ICD-10 Implementation: An update for physicians and coders

The transition to ICD-10 is much more than a mere increase in codes and field sizes. The descriptions of diagnosis codes in ICD-10 may be very different to what coders are used to seeing and using in ICD-9. Therefore, the complexity in transition is significant and shouldn’t be avoided by medical coders. 

An easier and successful transition before October 1, 2013 would require a well planned and efficiently managed implementation process. Although the ICD-10-CM/PCS implementation deadline is two years away, good training plans will ensure a smooth transition for physicians, inpatient and outpatient coders. 

Browse All: Medical Billing (http://www.medicalbillersandcoders.com/) 

Impacting Inpatient Coders: 

The ICD-10-CM/PCS final rule estimates that inpatient coders will need 50 hours of training. In order to ensure a successful transition, inpatient coders must: 

• Possess sufficient foundational knowledge of the biomedical sciences (e.g., anatomy, physiology, patho physiology, pharmacology, and medical terminology) 

• Learn how to apply ICD-10-CM/PCS codes correctly on inpatient encounters 

• Understand how to apply maps and crosswalks between ICD-9-CM and ICD-10-CM/PCS 

Impacting Outpatient coders: 

Outpatient coders would require approximately 16 hours of effective training in ICD-10-CM/PCS, presuming that coders already has the necessary knowledge in biomedical sciences. Other requirements are same as inpatient coders. 

Medical coders need to adhere to the stipulated timeline for the various steps of ICD-9 to ICD-10 transition. Though the first phase is already over, the coders can still take assistance from various online resources and webinars conducted by AMA, AAPC, AAHIMA, and many other associations to get the requisite training and prepare for the transition process. Proper training and guidance in using use ICD- 10 will help coders to remain abreast with the changing industry norms and play a vital role in the implementation process for their employers and clients. 

Physicians should keep track of the envisaged timeline for implementation of ICD-10 and prepare their clinic for smooth transition through its various phases: 

Phase 1: Implementation plan development and impact assessment (first quarter 2009 to second quarter 2011) 

Phase 2: Implementation preparation (first quarter 2011 to second quarter 2013) 

Phase 3: “Go live” preparation (first quarter 2013 to third quarter 2013) 

Phase 4: follow-up post-implementation (fourth quarter 2013 to fourth quarter 2014) 

Physicians should also ensure training for in-house coders, or hire coders trained in using ICD-10, as proper coding is required to keep their revenue cycle efficient and optimized. For physician practices or hospitals facing problems in getting their staff upgraded, outsourcing might be a feasible option.

Making Money With Google AdSense

Every day, tens of thousands of web sites are earning money through AdSense ads. Google's AdSense allows you to display ads on your web site and earn money each time someone clicks on one of the ads being displayed. These ads can be text only, image only or both. Website owners can choose which types of ads they would like displayed. Using AdSense on my own sites, I've learned quite a bit about which techniques can be used to enhance AdSense earnings. 

How much you earn with Google AdSense depends on a variety of things including the types and placements of the ads you show as well as the competitiveness of the ads. In a market or niche where there is little supply but high demand, ads generate more money for both Google and the publishers displaying Google AdSense. Before placing code on your web page, consider the fact that some ad placements generate higher click through rates than others. For example, ads placed above the fold tend to have a higher conversion rate than those towards the bottom of the page. 

Google has released a lot of information for advertisers regarding ideal placements and ad sizes. This information is based on reviewing data from across all of the advertisers withing the Google network. What is revealed in this information is that ads that appear on the top, left and bottom of the page, tend to have higher click through rates than other placements. Remember that this information is just a rule of thumb and doesn't hold true for every web site or web page. 

Placing ads within your the body of a web page is always a good idea. By providing context around your ads, you significantly increase click through rates. Sites that present ads off to the side rarely out perform web site that integrate AdSense into valuable content. These ads serve as a resource for browsers who are interested int he content being presented on your web page. 

Another area of AdSense that affects earnings is ad size. It has been proven that different ad sizes place in different locations will perform differently. Studies have shown that by simply changing ad format slightly produces a significantly better result. Many advertisers report that half banners and medium rectangles appear to work best, especially when displayed in niche content areas. Regardless of the size you think will work best, continually test to find which size produces the highest click through rate for you. 

The way in which you display your ads also has an impact on earning potential. Whether you are using the standard colors or a blended palette does make a difference. Some sites do better blending their ads in look and feel, making it more difficult for browsers to differentiate between content and ads. Others feel that contrast is necessary for users to notice ads. This may discourage click throughs but if other factors are fine tunes can have the opposite affect generating significant online revenue. 

Alter the number of ads you're running on your page. Should you only have one ad or multiple ads? This all depends on the layout of your site, flow of traffic, and ultimately how everything looks together. If you site is too clutter, people will leave. On the other hand, too bare and you may find that users ignore your ads. Continually test the number of ad placements to determine what is idea. I have found that 2 - 3 placements per page works best. 

The AdSense Formula For Making Money

I often get asked what the secret is to making money with Google's AdSense program. This often comes from people who are dreaming of setting up websites chock full of high-paying keywords for particular niche subjects and then sitting back and watching the money roll in. "What's the magic formula?" they ask me. If they're non-technical, I point them straight to my book, Make Easy Money with Google, and assure them that they'll learn everything they need from it. They may think it's hard, but it's not.

But what about the technical people? By this I mean the people who've already set up a blog or website, who have registered domain names, who are comfortable with basic Internet terminology and concepts. What is the "AdSense formula"?

The only AdSense formula that you need to know is this:

earnings = number of clicks * average price per click

This is what I call the Fundamental AdSense Formula because you can derive almost every AdSense "secret" directly or indirectly from this formula. Do you want to earn more with AdSense? You have two ways of doing it:

1. Increase the number of clicks, and/or

2. Increase the average price per click

Your earnings will only go up if you do one or the other, and ideally both. It's an obvious formula, yes, but it's amazing how many people lose sight of it in their quest for increased AdSense earnings.

Increasing the Number of AdSense Clicks

Increasing the number of times the ads on your site or blog are clicked is the most obvious strategy. There are two general strategies you can follow:

1. Increase the traffic to the site, and/or

2. Adjust the ads to make them more "clickable"

Getting traffic is hard and takes time, so don't look at it as a quick fix. The best way to get traffic is to provide useful, unique content and to rank highly in search engine rankings for keywords related to that content. In other words, use standard search engine optimization techniques. DO NOT "buy" traffic or use "link farms" or other dubious techniques. Other tips for getting traffic:

1. Publish articles, even free ones, with links back to your site.

2. Include a link to your site in the signature at the bottom of your emails or in any forum postings you make (if the forum allows it).

3. Participate in forums/groups related to the content of your site or blog. The key is to participate, not lurk, and don't just post messages promoting your site.

4. Add comments (relevant ones only, please) to other blogs, you can usually link back to yours. (This won't help your search engine rankings, but it may allow others who are reading those comments to find your own site.)

5. Syndicate your content (trivial if you have a blog) and make sure that the content is registered with syndication aggregators.

6. List your site in relevant directories.

Adjusting the ads is something you can do almost immediately:

1. Position the ads on the page in order to make them more noticeable. Google even publishes a helpful heat map (seehttps://www.google.com/support/adsense/bin/static.py?page=tips.html ) for AdSense publishers.

2. Choose the best AdSense ad format that works for your site.

3. Change the ad colors either to make the ads blend in with your site or to make them stand out. Again, it varies depending on the site.

Whatever you do, DO NOT ENTICE VISITORS TO CLICK THE ADS. Google is very strict about this, see the AdSense program policies (found at https://www.google.com/adsense/policies ) for the details.

Increasing the Average AdSense Price Per Click

Increasing the average price per click you receive from AdSense is the other strategy for increasing your overall AdSense earnings. You can do this by:

1. Carefully targeting your content, and/or

2. Filtering out and avoiding low-paying ads

Content targeting isn't just about creating relevant, unique content. It's also making sure that that content is written to target the higher-paying keywords associated with a given topic. This means:

1. Figuring out which keyword variations for that topic pay more. Often the more specialized variations and phrases pay more than the "generic" terms.

2. Ensuring that the keyword density of the content favors the higher-paying keyword variations. Seehttp://www.MakeEasyMoneyWithGoogle.com/vioxx-lawsuit.html for an example of well-targeted ads due to appropriate keyword density.

And to reduce the occurrence of lower-paying ads, consider these two strategies:

1. Use AdSense's competitive filter mechanism to screen out the ads that you don't want.

2. Show fewer ads on a page. The fewer ads you show, the more the higher-paying ads get displayed and clicked.

Many publishers also report that their earnings increase if they remove ads completely from pages with few or no clicks. Again, the "less is more" strategy favors the higher-paying ads.

There's No Magic

As you can see, there's no magic involved to increasing your AdSense earnings. The Fundamental AdSense Formula is easy to understand, but that doesn't mean it's easy to apply the formula. It takes time and effort to do it, just like most things.

SAVING SEEDS FROM YOUR GARDEN

For many gardeners, the garden actually begins in January when the first seed catalog arrives in the mailbox. While the cold wind howls outside, we retire to a cozy chair and leaf through the catalog, carefully notating which varieties of lettuce and tomatoes to try and wishing we had the space to plant each and every flower so artfully displayed on its pages.

But have you ever wondered where your great-grandparents acquired the seeds for their gardens, before there were seed catalogs and fancy garden centers?

They saved seeds for the next year from their own gardens!

Saving seeds from your own flowers or vegetables is a wonderful way to fully experience the cycle of plant growth. It’s also much less expensive than buying seeds each spring, and seeds saved from your plants will be well suited to the peculiarities of your own garden’s growing conditions. Not only that, it’s also quite a simple process.

Save seeds only from vigorous, healthy plants. Some plant diseases may be harbored in the seed where it will then be passed on to the next generation of plants. So don’t save seeds from a plant that is obviously diseased or has struggled all season. Collect seeds from the plants that have the characteristics you desire, such as height, hardiness, early or late ripening, flavor or vigor.

It is not recommended to save seeds from hybrid plants. Hybrids are the result of crossing two genetically different parent plants, both of which have been severely inbred to concentrate the desirable characteristics. The first generation, referred to as an F1 hybrid, is superior to the parents. But succeeding generations of plants grown from seed saved from an F1 plant tend to randomly revert to the characteristics of the original inbred ancestor plants.

Plants that are not hybrids are referred to as open pollinated. Many seed catalogs will identify which of their seeds are hybrids or open pollinated. If you intend to save your own seed, always start with open pollinated seeds. Some of these may also be identified as heirloom seeds. These heirloom varieties have been passed down for generations, often saved within one family for many years before becoming available to the general public.

Cross pollination is another concern for the seed-saving gardener. Cross pollination often results in seeds which have a different genetic makeup than that of the parent plant. Pumpkins, squash and small gourds may cross pollinate with each other, resulting in seeds that will grow to produce rather picturesque fruit. Sweet corn will cross pollinate with field corn or popcorn, and your 6-inch marigolds will cross with your neighbor’s 18-inch pompon marigolds. However, crossing will only occur within a species. Cucumbers won’t cross with squash, and cosmos won’t cross with pansies.

To avoid cross pollination, keep two varieties of the same species separated by as much space as possible. Some species, such as corn, are wind-pollinated and the pollen can travel great distances. These plants must be pollinated by hand and kept isolated from other varieties of their species. This can be done with corn, for example, by tying a small paper bag over selected ears before the silk emerges, then once the silk has appeared it is hand pollinated with pollen from the same plant or its healthy neighbors.

Seeds should be collected on a dry, sunny day. Frost doesn’t hurt most seed as long as the seed remains dry. Vegetables such as cucumbers, peppers and tomatoes should be allowed to become slightly overripe before their seeds are collected. Flower seeds and vegetable seed such as lettuce should be collected after the seedheads have become dry, but don’t wait too long, as many will shatter, meaning they’ll be dropped from the seedpod or seedhead if they remain on the plant too long.

Cucumber, squash and tomato seeds need an additional step before they are ready for storage. First the seeds must be separated from the pulp, then dried. Scoop the seeds from these vegetables, pulp and all. Place the whole mess in a container of water and give it a good stir, then let it settle a bit. The pulp will rise to the top while the seeds will sink to the bottom. Carefully pour off the pulp, and repeat the process until most of the pulp has been poured off. Then strain out the seeds and set them on newspapers to dry.

Seeds should go into storage as dry as possible. Give all seed a post-harvest drying period of at least a week, just to be sure they’re dry. Spread them out on a paper plate or newspapers in a warm area out of the sun while they dry.

It’s very important to keep the seed dry during storage. Store your dry seeds in tightly sealed jars, metal film containers, or old vitamin bottles. To save space, smaller quantities of several varieties of seeds can be stored in separate envelopes inside a jar. A cool, but never freezing, garage, closed-off spare room or cool basement can all be good places for storing seeds. Or simply keep your sealed jars of seeds in the refrigerator. Temperatures between 32 and 41 degrees Fahrenheit are ideal.

Be sure to label your jars and envelopes so when spring comes around again you’ll know which flower seeds and vegetable seeds you’re planting, and include the date the seeds were collected. Some seeds will remain viable for several years, but most will grow best if planted right away the following spring.

Try saving some vegetable or flower seeds from your garden this year and grow them next season. This endless cycle can allow you to realize the endless joy of gardening through all the seasons and all the stages of a plant’s life.

The bright future of Medical Transcription in India

A lot of transcription is outsourced to countries like China, Turkey and India. However before we get into Medical Transcription in India, let’s take a look at what medical transcription is actually about.

Medical Transcription as mentioned previously is basically the process of converting a doctor’sprescription which starts off as an audio file into a word document. This action is usually done by amedical transcriptionist.  Most hospitals in Europe and America are now outsourcing their transcription requirements to other countries. One of the countries that this is being outsourced to is India. There are number of reasons why Transcription in India is popular. 

1. Space Saving: By opting to outsource medical transcription, hospitals will not have to clear space and set up departments for medical transcriptionists to execute the task.  In a time where space constraints are a major issue for a number of hospitals, outsourcing seems like the perfect option. Moreover, storing transcripts as a soft copy is always more convenient and easy than dumping all themedical record files in a storeroom. Eventually, it even saves on the storage space!
2. Cost  Saving : Outsourcing medical transcription is cost saving in a number of different ways ;
   1. By not having to build an in-house medical transcription department, they save money on the cost of structuring an in- house office!
   2. Labor in developing countries like India is far cheaper than it is in the west.
   3. The value of the dollar and pound is far higher in countries like India. This means that the hospitals end up saving up a lot of money by choosing to outsource this work.
   4. Turnaround time - Turnaround time is critical in the medical industry. Countries like India and Turkey can hire more labors owing to the cheap labor wages. This makes the turnaround time extremely quick and efficient.
   5. Language - India has huge pool of English speaking resources. Medical transcriptionists in India all graduates and most of them are in fact science majors. Their qualification teamed with their fluency in the language makes medical transcription training easier.

Considering the growth of the medical industry in recent years and the importance that medical transcription has received it’s no wonder then that more and more people are opting for jobs as medical transcriptionist. Recent results of outsourcing work to India have proven extremely beneficial and more and more hospitals are now beginning to outsource this work to India. More and more doctors are now being wrongly sued by patients in hospitals across the west. In order to combat these wrong accusations medical transcriptions are absolutely necessary. So as long as there is a need for transcriptionists Medical Transcription India will continue to see business from the west.