend to them respectfully and intentionally. Emotional intelligence is an emerging science; we are living on the cutting edge, and this creates some confusion. The plurality of models, theories, and views is a sign of a healthy debate as different scholars and thought-leaders test the boundaries of this new field of study. In the last two decades there have been tremendous advances in our understanding of the intelligence of emotions and there is still much more to learn.
The task you and I have is to find the jewels of value amidst the bustle of new discovery and the hustle of marketing hype. As you learn about emotional intelligence and as you find practitioners and allies to support your implementation - keep the key principle in mind. If you want the benefits of emotional intelligence, you’ve got to link up thinking and feeling as two partners building a sustainable and prosperous alliance.
Joshua Freedman is the Chair of the NexusEQ Conferences (www.NexusEQ.com ) and the Director of Six Seconds Institute for Organizational Performance (www.EQperformance.com). He works with organizations such as Schlumberger, the US Navy, and FedEx to improve leadership, sales, and organizational performance by increasing emotional intelligence. To learn more about emotional intelligence, see www.6seconds.org
Author: Joshua Freedman
Keywords: emotional intelligence
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March 8th, 2009 at 10:07pm
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Even though there is no formal education for being a medical biller, medical billing itself can be quite complicated. There are enough rules and regulations to turn a sane man into a raving lunatic. The GU0 record does nothing to make the job any easier as it is probably the most complex CMN in the system. In this installment, we cover the GU0 record, picking up with field number 18.
GU0 field 18, positions 63 - 70, is the date of last medical exam. This field tells the carrier when the last date it was that the patient saw the doctor who prescribed this CMN. If the last date seen is before the date of the CMN, in some cases the carrier will not pay on the claim. This is why this date is required.
GU0 field 19, positions 71 - 78, is the initial date field. This field tells the carrier what the initial date of the CMN is. This is required because if the CMN is a recertification or a revised CMN, the carrier needs to know when the initial date was in order to know how to process the claim.
GU0 field 20, positions 79 - 86, is the revision or recertification date. Referring back to field 19, is this is a revised or recertified CMN, the date of that revision or recertification is transmitted here. By looking at this date and comparing it to the initial date, the carrier will know how to process the claim, depending on the item and the rules governing that item.
GU0 field 21, positions 87 - 88, is the length of need. This is the length of time, according to the physician, that the patient is going to need this item. It should be noted that this is only an estimate and not written in stone.
GU0 field 22, positions 89 - 96, is the date of signature. This field tells the carrier the date that the physician signed the CMN.
GU0 field 23, positions 97 - 106, is the ordering provider phone number. This field tells the carrier what the phone number is of the provider who prescribed this CMN. This number is needed in case the carrier needs to contact the provider.
GU0 field 24, position 107, is the certification on file field. This field tells the carrier if the actual paper CMN is on file at the provider’s office. There is a lot of legal gray area involved with this field that is beyond the scope of this article. Let’s just say that eventually that CMN better be on file and signed.
GU0 field 25, positions 108 - 111, is the certification form number. This tells the carrier what the exact CMN form number is. This is required because the GU0 record is created to handle a number of CMNs. In order to properly process the claim, the carrier needs to know exactly what CMN they are processing.
In our next installment of medical billing, we’ll be covering the GU0 record, picking up with field number 26.
Michael Russell
Your Independent guide to Medical Billing
Author: Michael Russell
Keywords: medical billing
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March 8th, 2009 at 10:07pm
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Medical billing can be a real nightmare. No wonder the turnover with medical billers is so great. Between the number of regulations, pile of forms and tons of red tape, it’s enough to make anybody crazy. One of the worst culprits is the DMEPOS CMN, or the GU0 record, which is used for electronic transmission of claims using NSF 3.01 specifications. In this installment, we’ll be covering the GU0 record, picking up with field number 8.
GU0 field 8, positions 32 - 33, is the HCPCS modifier. The HCPCS modifiers are one of the big reasons that medical billers lose their minds so quickly. Having to keep track of which modifier goes with what month can be a real pain in the backside. Fortunately, most electronic billing software packages take care of this for you. This field is used to tell the carrier which month of billing you’re in for the item or service in question.
GU0 field 9, position 34, is the warranty reply field. This field tells the carrier if the item being billed for this CMN is under warranty or not. If it is, the field is transmitted as a Y. If it isn’t, it is transmitted as an N. If this doesn’t apply, then the field is transmitted as a D.
GU0 field 10, positions 35 - 36, is the warranty length. If the item is under warranty, as designated by field number 9, then this field tells the carrier what the warranty period is in months.
GU0 field 11, position 37, is the warranty type. This field tells the carrier what type of warranty the item comes with. There are four valid entries for this field. A 1 is entered if the item comes with a full replacement warranty. A 2 is entered if the item comes with a pro rated replacement. A 3 is entered if the item comes with a parts and labor warranty. A 4 is entered if the warranty is for parts only. This field must be entered if required by the payer.
GU0 fields 12 - 15, positions 38 - 57, are the diagnosis codes. These fields tell the carrier what the diagnosis codes are, related to the piece of equipment that the CMN has been issued for. At the time of this writing, these are still ICD-9 codes and not the new ICD-10 codes. That may change at any time.
GU0 field 16, positions 58 - 59, is the patient height. This field tells the carrier what the patient height is in inches. Unlike many of the other height fields in the NSF specifications, this field is only two characters in length.
GU0 field 17, positions 60 - 62, is the patient weight. This field tells the carrier what the patient weight is in pounds. If the weight is under 100 pounds then the field is sent left zero filled. For example, 99 pounds is transmitted as 099.
In our next installment on medical billing, we’ll be covering the GU0 record picking up with field number 18.
Michael Russell
Your Independent guide to Medical Billing
Author: Michael Russell
Keywords: medical billing
Power by History of the Computer | Computer safety tips
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By admin
March 8th, 2009 at 10:07pm
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In the world of medical billing, there is no CMN more dreaded by billers than the DMEPOS CMN. This grandaddy of all CMNs is over 70 fields long. You practically need to be a certified medical practitioner to understand it to begin with. In the following series of articles, we’re going to cover the various fields of this monster of a CMN. If there is something you’re not clear on, consult your manual or call your carrier for complete instructions on how to fill out the field in question. So, if you’re ready, hang onto your brain cells because you are going to need them for what’s to follow.
First of all, it is important to know what DMEPOS stands for. It is an acronym for Durable Medical Equipment, Prosthetics, Orthotics and Supplies. In other words, this CMN covers just about everything under the sun related to those three categories. That is the reason why this CMN is so long. It needs to be able to handle a number of items. We’ll begin with field number 1.
GU0 field 1, positions 1 - 3, is the record type. This must be filled with GU0 and most come after all F records for this patient in the claim file. Also, if other CMNs are being transmitted, it must come after all CMNs from GA0 to GP0.
GU0 field 2, positions 4 - 5, is the sequence number. This is the number of the CMN in the claim file. There can be up to 99 CMNs transmitted with a claim file. So each record would be GU0-01, GU0-02 and so on.
GU0 field 3, positions 6 - 22, is the patient control number. This field must contain the same patient ID number that is transmitted in the CA0 record and all subsequent records that also transmit this information.
GU0 field 4, position 23, is the cert type. This field tells the carrier if the CMN is an initial, designated with a 1, a recert, designated with a 3, or a revised, which is designated with a 2. One of those codes must be entered. The field cannot be left blank.
GU0 field 5, positions 24 - 25, is the place of service. This field tells the carrier where the actual service is performed. This must match the info transmitted in the FA0 record field number 7.
GU0 field 6, position 26, is the replacement item field. This field tells the carrier if the item this CMN is for is a replacement item or not. If it is, a Y is entered. Otherwise, you enter an N. This must be entered for all CMNs except DMERC 8.02. For that CMN, this field must be blank.
GU0 field 7, positions 27 - 31, is the HCPCS procedure code. This field tells the carrier what the procedure code is for the item this CMN is prescribing.
In our next installment of medical billing, we’ll continue with our review of the GU0 record, picking up with field number 8.
Michael Russell
Your Independent guide to Medical Billing
Author: Michael Russell
Keywords: medical billing
Power by History of the Computer | Computer safety tips
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March 8th, 2009 at 10:07pm
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We’re finally coming to the end of our review of the GP0 record for medical billing of claims via electronic media, using NSF 3.01 specifications. In this installment we’ll be covering the last twelve fields, which is where most of the differences are between the parental nutrition CMN and the enteral nutrition CMN, which we reviewed previously when we covered the GE0 record. We pick up this installment with field number 22.
GP0 field 22, positions 78 - 92, is the amino acid name. This is the field that tells the carrier the name of the amino acid that is being administered to the patient. This field must be filled in with the actual name of the acid. No abbreviations or brand names allowed.
GP0 field 23, positions 93 - 96, is the amino acid volume. This field tells the carrier how much of the amino acid the patient is to receive per day, not per feeding, for parental nutrition therapy. This amount is transmitted in milliliters and must be exact.
GP0 field 24, positions 97 - 101, is the amino acid concentration. This field tells the carrier what the exact percentage of concentration is for the amino acid that is being given to the patient for parental nutrition therapy. In this case, a decimal is used to show a concentration that is less than a whole percentage, like 10.5%.
GP0 field 25, positions 102 - 105, is the amino acid weight. This field tells the carrier how much the amino acid that is given per day, weighs in grams. If the number of grams prescribed per day is greater than 100, then a narrative explanation must be given in field number 31.
GP0 field 26, positions 106 - 109, is the dextrose volume. This field tells the carrier how much dextrose is in the prescription given to the patient, per day. This field is transmitted in milliliters and must be exact.
GP0 field 27, positions 110 - 114, is the dextrose concentration. This field tells the carrier what the percentage of dextrose is, in relation to the entire solution given to the patient on a daily basis. As with field number 24, a decimal is used if not a whole percentage.
GP0 field 28, positions 115 - 118, is the lipids volume. This field tells the carrier what the volume of lipids is given to the patient on a daily basis. This field is also transmitted in milliliters and must be exact.
GP0 field 29, positions 119 - 123, is the lipids concentration. This field tells the carrier what the percentage of lipids is in relation to the whole mixture, given to the patient on a daily basis
GP0 field 30, positions 124 - 126, is the lipids frequency. This tells the carrier how many times per week lipids are used in therapy.
GP0 field 31, positions 127 - 226, is the narrative field. This field is used to give the carrier any information that is not covered above that is required, such as explanations.
GP0 field 32, position 227, is the administration technique indicator. This field is used to tell the carrier how the parental nutrition is being administered. Valid entries are N, G, J, or O.
GP0 field 33, positions 228 - 320, is filler national and must be filled with spaces.
In our next installment of medical billing, we’ll cover another in the long list of CMNs.
Michael Russell
Your Independent guide to Medical Billing
Author: Michael Russell
Keywords: medical billing
Power by History of the Computer | Computer safety tips
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March 8th, 2009 at 10:07pm
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Medical billing of parental nutrition claims is not an easy task. There are a lot of calculations that need to be done and a lot of things that need to be accounted for such as the actual product being dispensed, calories per day and so on. Computer programs make the job a little easier when billing through electronic media and NSF 3.01 specifications. In this installment we’ll be covering the GP0 record, picking up with field number 15.
GP0 field 15, position 63, is the ambulatory indicator. This field tells the carrier whether or not the patient is ambulatory. There are only two valid responses for this field. If the patient is ambulatory, an A is entered. If the patient is not ambulatory, an N is entered. The field cannot be left blank or the claim will be denied.
GP0 field 16, position 64, is the other forms of nutrient indicator. This field tells the carrier if the patient is receiving other forms of nutrition other than what this CMN is prescribed for. This is important because in some cases, if the patient is receiving other treatments, this claim may not be 100% payable. As it is, with Medicare, most claims are only 80% anyway. But if other feedings are involved, this claim may be even less than 80% covered.
GP0 field 17, position 65, is the type of mix indicator. This field tells the carrier the type of mix being administered to the patient. There are basically only two possible mixes. There is a home mix, where the ingredients are put together at the home or facility from various sources. This mix is transmitted with the letter H. A premix is when the mix is something that already comes put together by the manufacturer and just needs to be administered out of the package. This mix is transmitted with the letter P.
GP0 field 18, positions 66 - 68, is the parental frequency field. This field tells the carrier how many times per week the patient is to be fed. If the frequency is less than 100 times per week, which it will almost always be, the field must be left zero filled. So if the patient is fed three times a day, or 21 times in a seven day period, the field is transmitted as 021.
GP0 field 19, positions 69 - 73, is the HCPCS procedure code. This field tells the carrier the procedure code associated with the item being fed to the patient. This is not like the procedure code in the F record, which tells the carrier the condition of the patient or treatment of the patient.
GP0 fields 20 and 21, positions 74 - 77, are the two modifiers for the HCPCS procedure code. These fields transmit these modifiers to the carrier. The modifiers are usually determined by the month number of the CMN itself.
In our next installment of medical billing of claims via electronic media, we’ll pick up our discussion of the GP0 record with field number 22.
Michael Russell
Your Independent guide to Medical Billing
Author: Michael Russell
Keywords: medical billing
Power by History of the Computer | Computer safety tips
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By admin
March 8th, 2009 at 10:07pm
Under Uncategorized
Medical billing of parental nutrition claims, as with enteral nutrition claims is relatively new in comparison to other billable services. The parental nutrition CMN is electronically transmitted using the GP0 record. In this installment we’re going to cover the GP0 record, starting with field number 8.
GP0 field 8, positions 42 - 43, is the number of months of this certification. This field tells the carrier how long this CMN is going to be good for. An initial CMN is usually good for about 3 months. After the initial expires, the first recertification is usually for 9 months. After that, each recertification is usually for a year. There are of course exceptions.
GP0 field 9, positions 44 - 51, is the date last seen by physician. This field tells the carrier when the last date it was that the physician who prescribed this CMN saw the patient. If the period of time is too long before the certification, the CMN may be denied by the carrier.
GP0 field 10, position 52, is the non-physician visit indicator. This field is identical to the indicator for enteral nutrition claims. This tells the carrier what the medical evaluation of the patient was based on. There are only four possible entries. An N is entered if the evaluation was made by a visiting nurse. An L is entered if the evaluation was made by lab or clinical reports. An O is entered if the evaluation was made by other means. The field is left blank if it is not applicable.
GP0 field 11, positions 53 - 55, is the patient’s age. This tells the carrier how old the patient is in years. Enough space is left should the patient be over 100 years old. If however the patient is under 100, the field must be left zero filled. In other words, an age of 72 would be transmitted as 072.
GP0 field 12, positions 56 - 58, is the patient’s height. This field tells the carrier how tall the patient is in inches. If the patient is under 100 inches, which is more likely than not, then the field must also be left zero filled A height of 72 inches, or six feet, is transmitted as 072.
GP0 field 13, positions 59 - 61, is the patients weight. This field tells the carrier how much the patient weighs in pounds. If the patient is under 100 pounds the field needs to be left zero filled. A weight of 99 pounds would go over as 099.
GP0 field 14, position 62, is the level of consciousness indicator. This field tells the carrier what the patient’s level of consciousness is. There are two possible entries for this field C is entered if the patient is conscious and an I is entered if the patient is conscious impaired.
In our next installment of medical billing, covering electronic submission of claims and the GP0 record, we’ll be covering the parental CMN picking up with field number 15.
Michael Russell
Your Independent guide to Medical Billing
Author: Michael Russell
Keywords: medical billing
Power by History of the Computer | Computer safety tips
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