The plan's payment was greater than the gross amount payable by Medicare of $4, 000. No part of the $500 difference between the hospital's charges and the employer plan's payment can be billed to the beneficiary since the beneficiary's obligation, the deductible, was met by the employer plan payment. The provider files a no-payment bill reflecting a fully satisfied deductible. 264.15 EGHP Erroneously Pays Primary Benefits.--If you determine that an EGHP has inappropriately paid primary benefits, bill Medicare as primary payer and refund to the EGHP the amount it paid, except for an amount equivalent to the Medicare deductible and coinsurance amounts, and charges for noncovered services. 264.16 Claimant's Right to Take Legal Action Against an EGHP.--The Omnibus Budget Reconciliation Act of 1986 provides that any claimant has the right to take legal action against, and to collect double damages from, an EGHP that fails to pay primary benefits for services covered by the EGHP where required to do so under 1862 b ; of the Act. 264.17 Medical Services Furnished to ESRD Beneficiaries by Source Outside EGHP Prepaid Health Plan.
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Sumatriptan injection Imitrex ; .18 sumatriptan nasal .18 sumatriptan nasal Imitrex ; see tetracycline Sumycin .13 Surestep .8 Surmontil .17 Surmontil 25 & 50 mg see trimipramine Sustiva .14 Symbyax .16 Symlin .8 Symmetrel see amantadine Synagis .14, 23 Synalar see fluocinolone Synarel .11 Syntest .11 Synthroid see levothyroxine Taclonex .21 tacrine .17 tacrine Cognex ; .17 tacrolimus .15, 20 Tagamet see cimetidine Tambocor see flecainide Tamiflu .14 tamoxifen .15 Tapazole see methimazole Tarceva .15 Targretin .15 Tarka.6 Tasmar .19 Tavist see clemastine tazarotene .20 Tazorac .20 Tegretol see carbamazepine Tekturna .7 telithromycin .13 telithromycin Ketek ; .13 telmisartan .6 telmisartan Micardis ; .6 telmisartan HCTZ .6 telmisartan HCTZ MicardisHCT ; .6 temazepam .17 Temodar 140mg, 180mg . Temodar 20mg, 100mg . Temodar 250mg .15 Temodar 5mg .15 Temovate see clobetasol temozolamide .15 Tenex see guanfacine tenofovir .14 Tenoretic see atenolol chlorthalidone Tenormin see atenolol Tequin .13 Terazol 3 cream see terconazole vaginal.
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Cost effective analyses provide critical information about the economic consequences of alternative ways to improve population health outcomes. Increasingly scarce health care resources require that decision makers have information about the cost implications of effective interventions so that the tradeoffs associated with different ways of improving population based health can be fully evaluated. This seminar will introduce the concepts and practical issues related to cost effectiveness studies relevant to behavioral medicine. Alternative approaches that researchers and public and private decision makers may consider when conducting and using cost effectiveness studies will be reviewed. Issues related to planning for cost effectiveness analyses, the data necessary to conduct successful analyses and alternative empirical methods that may be used in these studies will be examined. Topics to be addressed include: the perspective that should be used in cost effectiveness studies, what outcomes should be used to measure effectiveness, what data elements must be collected and statistical techniques that are useful for cost effectiveness studies. Examples from behavioral medicine will be used to illustrate each of the topics addressed in the seminar including programs to increase screening for cancer and sexually transmitted diseases, use of evidence based tobacco dependent treatment programs, treatment for depression and other mental health needs among others. Seminar material is accessible to a non-technical audience, but is also relevant to those interested in conducting and applying economic analyses within behavioral medicine. Behavioral scientists, clinicians and health plan managers will benefit from the seminar. Economists and others interested in cost effectiveness analyses of behavioral health programs as well as designers and users of behavioral health interventions will also benefit from the presentation. Handouts describing the different tools for cost effectiveness analyses as well as a complete bibliography of materials referred to during the seminar will be distributed. CORRESPONDING AUTHOR: Paul A. Fishman, Center for Health Studies, Group Health Cooperative, Seattle, WA, for example, clariton.
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1. Sulkowski JA, Judy KD. Acute mental status changes. AACN Clin Issues. 1997; 8 3 ; : 319-334. 2. Johnson MH. Assessing confused patients. J Neurol Neurosurg Psychiatry. 2001; 71 suppl 1 ; : i7-i12. 3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington, DC: American Psychiatric Association; 1994. 4. Sandberg O, Gustafson Y, Brannstrom B, Bucht G. Prevalence of dementia, delirium and psychiatric symptoms in various care settings for the elderly. Scand J Soc Med. 1998; 26 1 ; : 56-62. 5. Schofield I. Assessing for delirium. Nurs Older People. 2002; 14 7 ; : 31-33. 6. Chan D, Brennan NJ. Delirium: making the diagnosis, improving the prognosis. Geriatrics. 1999; 54 3 ; : 28-30, 36, 39-42. Limmer D, Monosky K. Assessment of the altered mental status patient. Emerg Med Serv. 2002; 31 3 ; : 54-58, 81. 8. Kanich W, Brady WJ, Huff JS, et al. Altered mental status: evaluation and etiology in the ED. J Emerg Med. 2002; 20 7 ; : 613-617. 9. Hustey FM, Meldon SW, Smith MD, Lex CK. The effect of mental status screening on the care of elderly emergency department patients. Ann Emerg Med. 2003; 41 5 ; : 678-684. 10. Ferrera PC, Chan L. Initial management of the patient with altered mental status. Amer Fam Physician. 1997; 55 5 ; : 1773-1780. 11. O'Keefe KP, Sanson TG. Elderly patients with altered mental status. Emerg Med Clin North Am. 1998; 16 4 ; : 701-715. 12. Petrikas R, Schumann L. AMS: hypoglycemia. J Acad Nurse Pract. 1998; 10 4 ; : 175-180. 13. Nadel ES, Brown DF. AMS in an anticoagulated patient. J Emerg Med. 1997; 15 1 ; : 95-98. 14. Ahya SN, Flood K, Paranjothi S, et al, eds. The Washington Manual of Medical Therapeutics. 30th ed. Philadelphia, Pa: Lippincott, Williams & Wilkins; 2001. 15. Pickard T. Getting past the obvious in an ED case of AMS and ECG changes. JAAPA. 2000; 13 12 ; : 54-58. 16. Cheatham ML, Block EF, Nelson LD. Evaluation of acute mental status change in the nonhead injured trauma patient. Surg. 1998; 64 9 ; : 900-905.
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