HIFU Proposal

- Analysis should include the following factors: o Analysis of relevant physician behavior – urologists vs. generalists; doctors may refuse prescriptions and do not initiate treatment

Legally and ethically under Informed consent a patient has the right to refuse specialty treatment or referral but needs to be informed about the risks involved with delay or lack of the specific treatment recommended. Mostly, if the patient does agree to visit the specialist then, the specialist is responsible for the informed consent for the specific treatment. But is has been contested and help in courts that the primary care physician still is responsible for the patients welfare in all phases of treatment. For a provider in a busy practice it is difficult to keep track of all the referrals and at times, the specialist’s office has a different outlook on the matter.

Aeriel Ocampo 63944677 Dr. Fox’s Lab Dr. Fox is an emergency physician at UCI Medical Center, treating and diagnosing patients using an ultrasound. His scope of research involves looking at patients’ internal organs via ultrasound, which is much quicker and less harmful than using x-ray scans that are traditionally used in emergency departments. He is also a part of the American Institute of Ultrasound in Medicine (“Faculty and Staff”). Dr. Fox is also a director of instructional ultrasound and is the assistant dean at the UCI School of Medicine (“John Christian Fox”). He started an ultrasound rotation at the UCI School of Medicine, and with a grant given by SonoSite, Inc., the ultrasound curriculum is now embedded within the UCI School of Medicine curriculum (“Faculty and Staff”). He went to Tufts University School of Medicine, receiving his MD in 1997 (“John Christian Fox”). His main research focus is to try to incorporate ultrasound more into the emergency department, and tries to find revolutionary ways to utilize ultrasound, especially because it is very cost-efficient and images are seen real-time, unlike MRI scans or x-rays, which can emit harmful radiation or results take much longer to acquire. Eric Viquez is one of the Bio 199/EMRAP (Emergency Medicine Research Associates Program) students in Dr. Fox’s ultrasound lab. He is currently a 4th year undergraduate biological sciences major who is going to medical school in the fall; he shadows shifts with Dr. Fox and

• You have the right to get a second opinion from a provider at no cost. You can get a second opinion when you:

There was no documentation dated after the procedure performed on August 28, 2014, or before the date of service billed in this appeal. The medical documentation did not highlight acute symptoms warranting the need for the service in question.

As noted, on February 29, 2016, the patient was nonetheless admitted to the UCR hospitalist. This was a senior member of the UCR hospitalist team who knew or should have known all of the policies and procedures for admission, and should never have admitted the patient as an attending to the hospital. In so doing, he was directly and deliberately interfering with the doctor patient relationship.

I have not directly worked in a medical record setting before. The exposure I do have as a customer service representative at a medical group is accessing patient’s demographics, eligibility, billing information for claims, and authorizations for future services/procedures. I usually make changes to a members' address or phone number

The carrier has denied coverage of Harvoni 90mg – 400mg as not medically necessary. There is a letter from the carrier to the member dated 11/20/2015, which states in part:

Introduction Southside HMO serves 495,000 members throughout the eastern region of the United States. Servicing this amount of members means that the company is providing quality health care. Given this amount of volume it is understandable that there will be concerns at times raised from both our providers and the membership.

Bedside Report from the Emergency Department. Translational Research March 31, 2016     The modern day emergency room is a department that is constantly busy. In the hustle of caring for patients, there are some details of the patient’s care that can be overlooked in a standard phone report to the accepting nurse.

The final decision holds podiatrist and orthopedics specialist to the same standard. An expert testimony can be given based on the provider’s experience and knowledge of the procedure. According to Johnson (2008) “The standard of care against which a defendant's actions are judged may be that of a specialty other than his own. This holds for many specialties in which there is overlap of service. The example of a breast exam being the same for a gynecologist or breast surgeon speaks to the importance of the category of the procedure or care being rendered rather than the speciality of the provider. For the podiatrist this elevates them to the same level as other physicians and therefore hold them to the same standard. Had the decision been made in opposition to this finding, then that would have undermined the credibility of podiatric treatment and would therefore hold them to a lesser standard. While this dual standard may seem initially beneficial

Please accept this letter as Rebbecca M. Santistevans appeal to Colorado Access’s decision to deny medical coverage,( one week after the surgery), for the Bunionectomy. It is my understanding based on your letter of denial dated 06/05/2015 that this procedure has been denied because: Rationale: The Provider was (nonpar) non-contracted and there are (par) contracted providers in the area who could have done the procedure. The (nonpar) non- contracted provider did not check patient’s insurance benefits.

Journal Article Critique: “Increasing Hospital Admission Rates for Urological Complications After Transrectal Ultrasound Guided Prostate Biopsy”

High-Intensity Focused Ultrasound, HIFU, is rapidly becoming a growing prostate treatment. Because the area affected by the prostate cancer is targeted, the temperature can heat up quickly, which burns and destroys the cancer cells.

Prostate Cancer Eng 101 Andrell Nash Fortis College Abstract Prostate Cancer is a disease in which there is an uncontrolled growth of cells that lines the ducts of the prostate gland. The abnormal cells can spread throughout the prostate and nearby organs, such as the seminal vesicles. If not caught early they can spread (metastasized) to other organs of the body through the lymph or blood stream. (“...Treatment...” 13) Prostate Cancer can be like a silent killer. Some may show signs and symptoms of this disease while others may not. Some symptoms may include frequent urination, blood in the urine or semen, delayed or slowed start of urinary stream and dribbling or leakage of urine. Diagnosis testing for Prostate Cancer are digital