...Katherine Magno Allied Medical Center 1933 E. Frankford Rd #110 Carrolton, TX 12345 January 16, 2012 Attn: Director of Claims BlueCross Shield Insurance 124 Halfway Road, #111 Phoenix, AZ 1236 Re: Katherine Magno Policy #: 789-44-1010 Insured: Katherine Magno Treatment Dates: December 14, 2011 Amount: $ 18,000.00 To Whom It May Concern I am writing to assist our patient Katherine Magno in the appealing the decision of BlueCross Shield Insurance to deny his benefits for a Surgery on December 14, 2012. The basis for the rejection is that BlueCross Shield Insurance states they had no prior authorization on file for this date of service. Here are some Treatments that we did: • 191 Brain Tumor x4 • 61500 Craniotomy • Frontal Lobe- $ 8,000.00 • Temporal Lobe- $ 5,000.00 •Occipital Lobe- $ 3,000.00 •Parietal Lobe- $ 2,000.00 I am appealing this denial as the denial of this claim is not warranted. The explanation of benefits did not provide enough information to establish the validity of this decision to deny the claim. Therefore, I request you to provide the following information to support the denial of the treatment. Please provide the credentials and the name of the insurance representative who checked the treatment records. Also, please furnish the outline of the specific records reviewed and the description of any records that were missing and would be required to be produced in order to approve the treatment. Please do review this claim...
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...What does it take to become a neurosurgeon? The first step to becoming a neurosurgeon is to graduate high school. I will be graduating from Kipp Nashville Collegiate High School. I will graduate high school in the year 2021. I wish to graduate high school with at least a 3.75 GPA and a 32 on the ACT. After graduating high school, I need to go to college to get my bachelors degree. I either want to go to Vanderbilt University or Harvard University. It will take four years to get my bachelors degree. Right after I graduate college with my bachelors, I need to take the MCAT. The MCAT is the Medical College Admission Test, it will determine if I get into medical school. I want to either go to Harvard University Medical School or John Hopkins Medical School. Harvard University...
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...My job in the medical field that I picked is a neurosurgeon. A neurosurgeon is a surgeon that operates on the central nervous system. The central nervous system (or CNS for short) is made up of the spinal cord and brain, the two nerve transfer areas in our bodies. The spinal cord is very important, if it's damaged you can become paralyzed, meaning you lose all feeling and motion in that area of your body. There is many different parts of being paralyzed. There is paraplegic, meaning you lose feeling and motion of your legs. There is also tetraplegic meaning you lose feeling and motion of your arms. There is many more types of paralias but my job as a neurosurgeon is to do my best to repair the spinal cord as quickly and as efficiently as I...
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...Can lead to significant clinical improvement in idiopathic normal pressure hydrocephalus symptoms in approximately 60% of idiopathic normal pressure hydrocephalus patients • Cerebralspinal fluid shunting can improve bladder dysfunction in as many as 80% of idiopathic normal pressure hydrocephalus patients if performed early, but in no more than 50% to 60% performed in an advanced stage of the disease 17 • Cerebrospinal fluid shunting types: o Ventriculopleural o Ventriculoatrial o Ventriculoperitoneal • Currently it has been reported that 70% to 90% of patients with normal pressure hydrocephalus obtain a lasting clinical benefit From shunting compared to their preoperative state 2 DISPOSITION • Recommendations for specialist referral o Neurosurgeon should be consulted before any procedure is carried out.16 TREATMENT OPTIONS • Drug therapy 18 o Carbonic anhydrase inhibitors - Acetazolamide {ACTZ) o Itacts to decrease cerebrospinal fluid production by altering blood flow to the choroid plexus thereby decreasing cerebrospinal fluid (CSF) production • Nondrug and supportive care o Procedures 19 - Ventriculoperitoneal o General explanation o The standard treatment of normal pressure hydrocephalus is the implantation of a ventriculoperitoneal shunt o A shunt cerebrospinal fluid (CSF) from the lateral ventricles of the brain into the peritoneum o Tapping or aspirating the shunt is performed for both diagnostic reasons therapeutic reasons o Indication o Suspected ventriculoperitoneal...
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...Samantha Gonzalez Neurosurgeon The brain is the greatest machine that has ever been studied. Its amazing complexity is indescribable until this day. The practice of neurology is the study of how the brain functions according to its components: the nervous system and the spinal cord structure. Neurosurgeons are the “hands on practicians” of neurology. They study and perform surgeries on the brain, the spinal cord and also treat diseases that affect the nervous system. They are the closest humans to understanding the complexity of how the brain works. Through extensive years of education they are one the most recognized medical doctors and the most devoted. Neurology is the study of diseases that affect the nervous system and neurosurgeons are its great practitioners. They also deal with diseases or damage that is done to the spinal cord. The neurological treatment of the spinal cord, and its great connection with the brain is a essential part of neurological surgery and it’s a great part of what type of surgeries, neurosurgeons perform. The long journey to neurosurgery isn’t easy, and it starts with a great devotion to work hard in a four-year college. The most important step of the education process is to be accepted to a competitive medical school. A bachelor’s degree is necessary to be accepted into medical school. It would be preferred if its a bachelor’s degree concentrated in a field that relates to pre-medicine classes. Classes such as biology, chemistry, and...
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...case of emergency, the cardiologist will step in to perform possible heart surgery. Spina bifida does not usually affect the heart so the cardiologist will probably never have to hold a scalpel, but it is a safety measure taken for the baby to be carefully monitored throughout the entire surgery. Obstetrician “An obstetrician is a doctor who specializes in pregnancy, childbirth, and a woman's reproductive system.” (What is an Obstetrician, 1). In open fetal surgery, the obstetrician begins the surgery with locating the baby in the mother’s uterus. This tells the surgeons where to make an incision. The obstetrician does this as well. He/she is the one that will control blood flow with the stapler. After the surgery is started and the neurosurgeon is working, the obstetrician stays to monitor the mother’s uterus until the end....
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...insurance, cyber liability insurance and medical reinsurance. 2Q. The top 5 physician specialists with the highest premiums are neurosurgery, thoracic-cardiovascular surgery, general surgery, orthopedic surgery and plastic surgery. The reason these specialties have a high premium is because the risk of a claim to be filed is higher and payout on a claim is higher than any other specialties. 3Q. In the article “ Malpractice liability and defensive medicine: a national survey of neurosurgeons” the authors present information about the lack of liability for neurosurgeons. The surveys that that were done among neurosurgeons showed that in order to avoid medical liability the neurosurgeons chose to use defensive medicine, with performing extra tests, referring to different specialists and searching for a second opinion. All these extra protective actions lead to a higher cost in healthcare. In order to decrease liability coverage neurosurgeons have to reduced services they offer. For example, neurosurgeons in Pennsylvania avoid intracranial operations that have a high risk of poor results; instead they opt for elective spine operations. The lack of availability of malpractice of insurance leads to restricted access for many patients to neurosurgical care. The article “Effects of a malpractice crisis on specialist supply and patient access to care” presents information about the impact from a lack of malpractice insurance on surgical practices. The lack of affordability of malpractice...
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...Dinah Gibson 8/29/11 6th period When people hear the word neurosurgery, the first thought that pops into their head is brain surgery. Indeed, neurosurgeons perform brain surgery, however they are also involved in operating on other parts of the nervous system. The brain is an integral and marvelous part of a human's personality and being. Neurosurgeons are more than just brain surgeons. They are well trained to help patients with head and spine trauma, cerebrovascular disorders, such as aneurysms of the brain, and clogged arteries in the neck that can lead to stroke, chronic low back pain, birth defects, brain and spinal tumors, and abnormalities of the nerves. Disorders of the brain, spine and nerves commonly treated by neurosurgeons include: carotid artery disease, carpal tunnel syndrome, cervical spine disorders, epilepsy, head injuries, herniated disks, lumbar stenosis, spina bifida, and tumors. Becoming a neurosurgeon requires a long educational road, so be prepared for a lifelong learning experience. All neurosurgeons start with a Bachelor of Science degree, however some Bachelor of Arts graduates may be accepted into medical school programs. While in high school, take math and science classes. Also, not all medical schools require a bachelor's degree, so with good marks, some students can get accepted after two years of undergraduate studies. Check with the school for their requirements before applying. The next step is medical school, which...
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...First off , let me explain what is a Neurosurgeon for those who do not know what it is. A neurosurgeon is a person who Specializes surgeries on the brain and on the other areas of the Nervous system. To become one it takes hard work and dedication Become one. (background info) The oldest document containing information about head injuries was written in ancient Egypt in the 16th century B.C. Because no one knew Anything about anesthesia or sterilization of operating rooms, Many surgeons performed head surgeries only in cases where all other treatments had failed, because so many patients died after head injury treatments.Modern neurosurgern developed in the late 19th century as surgeons, aided by anesthesia and sterilization, succeeded in removing brain tumors and draining fluid from brain injuries without killing the majority of their patients. One benefit of being a neurosurgeon is the thorough education and training these specialists are given, ensuring that there will be little competition for their jobs. Before medical school, those who wish to be neurosurgeons must first obtain a bachelor's degree. While they are not required to major in biology, they must take at least some basic biology and chemistry courses as an undergraduate. These students then apply to medical school and spend four years studying for a Doctor of Medicine or M.D. degree. After receiving an M.D. degree, future neurosurgeons go on to a one-year surgical internship, followed...
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...Paul Kalanithi had showed proof that the people that are dying will have most information and guidance to teach us about life. Paul Kalanithi was known for being a neurosurgeon and a writer, a neurosurgeon is a physician who specializes in the diagnosis and surgical treatment of disorders of the central and peripheral nervous system. An obstacle Paul Kalanithi faced was when he was diagnosed with lung cancer. But that still didn’t stop him from pursuing his dreams. Paul Kalanithi was a neurosurgeon before he became famous and started writing. Claim should include one's argument about how this person motivates teenagers to achieve their own dreams or aspirations. “Paul grew up in Kingman, Arizona, before attending Stanford University, from...
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...In 2008, Ben Carson was a pediatric neurosurgeon at John Hopkins Hospital, but he is also an advocate for the inner-city children (Comarow, 2008, para. 1). Rainey (2014) explains that transformational leadership raise their constituents’ goals to a higher level (p. 349). Ben Carson is that type of leader in which he encourages young children to gain the confidence they need in order to become successful individuals (Comarow, 2008, para. 1). Objective Description Not only is Ben Carson a retired pediatric neurosurgeon, but there is also talks in the midst of him becoming a presidential candidate (Henderson, 2014, para. 1 & 4). He is also a published author. LeClaire (2013) explains that Dr. Carson supports prolife and has been instrumental in saving hundreds of babies from would be abortions (para. 1&16). Dr. Ben Carson is not only a leader with a huge following, but he is not afraid to take a stand on sensitive issues. Vision and Values Come to Life Dr. Carson believes that he has to accept responsibility for his actions. He also believes that everyone has certain gifts and talents to bring to the organization, and he uses those abilities to help his constituents achieve the set goals. He also works on boosting confidence in individuals so that they may be successful (Comarow, 2008, para. 1, 2 &4). His leadership qualities resemble that of transformational leadership elevating constituents’ goals to higher level (Rainey, 2014, p. 349). Lesson Learned There...
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...Jameson Blake and very young and talented sophomore, that plays wide receiver for the University of Charleston. He has a great body frame of 6’2; 185lbs and runs a 4.3 in the 40 yard dash. Blake had an amazing freshman year and is on track to have another great sophomore year. Family and friends are telling him that he has a change to play in the NFL if he keeps up the good work for the next two years. Blake was originally interested in becoming a neurosurgeon but after hearing all of this talk about the NFL he wants to change his major to business something that is less challenging so he can concentrate on training and working out to get bigger faster and stronger. Below is the information and evidence that I have researched and found answers to regarding the questions that you have given to me. 1. As a peer educator and friend of Jameson I was concerned with the choices that he was making wanted to talk to someone about this, I came to you as his academic advisor know what was going on. After speaking with the parents the father of Jameson, Mr. Blake was okay with the decisions that his son was making and was behind him all the way. He said, that Jameson “has a great chance to get drafted, and at the least be would be likely to be signed as an un-drafted free agent”. Which is true in some instances, but what he doesn’t really know is that it is less of a chance coming from a Division II school, especially as small school like UC. Statistics show that 1.7% of NCAA football...
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...with all the support she needs. When she was 13 years old, she dreamed of becoming a pediatric neurosurgeon that was her “difficult to get dream”. Her biggest fear was becoming something else, just like everyone told her it was going to happen. Until one day, a successful doctor gave her the best advice to keep dreaming for what she really wants and never giving up. When all the years passed, she graduated from medicine school and her biggest day is coming up. She’s going to be interviewed for jobs in hospitals. She is finally going to be working as a pediatric neurosurgeon. She is delighted for achieving her biggest dream. This is one of the most inspiring stories of all time, everyone told her: “what if you finish studying something else? Do you really want to go to medicine? It is really hard.” And Victoria just ignored them and said to herself: “who are you to tell me what is going to happen with my life? Unlike you, I am a very confident and goal-oriented person that knows exactly what she wants to study.” Today, those people who were telling her that, are still in college trying to figure out what to do with her life. They wish they could go back to when they told me that so they can undo it and say instead: “wow, you’re an admirable person honestly, I wish I could be like you, I wish I could be so dedicated like you.” Victoria, is a successful pediatric neurosurgeon in the...
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...Been Carson is a man of determination, a man of Dreams! Ben Came from a poor family living in detroit but his mother was an inspiration to not let his status hold him back from his dreams. Benjamin Carson was born sept. 18, 1951 to Sonya and Robert Carson. He was their second son. His mother dropped out of school in 3rd grade. Robert was a baptist minister. At the age of 8 years old Ben’s dad left them for another family, even though at the time 1959 Ben and his brother Curtis, age 10 were not told the exact reason as to why their dad left. This left Ben hurting tremendously as he loved his dad. For weeks Been would question his mother about the situation and he would pray that God help his parents get back together. Eventually he came to realize they could make it without him. “But dad never came home again. As the days and weeks passed, I learned we could get by without him. We were poorer than, and I could tell mother worried, although she didn’t say much to Curtis or me” (Curtis, Ben). After his dad left for good the family was even poorer than before. Sonja would try to get child support from Robert but he would never provide enough and would only give some money for a month or two after court and then he would stop again. In spite of the financial struggles they faced, the boys always had something to eat and a roof over their head. Their mother, Sonja had to work multiple jobs, one right after the other in order to be able to support the 3 of them. This resulted in having...
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...Assessment # 4 Compensation and Training Northwestern Memorial Hospital Part I: After first completing the reading for this assessment, I had a difficult time deciding what kind of HR strategy would work best for this organization. I wasn’t sure if the focus should be on cost or differentiation. Due to the type of work handled in the health care profession I decided that the organizations focuses more on providing excellent service to its patients. When this is combined with its desire to hire individuals and train them for long-term employment, I figured that the HR strategy that fits best is Committed Expert. Thusly, that is how the compensation strategy will be derived. Northwestern Memorial prides itself on its physicians and hospital staff so of course they pursue the best of the best to be employed by the organization. In order to recruit those types of candidates, the organization has to provide a very competitive compensation strategy. We’ve learned that compensation packages are made up of base pay, employee benefits, individual incentives, and group incentives. When it comes to base pay NMH needs to set the standard in order to draw in the talent they desire. They can’t offer what’s below market or the equivalent of the market. They have to set the bar. They have to show potential candidates that they are willing to pay more than other organization for a person with the right set of skills. Plus, due to the high level expertise, the candidate...
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