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What kinds of health problems are linked to excess weight?

2017-01-26T20:47:00.000-08:00

Men's Health Week

The week leading up to Father’s Day, June 10-16, is National Men’s Health Awareness Week. It is a time to focus on getting and/or keeping yourself or the man in your life healthy. Weight-related diseases are a growing cause of men’s health issues.

What kinds of health problems are linked to excess weight?

• type 2 diabetes

• high blood pressure

• heart disease and strokes

• certain types of cancer

• sleep apnea

• osteoarthritis

• fatty liver disease

• kidney disease

The table and graph below illustrate the significant increase in the percentage of overweight males in the 35-44 years category.

*Body mass index (BMI) equals weight in kilograms divided by height in meters squared.

(Source CDC: Data are based on measured height, without shoes, and weight of a sample of the civilian non-institutionalized population.)

**Age-adjusted to the year 2000 standard population using five age groups:20-34 years, 35-44 years, 45-54 years, 55-64 years, and 65 years and over

Closely linked to weight issues, is lack of physical activity.

Recommendations from the CDC are as follows:

Scenarios Aerobic Activity Amount/Week Muscle Strengthening Frequency/Week

1 Moderate Intensity 2 hours,30 minutes

All major muscle groups 2 or more days

2 Vigorous Intensity 1 hour, 15 minutes

All major muscle groups 2 or more days

3 Combined Intensity Up to 2 hours,30 minutes

All major muscle groups 2 or more days

Proper nutrition also plays an important part in maintaining a healthy weight. Here are the guidelines for the average adult daily 2000 calorie intake:

• 6 ounces of whole grains,

• 2 and ½ cups of vegetables,

• 2 cups fruit,

• 3 cups low fat dairy, and

• 5 and ½ ounces of lean protein

With diligent efforts to keep active and eat properly any man can optimize his chances for good

Appealing a Medicare Denial

If you have received a claim denial from your Medicare contractor you do have the right to submit an appeal. If you do not take assignment on the claim, your appeal rights can be limited.

clerical reopeningSee section at the bottom on Clerical Reopening when an appeal is not indicated.

First level of appeal: Redetermination

A redetermination is an examination of a claim by fiscal intermediary (FI), carrier, or MAC personnel who are different from the personnel who made the initial claim determination. The appellant (the individual filing the appeal) has 120 days from the date of receipt of the initial claim determination to file an appeal. A redetermination must be requested in writing. A minimum monetary threshold is not required to request a redetermination

Second level of appeal: Reconsideration

A party to the redetermination may request a reconsideration if dissatisfied with the redetermination decision. A qualified independent contractor (QIC) will conduct the reconsideration. The QIC reconsideration process allows for an independent review of medical necessity issues by a panel of physicians or other health care professionals. A minimum monetary threshold is not required to request a reconsideration.

Third level of appeal: Hearing by an administrative law judge (ALJ)

If at least $140 remains in controversy following the qualified independent contractor's (QIC's) decision, a party to the reconsideration may request an administrative law judge (ALJ) hearing within 60 days of receipt of the reconsideration decision. Appellants must send notice of the ALJ hearing request to all parties to the QIC for reconsideration. ALJ hearings are conducted by the Office of Medicare Hearings and Appeals (OMHA).

OMHABy clicking here you will find information on the OMHA website.

Fourth level of appeal: Review by the Medicare Appeals Council

If a party to an ALJ hearing is dissatisfied with the ALJ's decision, the party may request a review by the Medicare Appeals Council.

There are no requirements regarding the amount of money in controversy. The request for Medicare Appeals Council review must be submitted in writing within 60 days of receipt of the ALJ's decision, and must specify the issues and findings that are being contested.

Medicare AppealsBy clicking here you will find information on the Medicare Operations Division/Medicare Appeals Council.

Fifth level of appeal: Judicial review

If $1,400 or more is still in controversy following the Medicare Appeals Council's decision, a party may request judicial review before a Federal District Court judge. The appellant must request a Federal District Court hearing within 60 days of receipt of the Medicare Appeals Council's decision.

•The Medicare Appeals Council's decision will contain information about the procedures for requesting judicial review.

Medicare AppealsAdditional resources

Within the CMS websites you will find information related to the five levels in the Part A and Part B appeals process.

• CMS Appeals Web resources

• CMS Appeals process flowchart

CMS resource materials available for download

• MLN - The Medicare Appeals Process Brochure

CMS Internet-only manuals: Publication 100-04

• Chapter 29– Appeals of Claims Decisions

• Chapter 34– Reopening and Revision of Claim Determinations and Decisions

Minor errors or omissions on some Part B claims can be corrected for reprocessing using the clerical reopening process.

Medicare AppealsThere are two ways to initiate this process:

• Telephone reopening requests via the interactive voice response (IVR) allows providers/customers to request telephone re-openings on certain claims. For the IVR reopening request help sheet, click here

• For reopening requests in writing, use the clerical reopening .

corrected claimCommon clerical errors consist of:

• Mathematical or computational mistakes

• Transposed procedure or diagnostic codes

• Inaccurate data entry

• Misapplication of a fee schedule

• Computer errors

• Denial of claims as duplicates which party believes incorrectly identified as duplicate

• Incorrect data items such as provider number, modifier, date of service.

medically unlikely edit (MUE) and Key Medicare Benefits for Men’s Health

2017-01-25T20:47:00.000-08:00

Do you know MUE?

Working in medical billing is like being in a bowl of alphabet soup.

One of the probably less common acronyms is MUE: Medically Unlikely Edit.

Read below to find out what an MUE is, and why you should care.

what is a medically unlikely edit A medically unlikely edit (MUE) is an automated claim processing edit that compares the number of units submitted for a procedure code against the designated maximum units that are typically reported for that code on the vast majority of appropriately reported claims.

MUE The edit is applied to services billed by a single provider/supplier to a single beneficiary on the same date of service.

Automated claim processing edit

The MUE program was developed by CMS in an effort to reduce the paid claims error rate for Medicare claims that result from various circumstances such as:

• clerical entries

• incorrect coding based on:

o anatomic considerations

o procedure code descriptors

o procedure coding instructions

o established CMS policies

o nature of a service/procedure

o unlikely clinical treatment

MUE CMS does not publish MUE values for some codes. Some MUE values are confidential and may not be published.

CMS fiscal intermediaries

CMS fiscal intermediaries and Part A/Part B Medicare administrative contractors (A/B MACs) process claims with the fiscal intermediary shared system (FISS).

They adjudicate MUEs against each line of a claim rather than the entire claim. If a procedure code is reported more than once, each line with that code is separately adjudicated against the MUE. They will deny the entire claim line if the unit of service (UOS) on the claim line exceeds the MUE value for the procedure code listed on the claim line.

MUE For Example CPT Code 77300 is submitted on one service line for 11 units, if the MUE is 10, then all 11 are denied, instead of a just denying the one unit over the limit.

MUe value modifiersWhen there is a need to report medically reasonable and necessary units of service in excess of an MUE value modifiers can be used to report the same code on separate lines of a claim will enable a provider/supplier to report medically reasonable and necessary units of service in excess of an MUE value.

modifiersThe modifiers noted below will accomplish this purpose.

• 76 -- Repeat procedure by same physician

• 77 -- Repeat procedure by another physician

• Anatomic modifiers (e.g., RT, LT, F1, F2, 50)

• When is it appropriate to bill modifier 50?

• 91 -- Repeat clinical diagnostic laboratory test

• 59 -- Distinct procedural service (Note: Modifier 59 should be utilized only if no other modifier describes the service.)

MUE Effective April 1, 2013, CMS converted some claim line MUEs to date of service (DOS) MUEs. The total units of service (UOS) from all claim lines for a HCPCS/CPT code with the same date of service will be summed and compared to the MUE value. Claims denied based on DOS MUEs may be appealed usingsimilar processes to claim line MUE denials.

CMS does not publish which codes have DOS MUEs. Since all UOS for a HCPCS/CPT code on all claim lines with the same date of service are summed, reporting additional UOS on separate claim lines with a HCPCS/CPT modifier will not result in payment of UOS in excess of the MUE value.

Key Medicare Benefits for Men’s Health

For those providers servicing Medicare beneficiaries, Men’s Health Awareness Week is a good time for you to re-familiarize yourself with the wide range of covered preventive services. Identifying risk factors and utilizing screening tests for early detection can mean the difference between life and death.

As demonstrated by the chart below, several of leading causes of death in males age 65 and over in the United States, are routinely linked to preventable and /or highly treatable causes. This data was reported by Centers for Disease Control and Prevention for 2009.

The table below lists the covered service detailing eligibility requirements and other useful billing information:

Service : Procedure Code(s) : Coverage : Frequency

Abdominal Aortic Aneurysm Screening

G0389-U/S exam AAA Screening

Any beneficiaries with certain risk factors and a referral resulting from an IPPE visit.

Once in a lifetime

Alcohol Misuse Screening and Counseling

G0442-Annual screening, 15 min.

G0443-Brief face-to-face behavioral counseling for misuse, 15 min.

For screening: all beneficiaries.

For misuse, furnished by PCP: all competent beneficiaries.

G0442-Once annually

G0443-4 times per year

Annual Wellness Visit (AWV)

G0348-Initial Visit

G0349-Subseqeunt Visit

Any beneficiary that has been effective for Part B for at least 1 year.

G0348- Once in a lifetime

G0349- Once annually

Colorectal and Prostate Cancer Screenings

G0104-Flexible Sigmoidoscopy or G0106-Barium Enema

G0105-Colonoscopy

(high risk) or

G0120-Barium Enema

G0121-Colonoscopy (not high risk)

G0328-Fecal Occult Blood Test immunoassay

82270- Fecal Occult Blood Test by peroxidase activity.

Any beneficiary aged 50 or over who are at normal or high risk for developing

Colo-rectal cancer.

G0328/82270-Once annually

G0104-Once every 4 years or 120 months after G0121

G0121-Once every 10 years or 48 months after G0104 or every 24 months for high risk

G0106/G0120-Once every 48 months or 24 months for high risk.

Cardiovascular Disease Screenings

80061-Lipid Panel

82465-Cholesterol

83718-Lipoprotein

84478-Triglycerides

Any beneficiaries w/o signs or symptoms of cardiovascular disease

Every 5 years

Depression Screening

G0444-Annual screening, 15 min.

Any beneficiary as furnished by PCP with proper support staff.

Once annually

Diabetes Screening

82947-Blood Glucose; quantitative

82950-Glucose;post-glucose dose

82951-Glucose;3 specimen tolerance test

Any beneficiaries with risk factors or diagnoses with pre-diabetes.

Once annually if no pre-diabetes.

Twice annually with pre-diabetes.

HIV Screening

G0432-Infectious agent by EIS technique

G0433-Infectious agent by ELISA technique

G0435-Infectious agent by rapid antibody test

Any beneficiaries at increased risk for HIV infection or pregnant.

Annually for high risk beneficiaries.

Three times per pregnancy.

Immunizations (Seasonal Influenza, Pneumococcal, and Hepatitis B)

90654-90657, 90660-90662, Q2034-Q2039-Influenza Virus Vaccine/ G0008 administration 90669-90670,90732-Pneumococcal Vaccine/

G0009-Administration

90740,90743-90744, 90746-90747-Hepatitis B Vaccine/G0010 administration

Influenza and Pneumococcal: all beneficiaries.

Hepatitis B:i any beneficiaries at intermediate or high risk for

Influenza- Once per season.

Pneumococcal- Once in a lifetime.

Hepatitis B- Scheduled dosages as required.

Intensive Behavioral Therapy for Cardiovascular Disease

G0446-IBT to reduce cardiovascular disease risk; individual, face-to-face, bi-annual, 15 min.

Furnished by PCP: Male beneficiaries aged 45-79-encouraging aspirin use, adults aged 18 or older- screening for hypertension, adults with risk factors- promoting a healthy diet

Intensive Behavioral Therapy for Obesity

G0447-Behavioral counseling, face-to-face, 15 min.

Beneficiaries with BMI greater than or equal to 30 kg/m2, furnished by PCP.

One visit per week in first month.

One visit every 2 weeks, months 2-6.

One visit per month, months 7-12.

Prostate Cancer Screening

G0102-Digital rectal exam

G0103-Prostate Specific Antigen test

All male beneficiaries aged 50 and older.

Once annually

Tobacco Use Cessation Counseling

G0436-Counseling for the asymptomatic patient; intermediate >3min. up to 10 min.

G043-Couseling for the asymptomatic patient; intensive, > 10 min.

All outpatient and inpatient beneficiaries.

Two cessation attempts per year: attempt = max of four sessions, up to eight sessions in 12 months.

For More Information:

• MLN Preventive Services Educational Products for Health Professionals

• CMS Prevention website

• CMS Immunizations website

• MLN National Provider Calls and Events website

• Men’s Health Month website

Discharge Planning as Part of Community-Based Care Transition Program (CCTP) and Medicare: What is a Duplicate?

2017-01-24T20:47:00.000-08:00

CMS encourages Home Health Agencies, Hospices, Hospitals, Inpatient Psychiatric Facilities, Long-Term Care Facilities, and Swing Beds to review the guide on “Discharge Planning”(ICN 908184) found in the Medical Learning Network section of CMS.

This 20 page publication provides valuable detailed information for any provider of service involved in the patient discharge process.

CMS data suggests almost 20% of hospitalized Medicare patients are readmitted within 30 days of their discharge. This amounts to approximately 2.6 million beneficiaries being affected and costs the Medicare program an estimated $26 billion every year.

Increase medical costs

In an attempt to curb this expense, the CMS Innovation Center established by the Affordable Care Act has created the Community-Based Care Transition Program (CCTP). The ACA has earmarked up to $500 million for the CCTP that was launched in 2011 and will run for 5 years.

Community-Based Care Transition Program

The program starts with the basic principle that the healthcare community should work together to improve quality of patient care.

Reduced healthcare costs

The goal is to ultimately reduce hospital readmissions by a minimum of 20 % which would translate to a savings of $5.2 billion a year. This represents a significantly larger amount than the initial cost to CMS for the program.

Data for 2012 suggests the program is already working by preventing an estimated 70,000 readmissions.

Enrolled participants, referred to as Community-based organizations (CBOs) now numbering over 100, will work with hospitals to coordinate patient care transitions. If you would like to see who is participating in your area, you can select this link to access the CMS interactive map: http://innovation.cms.gov/initiatives/map/index.html?modelPass=CCTP

Care transition

Care transitions as referred to in this program, relate to hospital inpatients that are being discharged to their home, a nursing home, or other care facility. CBOs will use care transition services to identify risk factors that produce readmissions and coordinate the necessary actions to lessen the effect of those factors.

patient education

CBOs will be requred to provide:

Care transition services that begin no later than 24 hours prior to discharge

Timely, culturally and linguistically competent post-discharge education to patients

NOTE:This education is crucial so that patients understand potential additional health problems that may develop or a deteriorating condition.

Timely interactions between patients and post-acute and/or outpatient providers

Patient centered self-management support and information specific to the beneficiary’s condition

A comprehensive medication review and management

NOTE:This includes any appropriate counseling and self-management support.

The CBOs will be paid an all-inclusive rate per eligible discharge based on the cost of care transition services provided at the patient level and of implementing systemic changes at the hospital level. CBOs will only be paid once per eligible discharge in a 180-day period of time for any given beneficiary.

Performance and effectiveness of the CBOs will be gauged by the evaluation contractor and the implementation and monitoring contractor. Quality and utilization measures will consist of 30-day all cause readmission rates, and will also monitor 90-and 180-day readmission rates, mortality rates, observation services, and emergency department visits.

One major goal of the CCTP is to develop effective approaches to care interventions that will improve the quality of care while decreasing readmissions. This transparency of the COB’s should ensure accurate evaluations of both successes and shortcomings of this program.

Please follow this link to the CMS site for full details on this program:

http://innovation.cms.gov/initiatives/CCTP/

Medicare: What is a Duplicate?

Each Medicare claims processing system contains criteria to evaluate all claims received for potential duplication. The claims can be placed into two categories: exact duplicate or suspect duplicate. Each category is processed uniquely by the Medicare contractor.

CMSCMS has recently updated the Medicare Claims Processing Manual, Chapter 1, Section 120: “Detection of Duplicate Claims” based on change request (CR) 8121.

Duplicate claims : An exact duplicate claim is denied or rejected, if missing applicable modifiers, automatically by the claims processing system.

For exact duplicate denials, professional providers do have appeal rights, but institutional and DME providers do not.

suspect duplicateIf a claim is deemed suspect by the initial system review, the claim is suspended for further review by the Medicare contractor.

If suspect duplicate is denied after review, all providers have right to appeal.

Due to the nature of the service, some claims may only appear to be duplicates. Proper coding of the service with the applicable condition codes or modifiers will identify the claim as a separate payable service, not a duplicate. An example could be modifiers “LT” and “RT” for bilateral procedures.

By utilizing an advanced Medical Practice Management Billing Software like Iridium Suite from Medical Business Systems, duplicate claims submissions are easily prevented. A configurable Claim Scrubber as found in Iridium Suite will check each service entered and alert the user immediately if the same service is already on record.

This gives the user the opportunity to determine if the service is a true duplicate or if the service qualifies for an appropriate addition of a modifier.

See the information below for details on the process Medicare utilizes to identify duplicate claims.

Provider of Service duplicate claimsExact Duplicate suspect duplicate

Suspect Duplicate

Institutional institutional claims Claim matches identically on the following data:

1. Health insurance claim (HIC) number

2. Type of bill

3. Provider identification number

4. From date of service

5. Through date of service

6. Total charges (on the line or on the bill)

7. HCPCS, CPT-4, or procedure code/modifiers Claim matches on the following data:

1. Beneficiary information

2. Provider identification

3. Same date of service or overlapping dates of service

Professional professional claims

1. HIC number

2. Provider number

3. From date of service

4. Through date of service

5. Type of service

6. Procedure code

7. Place of service

8. Billed amount

The criteria for identifying suspect duplicate claims submitted by physicians and other suppliers vary according to the type of billing entity, type of item or service being billed, and other relevant criteria.

DMEDME supplies Claim matches identically on the following data:

1. HIC number

2. From date of service

3. Through date of service

4. Place of service 22

5. HCPCS

6. Type of service

7. Billed amount

8. Supplier

Keep Your Independence Day Safe

2017-01-23T20:46:00.000-08:00

Three-quarters of Americans plan to enjoy the outdoor cookout experience to celebrate the Fourth of July Holiday. With all that fun, come some obvious and not so obvious dangers. Read on to see tips on keeping everyone happy and healthy in the backyard or at the park.

HCAs

The smell of BBQ in the air starts your mouth watering. That sound of meat sizzling on the grill could kill you, or at least give you cancer.

Do this to reduce your risk:

1.Marinade meats for 30 minutes prior to grilling to reduce Hetercyclic Amines (HCA’s)

2.Cook meat properly. Burnt meat contains HCA’s causes gene damage Consumption of HCA’s can cause damage to genes. This can often be related to increased cancer risk.

3.Eat only 4-6 oz. of red meat per meal (18 oz. per week) or instead eat chicken, fish, fruits and veggies made on the grill.

causes gene damage Red meat increases the risk of colon cancer.

mosquito borne illness

Ants are famous for crashing the picnic, but the mosquito is much more harmful. Keep everyone comfortable and disease free by reviewing this information on those pesky, flying pests.

causes gene damage Mosquitoes spread dangerous diseases like West Nile Virus, Dengue and Malaria. Mosquitoes infect nearly 225 million people annually with Malaria resulting in approximately 781,000 deaths.

1.Mosquitoes are attracted by dark colors, body heat and smells from body chemicals like carbon dioxide and lactic acid. Dress in lightly colored protective clothing and use repellent containing DEET.

2.Eliminate breeding areas by draining all standing water where they lay their eggs.

3.Avoid peak mosquito hours: early morning and evening.

heat stress

We all wish for a bright sunny day for our holiday activities, but be cautious of the effects that summer time heat can have on your body.

1.Drink plenty of fluids, avoiding sugar sweetened drinks.

2.Protect your skin with sunscreen and wear loose-fitting, lightweight and light colored clothing.

3.Be aware of symptoms of heat-related illnesses like heat stroke and heat exhaustion. You can go to the CDC website to see a full guide on heat stress illnesses.

causes gene damage Excessive heat above 80 degrees with 40% or more humidity can have even more serious consequences for those people with diabetes. Diabetics should:

Check medication and test strips packaging and their glucose meter regarding effects of exposure to high temperatures. Take the necessary precautions to protect them and insulin pumps from the heat.

Keep insulin cool, preferably in a cooler without direct contact with ice or frozen gel packs.

For those on a restricted liquid intake, they should discuss with their doctor how best to adjust to their intake during times of high heat.

National HIV Testing Day

June 27th has been designated by the US Department of Health and Human Services to be National HIV Testing Day.

Since the discovery of the Human Immunodeficiency Virus in the 1980’s, HIV has affected numerous millions of people in the United States alone. The CDC estimates more than 1.1 million people in the United States are living with HIV infection currently and about 50,000 new cases are diagnosed each year.

The CDC also reports that almost 1 in 5 (18.1%) of infected individuals are unaware of their infection. As with any disease, the ideal way to fight the spread of HIV is with early detection. It allows those who are diagnosed to initiate treatment as soon as possible, increasing survival chances and quality of life. This also helps to eliminate the chance of unknowingly spreading the disease to others.

Healthcare professionals should take this opportunity to encourage high risk individuals to be screened for HIV. Information on testing that is geared to provider education is provided on the aids.gov website.

For patients, a screening location finder can be found on the CDC website by clicking here or also at http://aids.gov/.

The table below lists basic on the Medicare coverage for HIV Screening. Please consult the CMS Preventive Services website for complete detailed information.

Service : Procedure Code(s)

Coverage

Frequency

HIV Screening

G0432-Infectious agent by EIS technique

G0433-Infectious agent by ELISA technique

G0435-Infectious agent by rapid antibody test

Any beneficiaries at increased risk for HIV infection or pregnant.

Annually for high risk beneficiaries.

Three times per pregnancy.

Well in the realm of medical billing, RA means Remittance Advice.

2017-01-22T20:46:00.000-08:00

An RA is the detailed reply sent by a payer in response to a claim for a medical service. The details in the RA assist the biller in reconciling the payment that is received or provides the explanations for any non-paid items.

Many times it can also be referred to as an Explanation of Benefits (EOB).

An RA can come in two forms:

paper EOB : Standard Paper Remittance (SPR)

ERA : Electronic Remittance Advice (ERA)

Both contain similar information, but the ERA format has numerous advantages over the paper format. Most ERA’s are received within days of the claims processing by the payer instead of the weeks in can take for the SPR to arrive via mail.

Most of the best Medical Billing Software enables ERA data to be directly imported into the billing system where it can be auto-adjudicated.

This eliminates the time consuming and error prone task of manually keying in all the data from the RA

Iridium Suite Medical Billing Software by Medical Business Systems contains an integrated automated Payment Posting module that seamlessly imports and adjudicates all of your ERA’s.

The explanation of payment on the RA is typically detailed in a “coded” fashion utilizing combinations of alpha and numeric code sets. Medicare utilizes the most standardized version of these code sets, and they consist of four types:

Group codes: identify the responsible party or category of adjustment and are combined with CARCs

There are five group codes:

CO-Contractual Obligation
CR-Corrections and Reversal
OA-Other Adjustment
PIR-Payer Initiated Reductions
PR-Patient Responsibility

Claim Adjustment Reason Codes (CARCs): explain the adjustment of the non-paid amount

For a complete list of CARCs, visit Washington Publishing Company's website by clicking here.

Remittance Advice Remark Codes (RARCs): provide a more detailed explanation of the adjustment of a service line or claim level payment

For a complete list of RARCs, visit Washington Publishing Company's website by clicking here.

Provider Level Adjustment Codes: indicate an adjustment that applies to the pay to provider, not a specific service line or a claim

Provider Level Adjustment Codesare specific to Medicare. For a complete list, see the CMS publication by clicking here.

Follow this link to download an informational white paper on “Understanding Explanation of Benefits Statements.”

The Medicare Learning Network in April 2013 released “Remittance Advice Information: An Overview” Fact Sheet (ICN 908325). You can access this publication by clicking here.

CMS to Update the Benefit Manual for ESRD PPS

CMS details in a recent publication of the “MLN Matters” an implementation date of September 9, 2013 for the revisions to the "Medicare Benefit Policy Manual”. The manual will be updated to reflect change request (CR) 8261 providing information on the end-stage renal disease prospective payment system (ESRD PPS).

ESRD PPSThe background and implication of the ESRD PPS, are as follows:

•In August 2012, CMS released an analysis of patient claims in the new ESRD prospective payment system, which showed that this payment system has had no negative effects on patients’ health.

•The ESRD PPS, first implemented in 2011, expands renal dialysis services included in the single bundled payment to the dialysis facilities and provides for patient case-mix adjustments, facility level adjustments, and outlier payments. It is intended to improve efficiency.

•CY 2013 will be the third year of a four-year transition to the new payment system. The overall impact of the CY 2013 changes is projected to be a 3.0 percent increase in payments.

Hospital-based ESRD facilities have an estimated 3.6 percent increase in payments compared with freestanding facilities with an estimated 2.9 percent increase. Urban facilities are expected to receive an estimated payment increase of 3.0 percent compared to an estimated 2.9 percent increase for rural facilities.

•The ESRD QIP aims to promote continued improvement in the quality of care provided to patients with ESRD. The final rule focuses on clinical measures and has added the following QIP reporting measures to cover a broader range of patients who receive dialysis care:

o To evaluate anemia management

Anemia Management, a reporting measure.

o To evaluate dialysis adequacy

A clinical Kt/V measure for adult hemodialysis patients.

A clinical Kt/V measure for adult peritoneal dialysis patients.

A clinical Kt/V measure for pediatric in-center hemodialysis patients.

• The overall economic impact of the ESRD QIP is an estimated $24.6 million for PY 2015. The total expected payment reductions will be approximately $12.1 million, and the costs associated with the collection of information requirements for certain measures to be approximately $12.4 million.

• The estimated payment reduction will continue to incentivize facilities to provide higher quality care to beneficiaries. The reporting measures that result in costs associated with the collection of information are critical to better understanding the quality of care beneficiaries receive, particularly a patient's experience of care, and will be used to incentivize improvements in the quality of care provided.

The Job Description Of A Phlebotomy Technician and Venipuncture Technique

2017-01-21T14:39:00.000-08:00

The Job Description Of A Phlebotomy Technician

A phlebotomy technician is a medical professional that draws blood and other fluid samples from a patients body for the purpose of medical diagnosis and assessment or for purpose of blood donation.

The phlebotomy technician takes these blood samples from the patient using venipuncture, which is the most common method. Venipuncture entails getting the blood directly from median cubital vein, which lies within the anterior of the elbow.

Blood can also be obtained through a capillary method or from a small pinprick in the finger. A phlebotomy technician is the medical professional that is responsible for drawing blood using all of these methods.

The tasks attributed to a phlebotomy technician include making sure that all of the instruments used in the drawing of the blood is sterilized and safe.

After the blood draw is complete the phlebotomy technician is required to label the collection container immediately with the patient’s information, the reason for the blood draw and any other identifying information.

All relevant paperwork must be completed immediately in order to have a paper trail to trace the route of the sample, assuring the patient and the doctors that the correct blood sample is being used for the diagnosis and assessment.

The proper identification of the blood sample and having the appropriate paperwork completed is the most crucial part of the job as even the most minor error can lead to a misdiagnosis or a contamination., which can be detrimental to the patient, the doctor, the facility and everyone concerned.

Phlebotomist are required to keep detailed records about their patient’s blood test results and information within the computer system of the facility where they are employed. Many phlebotomy technicians are also charged with the responsibility of training new technicians in sample collections and analysis.

You must be able to put your patients at ease. Blood draws tend to be painless procedures, however, many patients are still very nervous about having their blood taken.

A good phlebotomy technician will have a comforting manner and will be able to ease their patients fears. Phlebotomy technicians are employed at almost every type of medical facility, including hospitals, clinics, doctor’s offices, diagnostic laboratories and of course, blood banks.

In order to become a practicing phlebotomy technician one must have a high school diploma or equivalent. A background in science or biology is helpful and a training program from a certified vocational training program must be completed. One must also pass a test from one of the following associations in order to become certified.

The American Society of Clinical Pathologists (ASCP)

The American Association of Medical Personnel (AAMP)

American Medical Technologists (AMT)

The National Credentialing Agency (NCA)

The training programs to become a phlebotomy technician typically take one year to complete. Certification and licensing is generally not required in most states, however, getting your certification will give you a big advantage when it comes to getting a job. Many employers will only hire phlebotomy technicians who are certified with a accredited association.

Venipuncture Technique

If you have ever had your blood drawn for a donation or for a medical test you may have ended up with a huge purple bruise on your arm or you may not have had any bruise at all and the only way you can tell that you gave blood at all is the little tiny mark from where the needle pricked your skin.

Phlebotomy technicians need to become skilled in venipuncture technique or phlebotomy technique as it is often called. Drawing blood should not be a painful experience for the patient either as the blood is being drawn or afterward.

Drawing blood is somewhat of an art, but a good technique is something that can be practiced and learned. If you are planning to be a phlebotomy technician the art of venipuncture is something that you should work on daily.

Preparing for Venipuncture

It is important to properly prepare the patient to prevent possible patient injury and infection. Possible fainting or dizziness can occur in even the healthiest patients so the patient should always be seated before starting. All tight or constricting clothing or jewelry should also be removed.

The phlebotomy technician or nurse will select the most appropriate vein for blood collection. The skin over the vein must then be cleaned thoroughly with a 70% alcohol solution wipe in a spiral motion from the inside out.

The phlebotomy technician should always practice good venipuncture techniques including:

1. Washing hands thoroughly with a hospital recognized antiseptic hand soap. The phlebotomy technician should also always wear examination gloves that are either latex or vinyl.

2. Selecting the most suitable vein. This is the vein that can most easily accommodate the blood draw with just one stick. No patient likes to be poked again and again.

3. Clean the area thoroughly with the hospital or clinic approved swabs, usually either povidone-iodine 1% or an alcohol or CHG prep.

The Vein Puncture

A tourniquet is usually applied about 3 to 4 inches above the collection site on an extremity, such as the arms. This forces the blood to pool inside the vein making it easier for the stick and for the blood collection or for an intravenous catheter insertion. The patient can also make a fist and this will also aid in the pooling of the blood in the vein.

The needle chosen is selected based upon the size of the patient, the patient’s age, the condition of the vein and the reason for the venipuncture.

The needles are flattened to point on one side. This flat side is called a bevel and it allows the needle to slide easily through the skin and into the vein.

The needle should be positioned with the bevel facing upward, parallel to the vein at a 15-degree angle so that it can press through the vein in a quick and smooth motion.

The phlebotomy technician should also be confident and have a steady hand when poking the patient. An unsteady hand can be frightening for a patient.

After the venipuncture is complete it is important to apply pressure to the site in order to stop the blood flow and prevent bruising.

7 Phlebotomy Tips And Tricks

2017-01-20T14:20:00.000-08:00

The act of drawing blood is actually quite a simple procedure. Even so, there are patients who get very nervous at the thought of giving blood and even some who claim to faint at the sight of needles.

While giving blood is a very simple procedure it still helps for a phlebotomy technician to instill confidence in their patients.

It is better for both the patient and the phlebotomy technician if the patient remains calm and the blood draw happens without a hitch.

The best phlebotomy tips are the ones that can reduce stress on both the technician and the patient, reduce workplace problems and keep any disasters to a minimum. With that in mind, here are a few helpful tips for phlebotomy technicians.

Phlebotomy Tips And Tricks

1. You should always keep one or two sets of clean scrubs in your work locker or in your car. If an arterial blood draw goes wrong and blood sprays all over you, you will need to change right away. Nothing will destroy a patient’s calm and confidence faster than seeing the phlebotomy technician with blood all over them.

And even the most perfect blood draws can go wrong. Patients can jerk and the needle spurts blood all over, or there are even patients who really do vomit. When dealing with healthcare patients all day long you have to be ready for the unexpected.

2. Make sure you are familiar with any new equipment. If you are not, make sure that you request a demonstration before you try to use in on a patient. If it appears that you are unfamiliar with the needles or any thing else that you use, it will only scare the patient, which will make it much more difficult for you.

Or even worse, you could possible cause the patient unnecessary pain or injury. The manufacturers are often upgrading and bringing new equipment to the labs for venipuncture in order to make it safer for you and the patient. Be familiar with all of the equipment before you even approach a patient.

3. Prepare yourself mentally every day. Do whatever you have to to be happy and cheerful. Your happy disposition is very important for your job. Healthcare can be stressful and even depressing but your patients are often going through much more stress than you are and you need to be able to offer cheer and comfort. This also helps to inspire confidence.

4. You must learn how to work best with the different personalities that you work with. Doctors and nurses often have their own stress and of course, they also have their own egos and personalities.

If someone you work with is rude or disrespectful of you, you need to maintain your composure and keep your calm and caring demeanor. It may be more difficult in the moment but it will serve you and your career in the long run.

5. Always explain the procedure to the patient. Even if you have met the patient before and even if you are in a hurry. Every patient has the right to courtesy and respect and they also have the right to not be touched without their permission.

Just carefully explain the procedure, develop rapport with the patient and your job will be significantly easier.

6. The patient also has a right to privacy. Close the door or the curtain, ask visitors to leave for a moment unless the patient specifically requests that they stay. Do this before you begin explaining the procedure.

7. Take care of yourself. You can’t be good for your patients if you are burning the candle at both ends or if you are tired, cranky or you really need a day off.

Healthcare workers actually have a high burnout rate so when you are away from work, enjoy yourself, refresh and rejuvenate so you can start anew with a great attitude when you get back to work.

The Role Of Phlebotomy Technicians In The Healthcare Industry

An important diagnostic tool within the medical industry is analyzing and evaluating the blood of a patient. The blood can indicate a myriad of concerns and a thorough analysis of the blood can can be of tremendous help in the diagnosis of disease.

Phlebotomy is the medical term that is used to describe the act of drawing blood from a vein. The professionals who are trained to collect the blood are known as phlebotomy technicians or phlebotomists.

Phlebotomy technicians have the responsibility of drawing blood samples from patients. A blood draw can consist of just a small tube, in the case of most diagnostic considerations, to as much as a pint at one time, in the case of blood donations.

Phlebotomy technicians usually work in hospital or clinical settings and they are an important member of the healthcare team. While the most complex blood draws will include a venipuncture needle, it is also the phlebotomist who collects the blood for a finger-prick hemoglobin test.

The primary role of the phlebotomy technician is to collect the blood for accurate and reliable laboratory testing, using venipuncture or capillary collection.

A phlebotomists may also work with the doctor on such specialized testing as bleeding time tests, therapeutic phlebotomy or specimen preparation.

They are also often the ones that are responsible for the important function of monitoring blood pressure and pulse during blood transfusions and for blood donations at the blood banks.

A certified professional can find employment opportunities in a variety of settings in including hospitals, clinics and doctor’s offices. Occasionally, their services may be required for private home care and they can often find employment in nursing and long-term care homes.

The job and career outlook is very good as new types of medical tests are continuously being developed and the medical industry is such a necessary component of our society. The career of phlebotomy technician is also expected to grow in the next decade and even further into the future because of the aging of the population.

In order to become a technician it is usually required that you have a high school diploma or its equivalent. Then it is recommended that you complete a short training course, usually around 3 months of specialized training either as an apprentice on-the-job or through a formal health care program.

Many schools now offer phlebotomy training programs which instruct on how to locate veins and the proper procedures for blood draws along with how to communicate with patients and put them at ease.

Once the training course has been completed the student may decide to become a certified professional. Most states do not require certification, however, many employers prefer certification and being certified can help your job prospects.

Certifications are available from the American Society of Clinical Pathologists (ASCP), the American Medical Technologists (AMT) and the American Association of Medical Personnel (AAMP). All of the certifications will require that the student be able to pass a standardized test that measures their knowledge and skills. Venipuncture, record keeping and sample safety will all be included.

Becoming a phlebotomy technician can be an excellent career opportunity, the field is constantly growing and the potential for a decent salary is good.

Venipuncture Procedure and Phlebotomy Courses and Certification

2017-01-19T14:20:00.000-08:00

Phlebotomy is the process of drawing and collecting blood from a human vein for medical purposes. The actual process is called venipuncture. Venipuncture is performed by specialized healthcare workers called phlebotomy technicians.

Phlebotomy technicians have been trained in this specialized procedure along with being educated in human anatomy and physiology, blood storage and collection procedures and safety protocol and procedures.

Before starting to draw blood the phlebotomist must have all of the necessary equipment and tools for the venipuncture lined up. You need to be completely prepared because after you start drawing the blood you will not be able to leave the patient except for a few minutes, depending, of course, on how much blood is being drawn.

A phlebotomist requires needles, syringes and collecting tubes. The collecting tubes are specialized vacuum tubes or bags that are designed to collect a certain amount of blood.

If you are drawing blood for medical test, it is usually a small tube. If you are collecting for blood donation it is a larger bag.

Some of the collection tubes for medical testing may contain additives to assist with the testing. The tubes are generally identifiable by the color of the rubber stopper on top.

The phlebotomist will also need tourniquets to identify the vein, antiseptic and gauze or cotton balls and tape to place over the vein after the blood draw. A specialized puncture-proof container with “bio-hazardous” markings on it is also required for the safe disposal of used needles.

Safety measures are of the utmost importance for phlebotomists. The phlebotomist must begin by washing their hands with a specialized antibacterial soap before every procedure.

The phlebotomist must also wear protective vinyl or latex gloves for every venipuncture and these gloves must be replaced with every procedure. A lab coat or gown must also be worn during the blood collection.

Venipuncture Procedure

After the venipuncture is completed all of the equipment used must be disposed of properly in accordance with bio-hazardous waste disposal policies.

Any potentially contaminated surfaces must be wiped down with a antibacterial bleach solution. Every surface must be completely cleaned every day with a bleach solution.

The phlebotomist first need to identify the patient and be sure that all of the accompanying information is correct. At this time, he or she should also explain the procedure and try to minimize any anxiety or discomfort that the patient might be feeling.

The patient will need to be in a proper position for venipuncture, usually with the arm extended with a closed fist. The phlebotomist will then select the appropriate vein for the blood collection.

The tourniquet is then placed three to four inches above the vein, which makes the vein bulge out with blood, making it easier for the venipuncture. The vein site is then cleaned with an alcohol pad and allowed to dry before the puncture of the needle.

The actual procedure of the venipuncture begins with the appropriate needle connected to the collection tube or bag. The phlebotomist will then insert the needle into the vein and the vacuum tube is then attached to the needle and the blood begins to flow. The tourniquet is then removed and the patient can relax their hand.

When the blood collection is complete, the needle is removed and a gauze pad is applied with slight pressure to the puncture site. This helps to halt the bleeding more quickly.

All needles and other tools should then be disposed of and all tubes or bags of blood should be immediately marked with the patient labels, the date and the time.

Filed in: Phlebotomist, Phlebotomy Job

Phlebotomy Courses and Certification

Graduating from an accredited phlebotomy training program is advantageous to a new phlebotomist who is looking for employment.

The majority of employers will want to see that you have completed this important training and that you have passed the tests for phlebotomy certification. A phlebotomy training program with prepare you for all of the different aspects of a job working as a phlebotomy technician, from phlebotomy technique to the more mundane administrative activities that go along with the job.

Graduates of accredited phlebotomy training programs receive a well-rounded education that can prepare them to pass the tests necessary for certification.

You may find phlebotomy training courses available through various health facilities, trade or vocational schools and community colleges.

The curriculum may vary from one school to the next but the basic education should remain the same. Typically a program will last from six to eight months with both classroom and clinical instruction. It is generally 150 to 230 instructional hours.

It is easy to find an accredited phlebotomy program. Many of the accrediting agencies are affiliated with schools and organizations that offer programs.

The National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) has a database of 59 schools throughout the United States along with program and contact information.

Phlebotomy programs can be part-time or full-time. In a part-time program a student may attend classes or clinics for two days a week for two semesters. A full time program may run as often as 5 days a week for one semester.

There will be classes on medical terminology, healthcare issues and phlebotomy instructions. There is also a phlebotomy practicum where you work with real patients under the instruction of a practicing phlebotomist.

Throughout the training program, phlebotomists will learn about the different systems in the body and how they work. These systems include the circulatory, lymphatic, respiratory, muscular and skeletal systems. You will learn about both anatomy and physiology.

Phlebotomy Certification

Phlebotomy students also learn about blood and cell composition. A clear understanding of how blood and cells re affects by different diseases and infections is helpful for a practicing phlebotomist.

However, thorough explanations of potential problems with patients should always be left up to the Doctor who ordered the tests. The phlebotomist should not discuss detailed medical conditions with patients.

Most importantly, a phlebotomy student will learn different blood sampling procedures. The most commonly used procedure is called a venipuncture but there are also other techniques.

Techniques also vary with the patient, with different techniques being used for newborns, children and the elderly and some adults depending upon their medical condition.

Laboratory safety is also a crucial concern for phlebotomists so they can keep themselves and their patients safe. A clear understanding of proper bio-hazardous waste is critical. Also the phlebotomist must know how to handle lab equipment and the clean up after the blood drawing procedure.

Most phlebotomy programs offer CPR and first aid certification. This is important because many patients may have preexisting conditions that may cause a problem when blood is drawn. Even a healthy person can faint or blackout when blood is drawn, especially if they have not eaten any food for awhile. The phlebotomist must be prepared for any eventuality.

Other topics in phlebotomy courses may include professional ethics and behavior, quality control, legal issues and computer training. Good record keeping is also an important skill for a practicing phlebotomist.

If you happen to mistakenly label a blood draw it could cause some serious problems with mixed up specimens and test results.

When you select a phlebotomy program it is wise to find one that has accreditation. Choosing an accredited program will automatically qualify you to take a certification test upon completion of your program.

You may also apply for Federal financial aid programs that can help you with the cost of tuition. An accredited program will most likely have job information available and may even be able to help you find employment. You may also want to consider the length of the program, most programs vary from one semester to one year in length.

Mobile Phlebotomists and Recommended Phlebotomy Study Guides

2017-01-18T14:20:00.000-08:00

A mobile phlebotomist is one who is trained in the science and practice of blood collection, but often travels between locations, including to a patients place of residence for blood draw procedures.

Mobile phlebotomists receive the same training and certification as a phlebotomist who is located in one facility and are required to follow the same health and safety procedures and protocols. Traveling phlebotomists also receive additional training to address issues that are not found in a clinical environment.

Phlebotomists often travel with blood drives to collect donations or may go to a facility to collect blood samples because of a breach in the facilities health and safety procedures.

Mobile phlebotomists often work for insurance companies who require medical screening before an insurance policy is issued. Phlebotomists who travel bring this type of health care service to an individual or group who may not be able to access the service on their own.

Being a phlebotomist on the go has challenges not seen in a clinical setting. The setting for blood draw might not be a safe and sterile environment and the phlebotomist will have to take the necessary steps to make the procedure as safe as possible.

This is where a phlebotomist who is creative and quick thinking will have the definite advantage over one who is used to a steady, clinical routine that never varies.

There are different types of blood draw equipment and the phlebotomist will have to know how to use that equipment supplied at the blood draw event. The location for the blood draw may be limited in space and have limited supplies.

A mobile phlebotomist will often travel with an assistant who is also trained in blood sample collection. The assistant will prepare the equipment and the patient for the blood draw routine and then document each patient and label all blood samples.

The assistant will sometimes screen blood donation candidates and take the necessary vital signs. If additional supplies are needed, it will be the assistant’s job to fetch them. The assistant will also be able to step in and perform blood draws in the event the phlebotomist is overwhelmed with patients.

Below Is A List Of Mobile Phlebotomy Services…

It is going to be just about impossible to list every mobile phlebotomy services, so we have come up with a small list of a number of the most significant providers in metropolitan areas.

1. Staci’s Phlebotomy Service – Seattle area. Their website is http://stacisphlebotomyservice.com/

2. ColMed – in almost every states. Their website is https://www.colmedservices.com/athome.htm

3.Bayside Mobile Medical Service – San Francisco Bay area. Their website is http://www.baysidephlebotomy.com/

4. Aim to Please Phlebotomy – Portland and Vancouver area. Their website is http://www.aimtopleasephlebotomy.com

5. Arizona United Phlebotomy – ofcourse the state of Arizona. Their website is http://www.unitedphlebotomyarizona.com/

6. Independent Phlebotomy Provider Group – Southern California area. Their website is http://www.ippg.biz/

7. Tender Touch – also the Southern California area. Their website is http://www.tendertouchmobile_demo.websiteworks.com/

A mobile phlebotomist may be employed by a health care facility, Doctor or other company providing blood draw procedures or may be employed as an independent contractor. Being an independent phlebotomist has challenges and responsibilities all their own.

An independent phlebotomist will be able to create their own schedule and work when they want and travel as much as desired. The independent phlebotomist may also be required to provide the necessary equipment and sample kits in addition to performing the blood draw procedures.

The independent mobile phlebotomist may have to be contracted with testing laboratories for testing purposes. The labs will have to have the necessary capacity to test the blood samples, if necessary, in a timely manner.

The phlebotomist will also need a courier, delivery service or other distribution method to deliver blood samples to the destination, whether it is a storage facility or testing lab.

Recommended Phlebotomy Study Guides

A good phlebotomy technician will need to have a solid phlebotomy education background. It is much easier to become a practicing phlebotomy technician by completing an accredited training program and getting the appropriate certification.

A good phlebotomy training program will include exams to test and make sure that you have the knowledge that is recommended. Certification can be achieved by completing a standardized phlebotomy exam.

Study guides on the subject of phlebotomy can help potential phlebotomy technicians to prepare for the exams. If you are enrolled in a training program you should consult your instructor about recommended reading lists and study guides.

Your best chance at employment in a career in phlebotomy is by preparing and passing a national certification exam. While many states do not require this certification, with the exception of California and Louisiana, many employers do require this certification.

Most phlebotomy technicians can benefit from the various phlebotomy study guides that are available. Each individual certifying agency will have their own recommended materials and study guides.

If you are taking the exam through the American Certifying Agency (ACA), the examination study guide and the content outline will be mailed to you.

If your certification testing is from the National Center for Competency Testing (NCCT) you will receive a review book, a practice test and various packages with study guides and information.

You should be able to get all of this online along with suggested reading lists. You can also get access to online practice tests for 90 days.

The American Medical Technologists (AMT) also offer certification. They will provide you with a downloadable candidate handbook, the exam outline, along with a suggested reading list. You may also purchase a practice test for small fee.

Guides

It is important to study for your certification exam and additional study guides may help you to retain the information. You may also want to review other study guides to help you.

One highly recommended study guide for phlebotomy technicians is “The Phlebotomy Exam Review (3rd edition)” by Ruth E. McCall and Cathee M. Tankersley. This study guide is comprehensive enough that it is recommended for ten national exams, including the ACA, the NCCT and the ASCP.

The Phlebotomy Exam Review (3rd edition) by Ruth E. McCall and Cathee M. Tankersley follows the accreditation guidelines from the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) in addition to the Clinical and Laboratory Standards Institute (CLSI).

It is contains a review of over 800 potential multiple choice questions, including the answers and the explanations.

Another study tool that you may find helpful is flashcards. Flashcards can help you to practice accessing the information quickly and they can be a fun way to enhance learning.

You can find flashcards at many different phlebotomy websites and you can usually purchase them in either a hard copy form or a download so that you can print them yourself or just use them on your computer.

There are many resources available to you if you are interested in phlebotomy. You can often get them in either a hard copy form or from an online source where you can download.

If you are just starting out and have no previous background you may want to look at the textbook “Phlebotomy Simplified” by Kathlenn Becan-McBride and Diana Garza.

This book gives a full background and explanation of phlebotomy plus it includes case studies, end of the chapter review questions and an accompanying CD so that you can study by listening also.

Books

If you are well into your career and you are a serious phlebotomist you may want a copy of “Procedures for the Collection of Diagnostic Blood Specimens (6th edition)” and a copy of “Devices for the Collection of Diagnostic Capillary Blood Specimens (6th edition)”.

Both of these valuable texts are produced by the CLSI and they are the basis for many written procedures throughout the industry. Another text, “Applied Phlebotomy” by Dennis J. Ernst is in line with the standards of the Clinical and Laboratory Standards Institute (CLSI).

This book contains very useful information about phlebotomy and blood collection and it is a great primer for anyone who is interested in becoming a phlebotomy technician.

Phlebotomy Jobs and Phlebotomy Training Centers

2017-01-17T14:18:00.000-08:00

Phlebotomy is the medical practice that involves the extraction of blood for the purpose of diagnosis, donation and transfusion. Phlebotomists are trained in the different techniques available to draw blood from adults, children or infants, as well as the proper care of the equipment involved.

Most phlebotomists are trained in a program exclusively for phlebotomy and drawing blood is their focus, as opposed to doctor’s, and nurses who learn to draw blood as part of their overall medical training.

Phlebotomy jobs are found in just about every area of medicine and are one area of medical practice that is increasing in demand.

Phlebotomy jobs are found in clinics, hospitals, research laboratories, blood banks, nursing homes, Doctor’s offices and other health care facilities.

Phlebotomists are also employed by insurance companies, facilities of incarceration and mobile clinics. According to the Bureau of Labor, phlebotomy remains to be an up and coming field that will only increase despite the fluctuation in the economy and the job market.

Acquiring a phlebotomy certification will give the job candidate a step ahead of those without a certification. Obtaining a certification allows the phlebotomist to demonstrate their capability of achieving a certain level of work, often surpassing the standard benchmark.

As the field of lobotomy becomes more competitive, employers are using the phlebotomy certification as a measure of competence.

Phlebotomy Careers

Phlebotomy jobs are typically 40 hour a week employment. If a phlebotomist is employed in a hospital or other care facility, the phlebotomist will work 40 hours, but the work schedule may include evenings, weekends and holidays.

Hospital emergency rooms typically have phlebotomists on all shifts to accommodate the around the clock arrival of patients. This allows the Doctor to make a diagnosis and begin treatment as soon as possible.

The benefits that come with phlebotomy jobs may include a competitive salary, health benefits, paid vacation and sick time, 401(k), tuition reimbursement, parking privileges, if applicable and uniform allowance.

Sometimes the benefits are negotiable, and the applicant may be able to wheel and deal more vacation time if they are not taking the company health insurance plan.

When applying for phlebotomy jobs, be sure your resume is in order. If you are just out of school, include a copy of your transcripts and a copy of the diploma, certificate or degree.

If you are already a certified phlebotomist, include a copy of your certificate. If you are scheduled to take the exam in the near future, be sure that is noted on your resume.

Once you have interviews for phlebotomy jobs, prepare for the interview by reviewing your classes or past work experience. No doubt the interviewer will ask about certain procedures and techniques and how to handle a patient that experiences certain effect such as shivering prior to or after drawing blood.

The interviewer might ask you to expand upon your experience as well as discuss why you are the best candidate for the job. Arrive early for the interview.

That will give you a few minutes to relax and collect your thoughts, as well as review your resume and any other paper work in your portfolio.

Phlebotomy Training Centers

Training to be a phlebotomist is not a time-consuming process, but sometimes finding the time to take the necessary classes can be a challenge. Phlebotomy classes are usually less than 6 months in duration and include classroom instruction as well as hands on, clinical training.

Phlebotomy training centers were developed to provide the necessary training for the busy professional who may have to hold down a full-time job, in addition to attending school.

Phlebotomy training centers offer a combination of online/offline class room settings. The program also includes working an intern or externship program. The home study portion of the program allows students to schedule their class work around the other day to day responsibilities they have.

This is the ideal program for busy professionals and parents who are not always available to attend regularly scheduled classes. It is an ideal program for those who cannot find a conveniently located school. In addition to the classes, the student will be required to perform clinical applications at a hospital or laboratory.

Phlebotomy schools that offer on site classes often combine lectures and clinical work in one learning package. The students will often perform blood draws on each other under the supervision of a Certified Phlebotomist or a Nursing Instructor. The students are also required to attend all classes.

Online classes usually have to be completed within a certain time frame, but the student is still able to create their own learning schedule. The clinical training will require students to perform a certain number of veinpunctures in a clinical setting, in the allotted time frame.

Upon success completion of the class studies and clinical applications, the student will receive a diploma, certificate of completion or efficiency or an associate’s degree, if it is a degree program. The student will also be qualified to take the state certification exam to become a certified phlebotomist.

To qualify for enrollment in Phlebotomy training centers, the student must be at least 18 years of age and have a high-school diploma or approved equal. Students from foreign countries must demonstrate English competence.

Phlebotomists must have the necessary dexterity and body mechanics to perform proper blood sampling techniques. Phlebotomists must be able to work under pressure as blood sampling is often critical in diagnostic procedures.

Before choosing school make sure they offer an accredited or certified program and follow the Clinical and Laboratory Standards Institute for teaching and laboratory procedures.

Check if the program also follows the guidelines for safety and quality assurance set forth by Occupational Safety and Health Administration (OSHA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which has recently changed its name to The Joint Commission (TJC).

It is important the staff at the Phlebotomy training centers is certified phlebotomist who also works in the field of phlebotomy. It is crucial instructors be up to date with the latest techniques and methods to perform veinpunctures as well as the latest regulations and safety standards.

National Phlebotomy Association and Top Phlebotomy Schools

2017-01-16T14:18:00.000-08:00

The National Phlebotomy Association (NPA) was founded in 1978 as an industry for the healthcare community and has been the sole organization to educate and certify the nation’s phlebotomist.

The NPA was established to bringing about professional standards and codes of ethics for this particular group of health care providers.

The National Phlebotomy Association is committed to developing educational programs and providing accreditation, researching issues involving phlebotomy and offering continuing education programs and promoting public and professional awareness.

The field of phlebotomy has expanded in the past several years. The threat of hepatitis and AIDS, as well as other infectious diseases threatening the health of the public, has brought into focus the importance of phlebotomy and the need for training programs.

The National Phlebotomy Association has been vigilant in working to maintain the highest standards of instruction and continuing education programs for health care professionals and to better protect the general public.

The National Phlebotomy Association has certified over 15,000 phlebotomists and accredited over 75 phlebotomy programs in healthcare training facilities, hospitals and universities and colleges.

To qualify for certification from the National Phlebotomy Association, the candidate will need to have one year of experience as a phlebotomist or complete a phlebotomy training program that teaches veinpuncture. The training program should be at least 200 hours with 160 hours of classroom instruction and 40 hours of practical training.

National Healthcareer Association Phlebotomy Exam

When applying to take the certification exam, the candidate will be required to submit a transcript of your courses along with the application fee.

Health care providers can take the phlebotomy certification exam even if the candidate performs phlebotomy as part of their job. The candidate must submit a letter from a superior explaining at least one year of practical experience.

The certification exam is conducted in two parts. The first part is a two hours written exam and one hour of practical demonstration.

The National Phlebotomy Association also offers an online preparation course that can be taken prior to the exam. Test scores will be available within 8 to 10 weeks beginning the month following the exam. The candidate must score at least 70% to pass the exam. Test scores will be mailed to each candidate.

In the event the candidate fails the exam, an application to retake the test may be submitted within 2 to 3 months following the first exam.

The candidate must submit a full and completed application along with the fee to apply to retake the exam. Each candidate is allowed to take the certification exam up to three times to pass the exam. After the third failure, the candidate is no longer eligible to take the exam.

When the candidate passes the exam, they will be a certified phlebotomist. The certification is valid for 12 months and must be renewed each year.

Beginning in 2010, the National Phlebotomy Association requires each certified phlebotomist to complete 1.8 hours of continuing education units, as part of the certification renewal process as well as pay a renewal fee.

Top Phlebotomy Schools

A phlebotomist is one of many professional medical specialists in the health care industry. The phlebotomist drays blood from patients for the purpose of diagnostic testing and blood drive collection. Phlebotomist’s are often hired by health care facilities for the sole purpose of drawing blood, relieving the nurse or certified nurse assistant from that duty.

Phlebotomy is a skill that can be learned in a short time period, and is a good way for someone to find out if they have the necessary skills and stamina, not to mention stomach, for a career in the medical profession. It is important to take the necessary classes at one of many top phlebotomy schools.

Top phlebotomy schools offer accredited programs that include classroom instruction, as well as, clinical practice. The clinical portion of the program is usually an internship offered at a local health care facility affiliated with the school or at a facility of the students own choosing.

Phlebotomy programs result in a diploma, certificate of completion or efficiency or an associate’s degree. The program tuition depends on the depth of the program.

Phlebotomy Schools

Kaplan Career Institute Kaplan Career Institute is a component of Kaplan Higher Education Campuses (KHEC), a division of Kaplan Higher Education Corporation (KHE). This Institution provides faster phlebotomy classes with flexible schedules for working men and women.

The Salter School of Nursing & Allied Health in Manchester is likewise providing a phlebotomy program with regard to anybody looking to enter the health care field.

Sanford-Brown is great Institution with a excellent group of educational facilities that offer phlebotomy classes.

CDM Institute has schools established all through New Jersey, Pennsylvania, and Delaware. They have hands-on training, fantastic amenities and smaller classes that are readily available days, nights and weekends for the working adult.

Everest Insittute another great school that offers hands-on training for faster learning.

The City College in Gainesville Florida has a great phlebotomist program. You’ll learn how to collect blood, work with lab tests, and making use of laboratory equipment.

Phlebotomy Certification

To become a certified phlebotomist requires completing an accredited program at authorized top phlebotomy schools or learning centers.

The class time is about 4 months long, but will vary depending on the intensity of the program. The classes concentrate on the methods and techniques to draw blood from a variety of patients and different parts of the body.

The techniques taught in class are specialized for adults and children under the age of two years old.

The class room instruction at top phlebotomy schools includes basic phlebotomy theory, infection control, physiology and anatomy.

The program will also include the cardiovascular system, pre-analytical errors and law and ethics pertaining to phlebotomy. The program may be split into a basic and advanced class. The basic course must be completed before taking the advanced class.

Phlebotomy Courses

The program will also include a clinical course where the student will learn to use the various pieces of equipment with hands on training in a laboratory setting.

The prerequisite to enroll in a phlebotomy program is a high school diploma or equivalent. The student should keep in mind; classes in a phlebotomy program are not usually transferable to other medical related programs.

The top phlebotomy schools will offer a course that also prepares the student to take the Phlebotomy National Exam.

The top phlebotomy schools are easy to find in your location with an Internet web search. In a matter of minutes, schools offering such programs will be at your fingertips.

It will be important to review each program and choose the one that has an all around program and not just clinical techniques. Programs are offered at community colleges, career and technology schools and teaching hospitals.

There are schools that offer weekend programs that are ideal for the person who has full time responsibilities during the week. The length of time to complete the program may be longer than a program that meets on a regular schedule during the week.

Venipuncture and Blood Draw

2017-01-15T14:18:00.000-08:00

Venipuncture is the procedure used to draw a blood sample from a patient or intravenous therapy through intravenous access.

The procedure is usually performed by phlebotomists, medical technicians, nurses or laboratory scientist, but sometimes EMT’s, paramedics, dialysis technicians, medical practitioners or other trained medical staff.

Venipunctureis an invasive procedure routinely performed for one of two reasons. One is to procure blood for the purpose of diagnostic testing or to monitor levels of certain blood components.

Blood analysis is one of the most used diagnostic tools in healthcare as the data are used to interpret a variety of clinical symptoms and signs.

Blood is typically taken from the vein called the median cubital. That vein lies close to the surface of the skin, in the cubital fossa anterior to the elbow.

Micro mini quantities of blood can be collected by fingersticks, but for most blood drawing, venipuncture is the procedure of choice.

Venipuncture Procedure

The procedure for a venipuncture is simple. The area of the puncture is sanitized with antiseptic.

The blood drawing specialist will wrap a restricting band type tourniquet around the upper part of the arm to be the subject of venipuncture that will apply the necessary pressure to make the vein fill with blood. The health care provider will slowly and carefully insert the needle into the vein.

The blood will collect in a vial that is airtight and attached to the needle. The vials are designed to draw a predetermined amount of blood for a specific type of blood analysis.

After the appropriate amount of blood is taken, the restricting band will be removed from your arm and the puncture treated with an antiseptic and covered with a small gauze bandage to keep the puncture from bleeding and to keep it clean.

Following the blood draw, the needles and caps are disposed in an appropriate sharps container. Needles are never reused, recapped, broken or bent after the one time use.

Rubber gloves will be worn by the person taking the blood sample and discarded in an appropriate container following the blood draw.

Preparation For A Venipuncture

The only preparation is to limit certain medications or to avoid food and drink prior to the procedure. Your Doctor will let you know ahead of time what preparation you may have to do. After the procedure you may experience some throbbing for a short time, but that will subside.

Veins vary in size from person to person and a venipuncture is more successful on some people than others. Other risks associated with a venipuncture include infection, hematoma, fainting or feeling light headed and excessive bleeding.

Venipuncture Technique And Tips

When drawing blood is a problem, there are a few troubleshooting hints that can be followed. First try repositioning the needle and if that does not work check the collection tube and make sure it is pushed completely back into the needle.

If the technician thinks the vacuum may be lost, try another needle. If that does not solve the problem, loosen the restricting band. The patient should never be stuck more than twice. If all else fails, call the supervisor.

Blood Draw

A blood draw is the process of removing blood samples form an individual for the purpose of testing.

The process does not take a long time, but the time it does take depends on how accessible the veins are. If the subject’s veins are small, they may be hard to access, as well as, if the veins are not close to the skin surface, that may present some extraction challenges.

A blood draw is performed by a phlebotomist or other health care professional trained to take blood samples. Doctors who order blood tests for their patients will discourage the patient from eating any food prior to the test, but will allow the patient to drink water.

The Doctor may also advise the patient to limit the intake of certain medications.

It is in the best interest of the patient to be well hydrated as the blood will flow more readily when the vein is punctured.

A blood draw is usually taken from the median cubital vein that is usually located close to the skins surface and located near the elbow.

How To Draw Blood

The procedure to perform a blood draw is not complicated. The patient will be required to expose the back side of their arm which means rolling up a long shirt sleeve or taking their arm out of the sleeve altogether.

The technician will swab the area of puncture with antiseptic. The blood draw specialist will wrap a tourniquet type band around the patients forearm in order to increase blood flow to the area of concern.

Once the vein is filled with blood, by visual observation, the technician will insert a small needle into the vein.

A pressurized vial is connected to the needle and will collect the extracted blood. The vials are designed to take a predetermined amount of blood for the predetermined blood test.

After the necessary volume of blood is extracted, and most tests or series of tests require multiple vials to be filled, the tourniquet is removed from the patients arm.

The technician will swab the area of the puncture with antiseptic and cover it with a small bandage to keep the puncture clean and from bleeding further.

Blood Draw Procedure

A blood draw is typically performed with a small, fine needle. The initial puncture may be uncomfortable, but the actual blood draw will not be painful. If the technician does not hold the needle still or if the puncture is made an angle, their nay be a little bit of discomfort involved.

There are a few risks involved with a blood draw including infection, fainting or feeling light headed, hematoma and excessive bleeding.

When drawing blood is a problem there are few things that can be tried. The needle can be repositioned and the collection vial can be checked to make sure it is pushed completely back into the needle.

If the vacuum has been lost, the technician will need to use a new needle. The technician can try loosening the tourniquet. The patient should never be stuck more than twice when taking blood.

Pharmacy Technician Training Program

2017-01-14T14:17:00.000-08:00

Pharmacy technicians are required to complete a pharmacy technician training program. Some states require a pharmacy technician to be certified while other states do not.

The pharmacy technician is well advised to be certified even if the state they work has voluntary certification. Obtaining a certification demonstrates the national standards for pharmacy technician has been met.

There are two organizations that offer pharmacy technician certifications. They are the PTCB, Pharmacy Technician Certification Board and ICPT, The Institute for the Certification of Pharmacy Technicians. Both certifications are accepted by most pharmacy employers.

When the technician is certified by the Pharmacy Technician Certification Board, the pharmacy technician will have the official title of Certified Pharmacy Technician (CPhT).

The certification must be renewed every two years and requires attending 20 hours of continuing education.

When the technician is certified by the Institute for the Certification of Pharmacy Technicians, the pharmacy technician will have the official title of Certified Pharmacy Technician (CPhT).

The certification must be renewed every two years and requires attending at least 20 hours of continuing education, with at least one hour in pharmacy law.

Skills

The pharmacy technician must have people relationship and communication skills, have the ability to be very accurate at all times and have an eye for detail.

Pharmacy technicians who work in patient care facilities are also responsible for reading patient charts and then preparing the medication and delivering it to the patient.

They also update patient files and change a patient’s medication when so directed by a doctor or other medical specialist or the licensed pharmacist.

Misconceptions about being a pharmacy technician

There are many rumors surrounding a pharmacy technician’s job. Here are several misconceptions that you may or may not have heard:

Misconception #1: A pharmacy technician’s days is filled with dull work

There are some people out there who think that being a pharmacy technician is dull work. Granted, it is not as glamorous as being an A-list film start or heiress-cum-socialite, but the pharmacy technician profession is seen as a noble one and is very much in demand with today’s booming health care sector.

Misconception #2: A pharmacy technician is a “slave”

A pharmacy technician is basically a licensed pharmacist’s helper or aide. Many think that this involves doing all the grunt work, which may be true at some point, but many pharmacy technicians have been known to rise up in ranks after displaying true professionalism in dealing with customers and completing tasks diligently.

Misconception #3: A pharmacy technician is paid poorly

This myth is untrue as most new pharmacy technicians have found rewarding jobs that pay $15 per hour. With the right certification and training, diligent pharmacy technicians can be paid more than $20 per hour with good career advancements.

Pharmacy Technician Programs and What does a pharmacy technician do?

2017-01-13T14:18:00.000-08:00

The ever expanding world of pharmacy technician is one of the fastest growing fields and predicted to be on the growth track by an increase of about 25% through the year 2018, according to the Bureau of Labor Statistics. Qualified pharmacy technicians are in demand and will be for the foreseeable future.

There are a number of schools that offer pharmacy technician programs for those ready to enter a field with a bright and secure future.

The programs available are associate degree, diploma and certificate of completion programs. Not all schools offer all programs.

The Internet has made it so easy to find just the right school. A simple web search for pharmacy technician schools or programs will reveal the schools in your area or the area you wish to attend school.

A link to the school will be provided in the web search reveal. The schools web page will contain the information you need to make a decision about where to apply and where to attend if accepted.

Selecting A Program

Before choosing a school, it is important to give some long-range thought to your education and employment goals. Where you want to be in 20 years, may have an impact on the school or type of completion award you receive.

If your goal is to someday be in a supervisory capacity or even teach, an associate degree program will serve you better than a diploma program.

It is possible to take a program that gives you enough of the basics to get a job and return to a degree program in the future, but that seems like duplicating effort somewhere along the line.

Preparing

Preparation for a career as a pharmacy technician really begins in high school. It is recommended to take math and science in high school as those two subjects are the basis for most pharmaceuticals.

The math involved is more than knowing how to push buttons on a calculator or calling up a program online to do the number crunching for you. Chemistry and biology are critical when preparing medications according to a prescription and there will be a heavy emphasis in those areas as your education progresses.

The program you decide to attend should be an accredited program. If you are to further your education, classes may or not be eligible for transferable credit, depending on the accreditation status of the program where the classes were taken.

If you decide to become certified, if your state has voluntary certification, only accredited programs are accepted by the certification board to qualify to take the exam.

One of the goals of the program is to prepare the student not only to find employment as a pharmacy technician, but to help prepare the student for the certification exam.

The exam is 100 multiple choice questions and is pass/fail. A good program will give the student the necessary tools and know how to study for the exam and pass it.

Even if the state you work in does not require certification, it is recommended to become certified.

Pharmacy Technician Job Description

A pharmacy technician is one who works under the supervision of a licensed pharmacist. His or her role is to perform many pharmacy related tasks.

The technician often handles the routine tasks in the pharmacy including preparation of prescribed medications, which will be checked by the licensed pharmacist before giving it to the patient, selecting the proper prescription container, creating prescription labels, medication compounding, expense and medication orders, take verbal prescriptions and calls from doctor’s, handle returns and expired credits and non licensed pharmacy management.

Job Description

The technicians also handle other pharmacy tasks including the preparation of insurance claim forms, maintenance of patient profiles, answering the telephone, taking inventory of over the counter medications, recommending over the counter medications to customers, completion of cash register transactions and being aware of the latest medications and their availability, as well as their side effects.

The pharmacy technician also advises the customer on health and diet issues, the proper foods and liquids to take with their medication and how to offset side effects of the medication. The pharmacy technicians will also advise customers on non medication, but medical related items such as the proper height a cane should be, or the best ace bandage to purchase.

Pharmacy technicians work mostly in retail pharmacy’s independently owned or part of a chain, while others work in hospitals, mail order or internet pharmacy’s or pharmaceutical wholesalers, nursing homes and assisted living facilities. Pharmacy technicians often work evening and weekends as well as a day time shift, including holidays.

What does a pharmacy technician do?

Just as a medical assistant is a doctor’s helper, so is a pharmacy technician the assistant to a licensed pharmacist. A pharmacy tech is hired to keep a pharmacy running smoothly and without issues. Roles and duties include:

Filling up prescription drug orders for customers. A pharmacy technician has to be accurate, efficient and conscientious while confirming prescription details and dosage. Failure to do so may result in unwanted legal action.

Be an attentive multi-tasker who is required to focus on many tasks at hand. Some of them include attending to customers queries while working the cash register.

Be patient while exuding good interpersonal skills. Being a good communicator will help bright pharmacy techs excel at their work and advance their career easily.

Be well-versed in insurance information and terminology. Part of the job of a pharmacy technician includes handling insurance claims and issues.

Pharmacy technicians’ workplace

7 out of 10 pharmacy technicians work in retail environment where you can find them applying for jobs at neighborhood pharmacies and grocery stores.

They have been known to be hired in hospitals and clinics while some opt to start employment in nursing homes if they do not prefer to work in a retail setting.

Pharmacy techs who are tech savvy may want to consider working at mail-order pharmacies and telepharmacies where they can use their skills and passion to an advantage.

Pharmacy Technician Schools

2017-01-12T14:17:00.001-08:00

The field of pharmacy technician is thriving, and the need for qualified pharmacy technicians will increase by about 25% through the year 2018.

That is due, in part, to the number of middle aged and elderly people who use more prescription medication than young people, and that will spur the demand for more pharmacy workers.

As science leads to more drugs, more people will qualify for those new medications, adding to the number of pharmacy customers, leading to a demand for more pharmacy workers, as well.

Also contributing to the demand for pharmacy technicians are the cost conscience consumers who are relying on the “healthcare clinics” held at some of the well established pharmacies.

As pharmacists become more involved with patient care, the technicians will assume a greater role and adopt some of the administrative duties carried out by pharmacy aides.

With the job prospects for pharmacy technicians looking good over the next 6 to 7 years, it might be time to consider a change in profession or a decision to pursue the field of pharmacy technician. The best place to start looking for a qualified school is the Internet.

A web search for pharmacy technician schools will reveal a number of schools. The web search can be fine tuned to search for schools only in your area or by state or region. Be sure the school you choose is accredited.

If you plan to pursue higher education using pharmacy technician as a stepping stone, you will only be able to transfer credits from an accredited school.

Pharmacy technician schools offer certificate programs, diplomas or technician associate degree.

There are pro’s and con’s to each type of program. The program chosen will be the one that fits your needs and desires for a career as a pharmacy technician.

List Of Schools

UEI College – Pharmacy Tech Diploma Program

US Career Institute – Online Certificate

National College – Campus Diploma and Associate

Everest College – Campus Certificate

Kaplan College – Campus Certificate and Diploma

Brown Mackie College – Campus Associate

Remington College – Campus Diploma

Virginia College – Campus Certificate, Diploma and Associate

Sanford-Brown College – Campus Diploma and Certificate

Sanford-Brown Institute – Campus Diploma and Certificate

YTI Career Institute – Campus Diploma

Certificate Program

The pharmacy technician certificate of completion program can be completed in about a year or less. They provide the basic of fundamental skills necessary to perform the tasks of a technician in retail or clinical setting.

The program is also beneficial to help the student prepare for the certification exams. A high-school diploma is required to apply to the program.

Diploma Program

The pharmacy technician diploma program takes about a year to complete and include more in depth subject matter than the certificate of completion program.

The course of study includes administrative and pharmaceutical classes and prepares the student to assist the licensed pharmacist with medication duties.

The diploma program is considered a good step toward a degree program. The diploma program also helps prepare the student to take any certification exams.

Associate Degree Program

The pharmacy technician associate degree program takes about 2 years to complete. The program provides a more thorough and comprehensive program than the certificate of completion and diploma programs.

The students can expect to receive a broad spectrum of training in the medical field as well as focused pharmaceutical training. The program includes an internship that provides vital on the job training and job experience. Students with an associate degree will be able to transfer some if not all of the credits to an advance degree program.

Pharmacy Technician Salary

When considering a career as a pharmacy technician, it is important to know what the salary levels are. The job is not always about the salary, but there should be some consideration for the pay levels available.

Looking at salaries may be a factor where employment is chosen. A high pressure, busy and demanding pharmacy may pay more than the quaint pharmacy in a not so populated area.

Geographic areas also play a role in dictating salaries. Areas of dense population tend to have a higher cost of living and salaries will reflect that. On the other hand, less densely populated areas will have a lower cost of living and the salary will also reflect that, as well.

Salaries Depend On Education

Salaries depend on several things, and they include education, certifications and years of experience. Education does not always mean the initial degree, diploma or certificate of completion.

It means staying current with the latest in pharmaceutical trends and medical technologies that effect what kind of medication is prescribed and at what intervals for it to be effective.

Certification

Those who become certified will be required to complete a certain number of hours of continuing education to remain certified. Education is not always about attending classes. It is about subscribing to the industry trade magazines and becoming members in the industries professional organizations.

Becoming certified and keeping that certification current is important to your professional status as a pharmacy technician. It also demonstrates to an employer you are serious about your career choice and serious employees are often more reliable and dedicated than one who lets their certification lapse, or who does not bother becoming certified because it is not required.

Experience

Nothing can take the place of experience. There are no shortcuts to gaining years of experience, except to outright lie about it and then there will come a time when that lie will catch up with you and add a black mark to your career.

As your years of experience expand, expect to see an increase in salary. The less an employer has to teach an employee, the better they like it.

Experience also means years of on the job learning and using that knowledge to do a better job and stay on the forefront of the changing needs and demands of pharmaceuticals. Experience also brings efficiency to the job, and that is something that takes time to learn.

Certified Pharmacy Technician Salary

The numbers below are the national average based on a salary study conducted in early 2011. There are factors that will affect the actual salary such as the supply and demand of qualified pharmacy technicians, geographic location and supervisory status.

an entry level pharmacy technician with 0 to 1 years of experience may see a salary of $22k to $39k per year
1 to 4 years of experience will bring with it a salary of $22k to $36k
5 to 9 years of experience range will see a salary of $24k to 35k
10 to 19 years of experience will bring a salary of $28k to $40k
20 years or more will translate to $29k to $48k per year.

HEALTH CARE Web sites

2012-09-26T19:48:00.002-07:00

5 Easy Ways to Save on Health Care

2012-09-26T19:21:00.000-07:00

With the rising cost of health care and no matching increase in wages, more and more people are choosing not to seek treatment or fill their prescriptions when they are sick since it is just too expensive. When it comes down to having to decide whether to pay your electric bill to keep your power turned on or to get a prescription filled, unfortunately the prescription often takes a backseat.

The good news is that there are many simple things you can do that can dramatically decrease the cost of health care and allow you to take care of yourself and your family without breaking the bank. Here are 5 easy ways to make health care more affordable.

Shop Around for Health Care

People are more than willing to shop around to save a dollar or two on the latest DVD or a pair of pants, but very few people do the same with their health care.

Just like in any industry, prices can vary greatly between doctors, hospitals and pharmacies. You can often find the same quality of care for a fraction of the cost simply by shopping around and comparing prices. Do keep in mind, though, that cost should not be the only deciding factor when choosing where you will get your health care. Be sure that the place offering the lowest price is reputable and offers high quality care before you jump into anything that you might regret.

There has been a lot of negative press surrounding ordering prescriptions online, however there are many legitimate online pharmacies where you can purchase your prescriptions and often save a lot of money. Before buying your drugs from an online pharmacy make sure they carry the Verified Internet Pharmacy Practice Sites (VIPPS) seal. This seal, which is sponsored by the National Association of Boards of Pharmacy, ensures that the drugs you order are exactly what you will receive.

If you have a simple ailment like a stomach ache or an ear infection you can consider going to one of the walk in clinics that are now open at some national retail stores like Wal-mart. These clinics offer quality care at a more affordable price and can be a great alternative to the high cost of a doctor's visit if you are not seriously ill.

Negotiate the Cost of Treatment

One thing that most people don't know is that the prices that doctors and hospitals charge are not always set in stone. Often, if you ask for a deal there is a good change you will get it.

Before asking for a discount on your treatment you should become informed as to what the typical cost for the procedure or service is so you will have a stronger leg to stand on when negotiating. If you have health insurance, you can call your insurance company and ask them what standards rates they pay for the service are for physicians in your area. Typically the rate the insurer pays will be less than what you were quoted, but it will give you a good idea of how low you can go.

If you don't have health insurance or don't want to call your insurance company, you can check out the information at the Center for Medicare and Medicade Services. They provide the costs for many inpatient, outpatient and physician services on their website. Once you know how much a procedure should cost it is easier to negotiate with your doctor or hospital to get a better deal.

Save Money on Prescriptions

We've already discussed shopping around to get the best price on your prescriptions, but there are several other ways you can save on prescriptions as well.

The first thing you should do is check with your doctor or pharmacist to see if there is a generic version of the drug you are taking. Buying the generic version can cut costs each month while still giving your the care that you need.

If there are no generic alternatives, check with your doctor if there is a lower cost drug that will still treat your condition but will save you money. Often simply switching name brands will save you a lot of money in the long run.

Another option to save on your prescriptions is to ask your doctor if you can buy higher dose pills and then split them into the correct dosage. Larger, high-dose pills are almost always priced the same as the smaller, lower-dose pills of the same drug. Making this simple change can quite literally save you hundreds of dollars a year on your prescriptions.

If you don't have health insurance or prescription drug coverage, you can look for a prescription discount card or program. There are quite a few programs available that require you to show financial need, however there are a few programs that are available for any income level. Just do some searching and you can probably find a program that will help to significantly cut your costs.

Relax!

Stress is one of the largest contributing factors to many health problems and doctor visits. Finding a way to relax and de-stress can do wonders to save your health. Try Yoga, meditation or just kicking back and listening to some music to unwind. Exercise is also a great stress reliever and has the added benefit of getting your blood pumping which also help you keep you healthier. Always check with your doctor before starting any exercises program to make sure it is safe for you.

If your schedule is too tight to fit in any time for relaxation, at least close your eyes and take some deep breaths every so often. This can help you to clear your mind and cut the stress.

Brown Bag It

Can taking your lunch to work with you really save you money on health care? You bet! Homemade food is almost always a healthier option than the food that you can get a restaurant, deli or fast foodjoint. Not only that, but restaurant portions are nearly always much larger than a single serving, which means in all likelihood you will eat more than you should. Eating fatty foods and packing on extra pounds can all lead to health problems which can add to up big health care costs.

Simply taking healthier lunches to work with you that are an appropriate portion size can help you maintain your weight and stay healthier. The best way to save money on health care is to avoid the doctor all together!

Try these 5 easy steps and you should be on your way to saving money on your health care in no time.

Medicare co insurance and Deductible

2012-09-23T18:46:00.001-07:00

Deductible

The beneficiary must pay some fixed amount in approved charges for covered Part B medical expenses each calendar year, and can be met by any combination of claims. Deductibles do not apply to flu and pneumococcal injections, clinical laboratory services, screening mammograms, pap smear collection, pelvic and breast exams, and prostate specific antigen (PSA) tests.

Coinsurance

Coinsurance is the portion or percentage of Medicare's approved amounts for covered services that a beneficiary is responsible for paying. Usually, the coinsurance portion is 20% of the Medicare approved amount. There is no coinsurance for those services that pay at 100%.

Note: The coinsurance will be higher for certain outpatient psychotherapy services.

What is physician UPIN and PIN?

2012-09-22T18:44:00.000-07:00

What is PIN

The provider identification number (PIN) is issued to the provider by the Provider Enrollment of the insurance. The PIN is the "billing" number.

What is UPIN

All physicians are issued a Unique Provider Identification Number (UPIN) by the Registry Medicare. The UPIN is the provider’s "referring" number and is sent to you along with your PIN.

UPIN directories are available through FOIA (Freedom of Information Act). Requests may be sent directly to the Upstate Medicare Division, P.O. Box 5200, Binghamton, NY 13902-5200.

However NPI replaces all above.

Medical Billing Codes Download for Free 2012

2012-09-19T19:18:00.000-07:00

Medical Billing and Coding: Basic Instructor's Edition
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Health Insurance and Mortality in US Adults Part 4

2012-08-26T18:15:00.000-07:00

Limitations
Our study has several limitations.
NHANES III assessed health insurance at a single point in time and did not validate self-reported insurance status. We were unable to measure the effect of gaining or losing coverage after the interview. Point-in-time uninsurance is associated with subsequent uninsurance.6 Intermittent insurance coverage is common and accelerates the decline in health among middle-aged persons.33 Among the nearelderly, point-in-time uninsurance was associated with significant decline in overall health relative to those with private insurance.13 Earlier population-based surveys that did validate insurance status found that between 7% and 11% of those initially recorded as being uninsured were misclassified.13 If present, such misclassification might dilute the true effect of uninsurance in our sample. We excluded 29.5% of the sample because of missing data. These individuals were more likely to be uninsured and to die, which might also bias our estimate toward the null.

We have no information about duration of insurance coverage from this survey. Further, we have no data regarding cost sharing (out-of-pocket expenses) among the insured; cost sharing worsened blood pressure control among the poor in the RAND Health Insurance Experiment, and was associated with decreased use of essential medications, and increased rates of emergency department use and adverse events in a random sample of elderly and poor Canadians.37,38 Unmeasured characteristics (i.e., that individuals who place less value on health eschew both health insurance and healthy behaviors) might offer an alternative explanation for our findings.

However, our analysis controlled for tobacco and alcohol use, along with obesity and exercise habits. In addition, research has found that more than 90% of nonelderly adults without insurance cite cost or lack of employer-sponsored coverage as reasons for being uninsured, whereas only 1% percent report ‘‘not needing’’ insurance.39 In fact, the variables included in our main survival analysis may inappropriately diminish the relationship between insurance and death. For example, poor physician-
rated health, poor self-rated health, and unemployment may result from medically preventable conditions. Indeed, earlier analyses suggest that the true effect of uninsurance is likely larger than that measured in multivariate models.13,40 In addition, Hadley found that accounting for endogeneity bias by using an instrumental variable increases the protective effect of health insurance on mortality.40

Conclusions
Lack of health insurance is associated with as many as 44789 deaths per year in the United States, more than those caused by kidney disease (n=42868).41 The increased risk of death attributable to uninsurance suggests that alternative measures of access to medical care for the uninsured, such as community health centers, do not provide the protection of private health insurance. Despite widespread acknowledgment that enacting universal coverage would be life saving, doing so remains politically thorny. Now that health reform is again on the political agenda, health professionals have the opportunity to advocate universal coverage

Health Insurance and Mortality in US Adults Part 3

2012-08-25T18:15:00.000-07:00

DISCUSSION
The uninsured are more likely to die than are the privately insured. We used a nationally representative data set to update the oft-cited study by Franks et al. and demonstrate the persistence of increased mortality attributable to uninsurance. Our findings are in accord with earlier research showing that lack of health insurance increases the likelihood of death in select illnesses and populations.5–7,13 Our estimate for annual deaths attributable to uninsurance among working-age Americans is more than 140% larger than the IOM’s earlier figure.23

By using methodologies similar to those used in the 1993 study, we found that being uninsured is associated with a similar hazard for mortality (1.40 for our study vs 1.25 for the 1993 study). Although the NHANES I study methodology and population were similar to those used in NHANES III, differences exist. The population analyzed in the original study was older on average than were participants in our sample (22.8% vs 55.6% aged 34 years or younger). The maximum length of follow-up was less (16 years vs 12 years), and the earlier analysis was limited to White and Black persons, whereas the present study also includes Mexican Americans.
The relative youthfulness and shorter follow-up in our study population would be expected to reduce our power to detect an elevated risk of death. In addition, if gaining Medicare reduces the effect of uninsurance on mortality, then the younger age and shorter length of follow-up in our study might strengthen the association between uninsurance and mortality compared with the earlier study. It is less clear how the differences in the racial and ethnic make-up of our study population would affect our ability to detect difference in risk of death. In fact, the increased likelihood of uninsurance among Mexican Americans who were nonetheless no more likely to die than non- Hispanic Whites might also be expected to reduce our power compared with the earlier study.

The original analysis confirmed vital status by review of decedents’ death certificates. The NCHS had developed a probabilistic matching strategy to establish vital status. A subsample underwent death certificate review and verification; 98.7% were found to be correctly classified following this review.16 Again, it is not clear how any misclassification would bias our results. Moreover, Congress extended Medicare coverage in 1972 to 2 nonelderly groups: the long-term disabled and those with end-stage renal disease.27 So, although both studies excluded Medicare enrollees, only ours entirely excluded disabled nonelderly adults who are at particularly high risk of death.

The mechanisms by which health insurance affects mortality have been extensively studied. Indeed, the IOM issued an extensive report summarizing this evidence.29 The IOM identified 3 mechanisms by which insurance improves health: getting care when needed, having a regular source of care, and continuity of coverage.

The uninsured are more likely to go without needed care than the insured. For instance, Lurie et al. demonstrated that among a medically indigent population in California, loss of government-sponsored insurance was associated with decreased use of physician services and worsening control of hypertension.28,29 The uninsured are also more likely to visit the emergency department30 and be admitted to the hospital31 for ‘‘ambulatory care sensitive conditions,’’ suggesting that preventable illnesses are a consequence of uninsurance.

The chronically ill uninsured are also less likely to have a usual source of medical care,32 decreasing their likelihood of receiving preventative and primary care. Discontinuity of insurance is also harmful; those intermittently uninsured are more likely to die than the insured.13 All of these factors likely play a role in the decline in health among middle-aged uninsured persons detected by Baker et al.33,34 This trend appears to reverse at age 65, when the majority gains access to Medicare coverage.35 Other studies suggest that extending health insurance not only improves health, but also may be cost effective.36

Health Insurance and Mortality in US Adults Part 2

2012-08-24T18:14:00.003-07:00

We repeated the analysis of the relationship of insurance to mortality after forcing all covariates in the model. In this Cox proportional hazards analysis, we controlled for gender, age, race/ ethnicity (4 categories), income (poverty income ratio), education, current unemployment, smoking status (3 categories), regular alcohol use, self-rated health (4 categories), physicianrated health (4 categories), and BMI (4 categories). We tested for significant interactions between these variables and health insurance status (i.e., P<.05). We handled tied failure times by using the Efron method. We performed multiple sensitivity analyses to analyze the robustness of our results.

We developed a propensity score model and controlled for the variables in our previous models (with the exception of health insurance status), as well as marital status; household size; census region; number of overnight visits in hospital in past 12 months; number of visits to a physician in past 12 months; limitations in work or activities; job or housework changes or job cessation because of a disability or health problem; and number of self-reported chronic diseases, including emphysema, prior nonskin malignancy, stroke, congestive heart failure, hypertension, diabetes, or hypercholesterolemia. Next, we included the propensity score in the multivariable model with the indicator for insurance status. In addition, we tested for the effect of including those covered by Medicaid by using our original Cox model and the propensity score adjusted analysis.

In a subsidiary analysis, we excluded employment and self- and physician-rated health, as these covariates may be a result of limited access to health care because of uninsurance. To facilitate interpretation of our hazard ratio, we first replicated the calculation in the IOM report to estimate the number of US adults who die annually because of lack of health insurance. This approach applies the overall hazard ratio to 9-year age strata and sums these figures to arrive at an annual number of deaths attributable to lack of health insurance. We then recalculated this figure by using the slightly different approach utilized by the Urban Institute, which does not age stratify when calculating total mortality. We believe this approach to be more accurate than that used to produce the IOM estimate, as it calculates mortality from the entire age range that the hazard ratio was calculated from, as opposed to calculating mortality over 10-year age strata.23

RESULTS

We display baseline characteristics of the sample in Table 1; 9004 individuals contributed 80657 person-years of follow-up time between 1988 and 2000. Of these, 16.2% (95% confidence interval [CI]=14.1%, 18.2%) were uninsured at the time of interview.

Uninsurance was associated with younger age, minority race/ethnicity, unemployment, smoking, exercise (less than 100 METs per month), self-rated health, and lower levels of education and income (P<.001 for all comparisons). Regular alcohol use and physicianrated health were also associated with higher rates of uninsurance (P<.05 for both comparisons). By the end of follow-up in 2000, 351 individuals, or 3.1% (95% CI=2.5%, 3.7%) of the sample, had died (Table 1). Significant bivariate predictors of mortality included male gender (P=.04), age (P<.001), minority race/ ethnicity (P<.001), less than 12 years of education (P=.008), unemployment (P=.02), smoking (P<.001), regular alcohol use (P=.04), worse self-rated health status (P<.001), and worse physician-rated health status (P<.001).

In the model adjusted only for age and gender, lack of health insurance was significantly associated with mortality (hazard ratio [HR]=1.80; 95% CI=1.44, 2.26). In subsequent models adjusted for gender, age, race/ ethnicity, poverty income ratio, education, unemployment, smoking, regular alcohol use, self-rated health, physician-rated health, and BMI, lack of health insurance significantly increased the risk of mortality (HR=1.40; 95%CI=1.06,1.84; Table 2). We detected no significant interactions between lack of health insurance and any other variables. Our sensitivity analyses yielded substantially similar estimates.

Replicating the methods of the IOM panel with updated census data24,25 and this hazard ratio, we calculated 27424 deaths among Americans aged 25 to 64 years in 2000 associated with lack of health insurance. Applying this hazard ratio to census data from 200526 and including all persons aged 18 to 64 years yields an estimated 35327 deaths annually among the nonelderly associated with lack of health insurance. When we repeated this approach without age stratification, (thought by investigators at the Urban Institute to be an overly conservative approach)23 we calculated approximately 44789 deaths among Americans aged 18 to 64 years in 2005 associated with lack of health insurance.

Health Insurance and Mortality in US Adults Part 1

2012-08-24T18:12:00.002-07:00

NHANES III staff interviewed respondents in their homes regarding demographics (including health insurance). Participants responded to questions about race, ethnicity, income, and household size. The sample design permits estimation for 3 racial/ethnic groups: non-Hispanic White, non-Hispanic Black, and

Mexican American. The NCHS created a variable that combined family income and the poverty threshold during the year of interview (the poverty income ratio), allowing income to be standardized for family size and compared across the 6 years of data collection.18

NHANES III interviewers also collected data on education, employment, tobacco use, alcohol use, and leisure exercise. We analyzed education dichotomously, comparing those with 12 years or more education to those with less than 12 years. We considered respondents to be unemployed if they were looking for work, laid off, or unemployed. All others, including the employed, students, homemakers, and retirees were considered ‘‘not unemployed.’’ We considered smokers in 3 categories: current smokers, former smokers (those who had smoked more than 200 cigarettes in their lifetime), and nonsmokers. We labeled those drinking more than 6 alcoholic beverages per week as regular drinkers. We analyzed exercise in 2 groups:those achieving greater than or equal to 100 metabolic equivalents (METs) per month, versus those achieving less than 100 METs per month.19,20

NHANES III
measured participants’ selfperceived health in 5 categories: excellent, very good, good, fair, and poor. We combined the last 2 groups because of small numbers.

NHANES physicians performed physical examinations on all participants and provided an impression of overall health status rated as excellent, very good, good, fair, and poor.21We combined the final 2 groups because of small numbers. We analyzed body mass index (BMI; weight in kilograms divided by height in meters squared) in 4 categories: less than 18.5; 18.5 to 25; more than 25 to less than 30; and 30 and higher.

NHANES III oversampled several groups, including Black persons, Mexican Americans, the very young (aged 2 months to 5 years), and those aged older than 65 years. To account for this and other design variables we used the SUDAAN (version 9.1.3, Research Triangle Institute, Research Triangle Park, NC) SURVIVAL procedure and SAS (version 9.1, SAS Institute Inc, Cary, NC) PROC SURVEYFREQ to perform all analyses. We (as did Franks et al.5) employed unweighted survival analyses and controlled for the variables used in determining the sampling weights (age, gender, and race/ethnicity) because of the inefficiency of weighted regression analyses.22

We analyzed the relation between insurance, demographics, baseline health status variables, and mortality by using c2 tests. We then used a Cox proportional hazards survival analysis controlling only for age and gender to determine if lack of health insurance predicted mortality.

Health Insurance and Mortality in US Adults

2012-08-24T18:11:00.001-07:00

The United States stands alone among industrialized nations in not providing health coverage to all of its citizens. Currently, 46 million Americans lack health coverage.1 Despite repeated attempts to expand health insurance, uninsurance remains commonplace among US adults.
Health insurance facilitates access to health care services and helps protect against the high costs of catastrophic illness. Relative to the uninsured, insured Americans are more likely to obtain recommended screening and care for chronic conditions2and are less likely to suffer undiagnosed chronic conditions3 or to receive substandard medical care.4 Numerous investigators have found an association between uninsurance and death.5–14

The Institute of Medicine (IOM) estimated that 18314 Americans aged between 25 and 64 years die annually because of lack of health insurance, comparable to deaths because of diabetes, stroke, or homicide in 2001 among persons aged 25 to 64 years.4 The IOM estimate was largely based on a single study by Franks et al.5 However, these data are nowmore than 20 years old; both medical therapeutics and the demography of the uninsured have changed in the interim.
We analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III). NHANES III collected data on a representative sample of Americans, with vital status follow-up through 2000. Our objective was to evaluate the relationship between uninsurance and death.
METHODS
The National Center for Health Statistics (NCHS) conducted NHANES III between 1988 and 1994. The survey combined an interview, physical examination, and laboratory testing. NHANES III employed a complex sampling design to establish national estimates of disease prevalence among the noninstitutionalized civilian population in the United States.15 Staff performed interviews in English and Spanish.

The NHANES III Linked Mortality File matched NHANES III records to the National Death Index (NDI). The NCHS’s linkage, which uses a probabilistic matching strategy through December 31, 2000, is described elsewhere.16 The NCHS perturbed the file to prevent reidentification of survey participants. Vital status was not altered in this process. The publicly released data yield survival analysis results virtually identical to the restricted-use NHANES III Linked Mortality File.17

In designing our analysis, we hewed closely to Franks’5 methodology to facilitate interpretation of time trends. We analyzed data for individuals who reported no public source of health insurance at the time of the NHANES III interview. First, we excluded those aged older than 64 years, as virtually all are eligible for Medicare. Of the 33994 individuals participating, 14798 were aged between 17 and 64 years at the time of the interview. In keeping with earlier analyses,5–7,13 we also excluded nonelderly

Medicare recipients and persons covered by Medicaid and the Department of Veterans Affairs/Civilian Health and Medical Program of the Uniformed Services military insurance (n=2023), as a substantial proportion of those individuals had poor health status as a prerequisite for coverage. Of the 12775 participants not covered by government insurance, we excluded 663 (5.2%) who lacked information on health insurance. We excluded 974 of the remaining 12112 who were covered by private insurance or uninsured at the time of the interview because of failure to complete the interview and physical examination. Of the remaining 11138, we included only the 9005 with complete baseline data from both the interview and physical examination in our final analysis (Figure 1). Among those with complete insurance data, those with complete interview and examination data were both less likely to be uninsured (16.4% vs 21.6%; P<.001) and less likely to die (3.0% vs 4.5%; P<.001).