CFRN test - Certified Flight Registered Nurse Updated: 2024 | ||||||||
Precisely same CFRN dumps questions as in real test, WTF! | ||||||||
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Exam Code: CFRN Certified Flight Registered Nurse test January 2024 by Killexams.com team | ||||||||
CFRN Certified Flight Registered Nurse 1. General principles of transport nursing practice A. Transport physiology 1. Physiologic stressors of transport 2. Effects of altitude on patients B. Scene operations 1. Secure landing zone 2. Incident Command System C. Communications 1. Radio operations 2. Patient handoff (e.g., history from referring provider, updates for receiving provider, SBAR) 3. Crew resource management D. Safety and survival 1. ELT 2. Navigation (e.g., maps, GPS, night-vision goggles) 3. Transponder codes 4. Survival principles (post-crash) 5. Transport vehicle emergencies 6. Pre-mission preparation (e.g., shift preparedness, risk assessment, crew briefings, weather limitations,AMRM) E. Management of man-made disasters (e.g., terrorism, industrial accident, transportation accident, mass casualties) F. Professional issues 1. Evidence-based practice and research 2. Legal issues a. HIPAA b. EMTALA c. Consent d. Mandatory reporting (e.g., abuse, neglect, diversion, non-accidental trauma) e. Legal concepts in patient care (e.g., negligence, assault, battery, abandonment) 3. Ethical issues 4. Psychosocial issues in transport, including families G. Management 1. Quality management and fair work environment 2. Outreach and community education 3. Stress management (e.g., self-care, post-traumatic critical incident) 2. Resuscitation principles 27 31 A. Principles of assessment and patient preparation 1. Physical assessment 2. Pain and comfort assessment 3. Preparing the patient for transport (i.e., packaging) B. Airway management 1. Airway assessment 2. Airway management 3. Difficulties encountered with airway 4. Rapid Sequence Induction for Intubation (RSI), including pharmacology C. Mechanical ventilation 1. Invasive ventilation 2. Non-invasive ventilation D. Perfusion 1. Components of oxygen delivery 2. Shock pathophysiology 3. Trauma triad (hypothermia, acidosis, coagulopathies) 4. Acid base imbalances 3. Trauma 26 31 A. Principles of management 1. Mechanism of injury 2. Shock a. Hypovolemic b. Obstructive c. Distributive (including neurogenic) d. Cardiogenic 3. Immobilization B. Neurologic 1. Traumatic brain injuries 2. Spinal cord injuries 3. Post-traumatic seizures C. Thoracic 1. Chest wall injuries 2. Pulmonary injuries 3. Cardiac injuries 4. Great vessel injuries D. Abdominal 1. Hollow organ injuries 2. Solid organ injuries 3. Diaphragmatic injuries 4. Retroperitoneal injuries 5. Abdominal compartment syndrome E. Orthopedic 1. Vertebral injuries 2. Pelvic injuries 3. Compartment syndrome 4. Amputations 5. Extremity fractures 6. Soft-tissue injuries F. Burn 1. Chemical burns 2. Electrical burns 3. Thermal burns 4. Radiological burns 5. Inhalation injuries G. Maxillofacial and neck 1. Facial injuries, including fractures 2. Ocular injuries 3. Blunt and penetrating neck injuries 4. Medical emergencies 44 44 A. Neurologic 1. Seizure disorders 2. Stroke 3. Neuromuscular disorders 4. Space occupying lesions a. Blood b. Tumors c. Abscesses d. Hydrocephalus e. Encephalopathies B. Cardiovascular 1. Acute coronary syndrome 2. Congestive heart failure 3. Pulmonary edema 4. Dysrhythmias 5. Aortic abnormalities 6. Hypertension 7. Mechanical/circulatory support (e.g., IABP, VAD, pacing) C. Pulmonary 1. COPD 2. Acute lung injury/ARDS 3. Pulmonary infections 4. Asthma 5. Pulmonary embolism D. Abdominal 1. Abdominal compartment syndrome 2. GI bleed 3. Conditions of the hollow organs (e.g., obstruction,rupture) 4. Conditions of the solid organs (e.g., pancreatitis, hepatitis) E. Electrolyte disturbances F. Metabolic and endocrine 1. Diabetic emergencies 2. Neuroendocrine disorders (e.g., diabetes insipidus, SIADH, HHNK) 3. Thyroid conditions 4. Adrenal disorders G. Hematology 1. Coagulopathies (including platelet disorders) 2. Anemias H. Renal 1. Acute kidney injury (i.e., acute renal failure) 2. Chronic renal failure I. Infectious and communicable diseases 1. SIRS and sepsis 2. Isolation precautions (e.g., MRSA, influenza-like illness, highly-infectious diseases) J. Shock 1. Hypovolemic 2. Obstructive 3. Distributive (including neurogenic and anaphylaxis) 4. Cardiogenic K. Environmental and toxicological emergencies 1. Environment a. Allergic reactions b. Cold related (e.g., hypothermia, frostbite) c. Heat related (e.g., heatstroke, heat exhaustion) d. Submersion injuries (i.e., diving injuries, drowning, near drowning) e. Bites and envenomation 2. Toxicology A. Obstetrical patients 1. Complications of pregnancy 2. Delivery and post-partum care of mother and infant 3. Trauma B. Pediatric 1. Trauma 2. Medical (e.g., respiratory, cardiac, and neurological emergencies, metabolic disturbances) C. Geriatric 1. Trauma (e.g., falls, immobilization) 2. Medical (e.g., drug interactions and comorbidities, dementia) D. Bariatric (e.g., logistical issues, drug dosage, skin issues,airway management) Procedures PA catheter Point-of-care testing Video laryngoscopy Chest radiographs Transvenous pacing Capnography for non-intubated patients Surgical cricothyrotomy Therapeutic hypothermia Central venous pressure measurement Arterial line Needle cricothyrotomy Needle thoracostomy Tourniquet application Central line Chest tube Pelvic stabilization Non-invasive mechanical ventilation Traction splint 12-lead ECG Invasive mechanical ventilation Transcutaneous pacing Blood product administration Capnography for intubated patients Endotrachael intubation Initiate/titrate medications Intraosseous catheter IABP operation Escharotomy CT scans Medical circulatory devices (VAD, Impella®) Fracture/dislocation reduction ICP monitoring Pericardiocentesis Neck radiographs Ventriculostomy monitoring | ||||||||
Certified Flight Registered Nurse Medical Registered test | ||||||||
Other Medical examsCRRN Certified Rehabilitation Registered NurseCCRN Critical Care Register Nurse CEN Certified Emergency Nurse CFRN Certified Flight Registered Nurse CGFNS Commission on Graduates of Foreign Nursing Schools CNA Certified Nurse Assistant CNN Certified Nephrology Nurse CNOR Certified Nurse Operating Room DANB Dental Assisting National Board Dietitian Dietitian EMT Emergency Medical Technician EPPP Examination for Professional Practice of Psychology FPGEE Foreign Pharmacy Graduate Equivalency NBCOT National Board for Certification of Occupational Therapists - 2023 NCBTMB National Certification Board for Therapeutic Massage & Bodywork NET Nurse Entrance Test NPTE National Physical Therapy Examination OCN Oncology Certified Nurse - 2023 PANCE Physician Assistant National Certifying VTNE Veterinary Technician National Examination (VTNE) CNS Clinical Nurse Specialist NBRC The National Board for Respiratory Care AHM-540 AHM Medical Management AACN-CMC Cardiac Medicine Subspecialty Certification AAMA-CMA AAMA Certified Medical Assistant ABEM-EMC ABEM Emergency Medicine Certificate ACNP AG - Acute Care Nurse Practitioner AEMT NREMT Advanced Emergency Medical Technician AHIMA-CCS Certified Coding Specialist (CPC) (ICD-10-CM) ANCC-CVNC ANCC (RN-BC) Cardiac-Vascular Nursing ANCC-MSN ANCC (RN-BC) Medical-Surgical Nursing ANP-BC ANCC Adult Nurse Practitioner APMLE Podiatry and Medical BCNS-CNS Board Certified Nutrition Specialis BMAT Biomedical Admissions Test CCN CNCB Certified Clinical Nutritionist CCP Certificate in Child Psychology CDCA-ADEX Dental Hygiene CDM Certified Dietary Manager CGRN ABCGN Certified Gastroenterology Registered Nurse CNSC NBNSC Certified Nutrition Support Clinician COMLEX-USA Osteopathic Physician CPM Certified Professional Midwife CRNE Canadian Registered Nurse Examination CVPM Certificate of Veterinary Practice Management DAT Dental Admission Test DHORT Discover Health Occupations Readiness Test DTR Dietetic Technician Registered FNS Fitness Nutrition Specialist MHAP MHA Phlebotomist MSNCB MSNCB Medical-Surgical Nursing Certification NAPLEX North American Pharmacist Licensure Examination NCCT-TSC NCCT Technician in Surgery NCMA-CMA Certified Medical Assistant NCPT National Certified Phlebotomy Technician (NCPT) NE-BC ANCC Nurse Executive Certification NNAAP-NA NNAAP Nurse Aide NREMT-NRP NREMT National Registered Paramedic NREMT-PTE NREMT Paramedic Trauma Exam OCS Ophthalmic Coding Specialist PANRE Physician Assistant National Recertifying Exam PCCN AACN Progressive Critical Care Nursing RDN Registered Dietitian VACC VACC Vascular Access WHNP Women Health Nurse Practitioner AACD American Academy of Cosmetic Dentistry RPFT Registered Pulmonary Function Technologist ACLS Advanced Cardiac Life Support - 2023 GP-Doctor General Practitioner (GP) Doctor GP-MCQS Prometric MCQS for general practitioner (GP) Doctor INBDE Integrated National Board Dental Examination (Day 1 exam) Podiatry-License-Exam-Part-III Podiatry License test Part III - 2023 | ||||||||
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Medical CFRN Certified Flight Registered Nurse https://killexams.com/pass4sure/exam-detail/CFRN B. status epilepticus C. trismus D. drug overdose E. head injury Answer: A Question: 8 The most effective means of minimizing heat loss and facilitating survival in open water is to tread water. A. False B. True Answer: A Question: 9 Which of the following statements comprises a component of the Emergency Medical Treatment and Active Labor Act (EMTALA)? A. Any patient who arrives at an emergency department and requests an examination to determine the presence or absence of an emergency medical condition shall be provided such an examination. a patient must be transferred, the transfer facility must have the space and personnel B. If necessary to care for the patient. C. In the case of a patient transfer, the referring facility must provide all necessary documentation to the transfer facility. D. In the case of a patient transfer, qualified personnel, necessary medical equipment, and the most appropriate transport mode must be available. E. All of the above statements comprise components of the Emergency Medical Treatment and Active Labor Act(EMTALA). Answer: E For More exams visit https://killexams.com/vendors-exam-list Kill your test at First Attempt....Guaranteed! | ||||||||
ChatGPT is still no House, MD. While the chatty AI bot has previously underwhelmed with its attempts to diagnose challenging medical cases—with an accuracy rate of 39 percent in an analysis last year—a study out this week in JAMA Pediatrics suggests the fourth version of the large language model is especially bad with kids. It had an accuracy rate of just 17 percent when diagnosing pediatric medical cases. The low success rate suggests human pediatricians won't be out of jobs any time soon, in case that was a concern. As the authors put it: "[T]his study underscores the invaluable role that clinical experience holds." But it also identifies the critical weaknesses that led to ChatGPT's high error rate and ways to transform it into a useful tool in clinical care. With so much interest and experimentation with AI chatbots, many pediatricians and other doctors see their integration into clinical care as inevitable. The medical field has generally been an early adopter of AI-powered technologies, resulting in some notable failures, such as creating algorithmic racial bias, as well as successes, such as automating administrative tasks and helping to interpret chest scans and retinal images. There's also lot in between. But AI's potential for problem-solving has raised considerable interest in developing it into a helpful tool for complex diagnostics—no eccentric, prickly, pill-popping medical genius required. In the new study conducted by researchers at Cohen Children’s Medical Center in New York, ChatGPT-4 showed it isn't ready for pediatric diagnoses yet. Compared to general cases, pediatric ones require more consideration of the patient's age, the researchers note. And as any parent knows, diagnosing conditions in infants and small children is especially hard when they can't pinpoint or articulate all the symptoms they're experiencing. For the study, the researchers put the chatbot up against 100 pediatric case challenges published in JAMA Pediatrics and NEJM between 2013 and 2023. These are medical cases published as challenges or quizzes. Physicians memorizing along are invited to try to come up with the correct diagnosis of a complex or unusual case based on the information that attending doctors had at the time. Sometimes, the publications also explain how attending doctors got to the correct diagnosis. Missed connectionsFor ChatGPT's test, the researchers pasted the relevant text of the medical cases into the prompt, and then two qualified physician-researchers scored the AI-generated answers as correct, incorrect, or "did not fully capture the diagnosis." In the latter case, ChatGPT came up with a clinically related condition that was too broad or unspecific to be considered the correct diagnosis. For instance, ChatGPT diagnosed one child's case as caused by a branchial cleft cyst—a lump in the neck or below the collarbone—when the correct diagnosis was Branchio-oto-renal syndrome, a genetic condition that causes the abnormal development of tissue in the neck, and malformations in the ears and kidneys. One of the signs of the condition is the formation of branchial cleft cysts. Overall, ChatGPT got the right answer in just 17 of the 100 cases. It was plainly wrong in 72 cases, and did not fully capture the diagnosis of the remaining 11 cases. Among the 83 wrong diagnoses, 47 (57 percent) were in the same organ system. Among the failures, researchers noted that ChatGPT appeared to struggle with spotting known relationships between conditions that an experienced physician would hopefully pick up on. For example, it didn't make the connection between autism and scurvy (Vitamin C deficiency) in one medical case. Neuropsychiatric conditions, such as autism, can lead to restricted diets, and that in turn can lead to vitamin deficiencies. As such, neuropsychiatric conditions are notable risk factors for the development of vitamin deficiencies in kids living in high-income countries, and clinicians should be on the lookout for them. ChatGPT, meanwhile, came up with the diagnosis of a rare autoimmune condition. Though the chatbot struggled in this test, the researchers suggest it could Excellerate by being specifically and selectively trained on accurate and trustworthy medical literature—not stuff on the Internet, which can include inaccurate information and misinformation. They also suggest chatbots could Excellerate with more real-time access to medical data, allowing the models to refine their accuracy, described as "tuning." "This presents an opportunity for researchers to investigate if specific medical data training and tuning can Excellerate the diagnostic accuracy of LLM-based chatbots," the authors conclude. The admission test for medical colleges under 2023-24 academic sessions will be held on February 9. The one-hour-long admission test will begin at 10am on the day. All coaching centres will remain closed for a month. The decision was taken at a meeting on the MBBS and BDS admission tests for the academic year 2023-24 held at the Ministry of Health and Family Welfare on Sunday. Health and Family Welfare Minister Zahid Maleque presided over the meeting. Our experts answer readers' insurance questions and write unbiased product reviews (here's how we assess insurance products). In some cases, we receive a commission from our partners; however, our opinions are our own. Many of the best life insurance companies offer no-exam life insurance, which has the obvious appeal of skipping medical exams. 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Compare the Best No test Life InsuranceMany insurers offer a range of permanent and term life insurance policies that require a medical exam. These companies offer the best no medical test life insurance policies. Best Term Life PolicyEthos No Medical test Life InsuranceEthos Life accepts applicants up to age 65 with a 100% online application process, and limits are as high as $2 million. Ethos Life asks a few basic medical questions, but coverage is effective immediately once approved. In addition, every customer buying policies like this from Ethos Life is eligible for a 30-day look period, which is another way to say you can cancel and get your money back in the first 30 days with no penalties.
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Prudential Life Insurance Review Best for Guaranteed AcceptanceMutual of Omaha No Medical test Life InsuranceMutual of Omaha Life Insurance has high financial stability and customer satisfaction ratings across different types of insurance. Guaranteed life policies are available for adults between the ages of 45 and 85. In New York state, the age range is 50-75. Policies can be as small as $2,000 in most states and as large as $25,000 with no health questions or medical exams. Mutual of Omaha's no medical test policies have a graded death benefit. If you die within two years of the policy start date, the company will not pay the full policy. Instead, it delivers 110% of the premiums paid. The Mutual of Omaha website boasts same-day payouts on most policies. Policies for children are also available.
Mutual of Omaha Life Insurance Review Best for Waiting PeriodAAA No Medical test Life InsuranceAAA Life Insurance offers immediate death benefits for qualified applicants between 18 and 75. In other words, once your policy starts, you are eligible for the full policy benefit. Policies are available with limits as low as $25,000 and as high as $500,000. While a medical test is not required, health questions are. AAA offers term policies with limits as high as $500,000. For a whole life policy, the limit is $25,000. But applicants can add a rider doubling the payout for accidental death coverage. Younger people have no waiting period for benefits. For applicants over age 45, AAA pays out 130% of the premiums paid up to the date of death for the first two years.
No Medical test Life Insurance FAQsA no medical test life insurance policy could be right for you if you're able to qualify and don't need special coverage. These policies are the easiest to get for young applicants with no significant health issues. Older applicants can buy with some companies, but acceptance is not guaranteed. No medical test policies offer less coverage with higher premiums in most cases. If you do not qualify for the no medical test policy you want, insurance agents can help you explore alternatives. No medical test means life insurance companies will not check your blood pressure, cholesterol, etc. However, companies have access to prescription history and other personal records, and underwriters base decisions partly on this history. You'll have to decide whether you prefer a whole or term policy based on your situation if you're getting no medical life insurance. A term policy has an expiration date, and extensions or conversions to a whole life policy are not guaranteed. If anything, your rate may be higher if you try to convert your policy. The insurer looks at you just as it would any other applicant of your age, health, etc. A whole life policy locks in premiums and payouts. There are alternatives to a new medical test life insurance policy. Insurance agents can quote you medical test policies if you're denied a no medical test option. An experienced agent may be able to assess your application before starting the process to avoid official denials. If you're concerned about premium limits, you can explore options like IUL (indexed universal life) for permanent life insurance that increases your benefit as long as you make premium payments. A no medical test life insurance policy may hold a certain appeal for older applicants and those in failing health. However, the life insurance market is the opposite of what you might expect. 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Yes, you can really get life insurance without a medical exam, but your options will be different. That's because you'll need to choose a guaranteed issue policy — a specific type of insurance that lets you bypass the medical test requirement — and it will probably cost more than a regular policy including a medical exam. The highest amount of life insurance you can get without a medical test is lower than what you could get with a medical exam. Guaranteed issue policies that don't require medical exams typically top out at $25,000 or $50,000 in coverage, while standard life insurance policies can offer millions in coverage. How to Pick the Best No Medical test Life Insurance Policy for YouParticularly when choosing life insurance, customization is critical. Buyers don't need to add every rider, but a little research goes a long way in selecting the right company. Some applicants will not qualify for a no medical test life insurance policy. 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If you're looking for more information about a specific life insurer, our individual reviews offer a deep dive into individual policies, riders, and more. The same considerations are used for all competitors to ensure readers have the edge to make informed decisions in an ever-changing market. See our insurance rating methodology for more details. Top Offers From Our Partners
Hospitals and insurers are racing to find new artificial intelligence tools to give them an edge in billing and processing their part of the $4 trillion in medical expenses Americans accrue each year. As one of the largest parts of the U.S. economy undergoes perhaps its biggest transition in decades, billions of dollars are at stake — not only for health care providers and insurers, but also for the government, which handles millions of Medicare and Medicaid claims every year. For providers, the dream is an AI tool that can quickly and aggressively code procedures and file claims. Insurers — and the government agencies that pay for health care — want comparable technology to scrub those bills. “Everyone’s trying to maximize revenue while toeing the line on, effectively, fraud,” said Nick Stepro, chief product and technology officer at Arcadia, a company that works with health care organizations on both sides of the divide looking to build the technology. It’s true, he believes, that advanced AI will bring a host of positive impacts to the health system — but perhaps not before it further inflames the feuds over bills between your health plan and your medical provider. “Now, all of a sudden, you have this massive superpower that is generative AI,” he said. “That’s going to let people move really, really, really quickly in this space — and sort of create an arms race.” Getting there first isn’t only about winning the billing wars: Both providers and insurers hope to reap efficiencies if they can downsize their huge administrative workforces, reduce liability or speed up their paperwork processing. For policymakers, AI is adding a wrinkle to Washington’s perpetual fretting over the high cost of health care. Some in Congress and President Joe Biden want to streamline the prior-authorization process insurers require before they approve some treatments. Washington’s also taking another look at how surprise billing is handled — a 2020 law has thus far failed to stem the disputes between providers and insurers over care patients received unwittingly from out-of-network doctors. Nearly everyone in health policy is trying to figure out how to stretch a beleaguered workforce facing growing demand for care. But Congress has barely begun to grapple with how AI could affect these issues. And the administration is just beginning to work out its approach to regulating the technology — even as the ground is shifting for hospitals, doctors and insurers vying for a tech edge. ‘We need to have an AI strategy’Business is booming for Punit Soni, CEO of the health AI company Suki. “We are seeing that every health system across the country is saying: ‘We need to have an AI strategy,’” he said. Soni’s company aims for the trifecta his provider clients want — happier clinicians, more patients and more money — by assisting doctors in taking notes and coding the care delivered. Buyers of the company’s tools are sometimes seeing revenue rise over 20 percent, he said — and seeing denials fall by nearly the same amount. “When we meet health systems, we give them a buffet, and we say: ‘Here’s a bunch of things we can impact that matter to you,’” he said. “All three are really serious [return-on-investment] objectives.” For hospitals amid a money crunch, Soni’s promises are soothing. According to credit rating firm Fitch Ratings, they lack cash and face ongoing struggles to staff their facilities. They’re also bracing for a 3.4 percent cut in Medicare reimbursements to doctors in January, unless Congress acts to avert it. Doctors describe the pending cut as an existential threat to their practices. The health industry could see more defaults in 2024 compared with earlier years, a exact Moody’s analysis found. More than 20 health, tech and policy leaders interviewed for this story — as well as presenters at the Healthcare Information and Management Systems Society conference on AI earlier this month in San Diego — underscored that interest in how artificial intelligence will affect the industry’s bottom line is front-of-mind. Even AI that benefits patient care and betters administrative systems has to be paid for, they said. Some health systems told POLITICO they want to reap savings by coding their bills more accurately and, therefore, reducing their liability. Others highlight the benefits of reducing the labor needed to complete administrative tasks. And nearly all providers are keenly interested in making their staff happier by reducing burnout. Health system executives said they want to see tangible progress on their AI investments every 90 days, and they’re partnering with tech companies and even other health groups to produce results faster. There’s another reason for hospitals and doctors’ practices to proceed swiftly and deliberately: The insurers that pay their bills have long sought ways to better scrutinize the charges, and AI is just the latest tool, said Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association, a doctors’ group. He said doctors often fear overcoding because of the stiff penalties that can come with it. But he also acknowledged another way they may think about it. “One could say, ‘all is fair and love and war — the payers are using it, the providers should too.’” ‘The perfect storm coming’Some of the biggest health insurers — including Humana and UnitedHealth — face lawsuits claiming they are using AI to deny care. The plaintiffs in the suits, filed this fall, argue the companies rejected doctors’ orders more often after embracing AI tools to monitor care. A spokesperson for naviHealth’s nH Predict tool, cited in the UnitedHealth and Humana suits, said the plaintiffs misunderstand the role of the technology — that it’s used to evaluate what care may be needed, not to decide whether to approve it. Humana and UnitedHealth declined to comment on the pending litigation. Each of the companies said it wants to implement the tech in ways that both promote patient wellbeing and increase efficiency. More broadly, insurers say they are making major investments in AI, both to cut their own administrative costs and to weed out fraud in the bills they receive. “It feels like the perfect storm coming of the technology really becoming a more significant asset to the company if deployed correctly,” said Craig Richardville, chief information officer of Salt Lake City-based Intermountain Health, which does business as both a provider and payer. The government, meanwhile, is caught in the middle. Every year, it incurs $60 billion in fraudulent Medicare bills, according to government estimates. Medicaid fraud costs the states and federal government tens of billions more. The government already creates many of the rules that govern health care billing and is using AI to combat fraud, according to the National Health Care Anti-Fraud Association, an alliance of government agencies and private insurers. A spokesperson for the Centers for Medicare and Medicaid Services said in a statement that “CMS continually assesses opportunities to safely and responsibly leverage new, innovative strategies and technologies, including AI, to more effectively accomplish its mission.” At the same time, the agency has to answer to patients skeptical of strict anti-fraud measures that can result in denied care. Starting Jan. 1, CMS will begin requiring the private insurers who run Medicare plans to ensure they’re “making medical necessity determinations based on the circumstances of the specific individual, as opposed to using an algorithm or software,” according to congressional testimony. ‘It’s going to add gasoline’When insurers and providers can’t agree on a bill, it’s often patients caught in the middle — or stuck on hold waiting to talk to a customer service representative. If AI helps insurers deny care, or amps up the fights between medical providers and health plans over bills, will patients have to mediate? The 2020 legislation Congress passed to help patients who receive surprise medical bills from providers outside of their networks underscores the policy thicket. A mediation process set up by the Department of Health and Human Services to sort out the bills has received more than 20 times as many claims from providers as the government anticipated, and 60 percent remain unresolved, according to a exact tally. This month, the administration said it was reworking its process. Still, both providers and insurers say they expect the AI takeover of the billing process to help patients more than it hurts them. “Do I think people will use it as a hammer?” said John Couris, president and CEO of Florida Health Sciences Center, which runs Tampa General Hospital, of the technology. “I mean, I think they probably will — on both sides.” But Couris said the health industry is mostly just “desperate” for AI products that fix the complicated billing systems that so frustrate patients. Even so, policymakers charged with making sure that happens are just beginning to evaluate their role. Some House Democrats, including Reps. Judy Chu of California and Jerry Nadler of New York, have opened an inquiry into whether private plans in Medicare are too quick to use AI to deny care, while others, from Senate Majority Leader Chuck Schumer (D-N.Y.) to Rep. Cathy McMorris Rodgers (R-Wash.), are holding hearings and forums on how the tech will change the way doctors treat patients — and bill for that treatment. Mostly, Congress is just beginning to talk about legislation. Sens. John Thune (R-S.D.) and Amy Klobuchar (D-Minn.) introduced a bill last month that would task the Commerce Department with conferring with other agencies to begin the process of setting some guardrails. Biden issued an executive order in October that set some reporting deadlines for agencies to assess what should be done. HHS issued transparency rules for health AI earlier this month, but its focus was technology used in clinical decision-making, not billing. Meanwhile, nearly every aspect of the health care industry is trying to gain an advantage with major stakes: AI’s role in billing could impact the sustainability of Medicare, Medicaid and private insurers, as well as hospitals, clinics and providers of all kinds. Stepro of Arcadia, who’s helping both providers and insurers build the tools they hope will help them thrive, senses the urgency. “It’s going to add gasoline to a lot of existing tension in how money flows in health care,” he said. Chelsea Cirruzzo contributed to this report. New Delhi Diploma in Pharmacy ( D.Pharm) candidates from next year have to give exit test in order to get their degrees and qualify to practice, a exact circular issued by the Pharmacy Council of India (PCI) has mandated. The test will be held in July-September 2024 for the 2022–24 academic session, the PCI has informed Further, the Pharmacy Council of India (PCI) directed the various state pharmacy councils and registration tribunals not to register the candidates admitted to the Diploma in Pharmacy program during the 2022-23 academic session and passed in the 2023-24 academic session as pharmacists until they pass the exit examination and fulfil the other prescribed conditions under section 32(2) of the Pharmacy Act. The Medical Dialogues team had earlier reported that in February 2022, the Pharmacy Council of India, via a Gazette notification, released the "Diploma in Pharmacy Exit Examination Regulations, 2022" which called for a Diploma in Pharmacy Exit Examination after the completion of the course, making it mandatory for registration and a license to practice as a pharmacist. The exit examination was further scheduled to take place twice a year or as frequently as may be required as per the schedule of examinations announced by the prescribed authority. The examination date and centre will also be assigned to candidates by the prescribed authority based on the availability of the examination centres, the council stated. The PCI has now informed that the said test will be conducted by the National Board of Examination in Medical Sciences (NBEMS) from next year onwards. PCI further stated that the said test will be conducted in the month of July-September, however, the date has not yet been declared.
It further directed the state councils not to register new candidates as pharmacists, till they clear the exit exam
Hospitals and insurers are racing to find new artificial intelligence tools to give them an edge in billing and processing their part of the $4 trillion in medical expenses Americans accrue each year. As one of the largest parts of the U.S. economy undergoes perhaps its biggest transition in decades, billions of dollars are at stake — not only for health care providers and insurers, but also for the government, which handles millions of Medicare and Medicaid claims every year. For providers, the dream is an AI tool that can quickly and aggressively code procedures and file claims. Insurers — and the government agencies that pay for health care — want comparable technology to scrub those bills. “Everyone's trying to maximize revenue while towing the line on, effectively, fraud,” said Nick Stepro, chief product and technology officer at Arcadia, a company that works with health care organizations on both sides of the divide looking to build the technology. It’s true, he believes, that advanced AI will bring a host of positive impacts to the health system — but perhaps not before it further inflames the feuds over bills between your health plan and your medical provider. “Now, all of a sudden, you have this massive superpower that is generative AI,” he said. “That's going to let people move really, really, really quickly in this space — and sort of create an arms race.” Getting there first isn’t only about winning the billing wars: Both providers and insurers hope to reap efficiencies if they can downsize their huge administrative workforces, reduce liability or speed up their paperwork processing. For policymakers, AI is adding a wrinkle to Washington’s perpetual fretting over the high cost of health care. Some in Congress and President Joe Biden want to streamline the prior-authorization process insurers require before they approve some treatments. Washington’s also taking another look at how surprise billing is handled — a 2020 law has thus far failed to stem the disputes between providers and insurers over care patients received unwittingly from out-of-network doctors. Nearly everyone in health policy is trying to figure out how to stretch a beleaguered workforce facing growing demand for care. But Congress has barely begun to grapple with how AI could affect these issues. And the administration is just beginning to work out its approach to regulating the technology — even as the ground is shifting for hospitals, doctors and insurers vying for a tech edge. ‘We need to have an AI strategy’Business is booming for Punit Soni, CEO of the health AI company Suki. “We are seeing that every health system across the country is saying: ‘We need to have an AI strategy,’” he said. Soni’s company aims for the trifecta his provider clients want — happier clinicians, more patients and more money — by assisting doctors in taking notes and coding the care delivered. Buyers of the company’s tools are sometimes seeing revenue rise over 20 percent, he said — and seeing denials fall by nearly the same amount. “When we meet health systems, we give them a buffet, and we say: ‘Here's a bunch of things we can impact that matter to you,’” he said. “All three are really serious [return-on-investment] objectives.” For hospitals amid a money crunch, Soni’s promises are soothing. According to credit rating firm Fitch Ratings, they lack cash and face ongoing struggles to staff their facilities. They’re also bracing for a 3.4 percent cut in Medicare reimbursements to doctors in January, unless Congress acts to avert it. Doctors describe the pending cut as an existential threat to their practices. The health industry could see more defaults in 2024 compared with earlier years, a exact Moody’s analysis found. More than 20 health, tech and policy leaders interviewed for this story — as well as presenters at the Healthcare Information and Management Systems Society conference on AI earlier this month in San Diego — underscored that interest in how artificial intelligence will affect the industry’s bottom line is front-of-mind. Even AI that benefits patient care and betters administrative systems has to be paid for, they said. Some health systems told POLITICO they want to reap savings by coding their bills more accurately and, therefore, reducing their liability. Others highlight the benefits of reducing the labor needed to complete administrative tasks. And nearly all providers are keenly interested in making their staff happier by reducing burnout. Health system executives said they want to see tangible progress on their AI investments every 90 days, and they’re partnering with tech companies and even other health groups to produce results faster. There’s another reason for hospitals and doctors’ practices to proceed swiftly and deliberately: The insurers that pay their bills have long sought ways to better scrutinize the charges, and AI is just the latest tool, said Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association, a doctors’ group. He said doctors often fear overcoding because of the stiff penalties that can come with it. But he also acknowledged another way they may think about it. “One could say, ‘all is fair and love and war — the payers are using it, the providers should too.’” ‘The perfect storm coming’Some of the biggest health insurers — including Humana and UnitedHealth — face lawsuits claiming they are using AI to deny care. The plaintiffs in the suits, filed this fall, argue the companies rejected doctors’ orders more often after embracing AI tools to monitor care. A spokesperson for naviHealth's nH Predict tool, cited in the UnitedHealth and Humana suits, said the plaintiffs misunderstand the role of the technology — that it’s used to evaluate what care may be needed, not to decide whether to approve it. Humana and UnitedHealth declined to comment on the pending litigation. Each of the companies said it wants to implement the tech in ways that both promote patient wellbeing and increase efficiency. More broadly, insurers say they are making major investments in AI, both to cut their own administrative costs and to weed out fraud in the bills they receive. “It feels like the perfect storm coming of the technology really becoming a more significant asset to the company if deployed correctly,” said Craig Richardville, chief information officer of Salt Lake City-based Intermountain Health, which does business as both a provider and payer. The government, meanwhile, is caught in the middle. Every year, it incurs $60 billion in fraudulent Medicare bills, according to government estimates. Medicaid fraud costs the states and federal government tens of billions more. The government already creates many of the rules that govern health care billing and is using AI to combat fraud, according to the National Health Care Anti-Fraud Association, an alliance of government agencies and private insurers. A spokesperson for the Centers for Medicare and Medicaid Services said in a statement that “CMS continually assesses opportunities to safely and responsibly leverage new, innovative strategies and technologies, including AI, to more effectively accomplish its mission.” At the same time, the agency has to answer to patients skeptical of strict anti-fraud measures that can result in denied care. Starting Jan. 1, CMS will begin requiring the private insurers who run Medicare plans to ensure they’re “making medical necessity determinations based on the circumstances of the specific individual, as opposed to using an algorithm or software,” according to congressional testimony. ‘It's going to add gasoline’When insurers and providers can’t agree on a bill, it’s often patients caught in the middle — or stuck on hold waiting to talk to a customer service representative. If AI helps insurers deny care, or amps up the fights between medical providers and health plans over bills, will patients have to mediate? The 2020 legislation Congress passed to help patients who receive surprise medical bills from providers outside of their networks underscores the policy thicket. A mediation process set up by the Department of Health and Human Services to sort out the bills has received more than 20 times as many claims from providers as the government anticipated, and 60 percent remain unresolved, according to a exact tally. This month, the administration said it was reworking its process. Still, both providers and insurers say they expect the AI takeover of the billing process to help patients more than it hurts them. “Do I think people will use it as a hammer?” said John Couris, president and CEO of Florida Health Sciences Center, which runs Tampa General Hospital, of the technology. “I mean, I think they probably will — on both sides.” But Couris said the health industry is mostly just “desperate” for AI products that fix the complicated billing systems that so frustrate patients. Even so, policymakers charged with making sure that happens are just beginning to evaluate their role. Some House Democrats, including Reps. Judy Chu of California and Jerry Nadler of New York, have opened an inquiry into whether private plans in Medicare are too quick to use AI to deny care, while others, from Senate Majority Leader Chuck Schumer (D-N.Y.) to Rep. Cathy McMorris Rodgers (R-Wash.), are holding hearings and forums on how the tech will change the way doctors treat patients — and bill for that treatment. Mostly, Congress is just beginning to talk about legislation. Sens. John Thune (R-S.D.) and Amy Klobuchar (D-Minn.) introduced a bill last month that would task the Commerce Department with conferring with other agencies to begin the process of setting some guardrails. Biden issued an executive order in October that set some reporting deadlines for agencies to assess what should be done. HHS issued transparency rules for health AI earlier this month, but its focus was technology used in clinical decision-making, not billing. Meanwhile, nearly every aspect of the health care industry is trying to gain an advantage with major stakes: AI’s role in billing could impact the sustainability of Medicare, Medicaid and private insurers, as well as hospitals, clinics and providers of all kinds. Stepro of Arcadia, who’s helping both providers and insurers build the tools they hope will help them thrive, senses the urgency. “It's going to add gasoline to a lot of existing tension in how money flows in health care,” he said. Chelsea Cirruzzo contributed to this report. | ||||||||
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