1. An integrated emergency medical transportation database system having a billing modifier module, the system comprising:
a medical emergency database configured to store at least clinical encounter information and transport information, wherein the transport information is associated with the clinical encounter information by at least including a location of a patient medical emergency; and
a billing modifier module configured to access the clinical encounter location stored in the medical emergency database and configured to compare the clinical encounter location to a list of geographic areas, and further configured so that the result of the comparison is used to determine at least one billing modifier to be applied to the medical charges associated with the medical emergency.
2. The system of claim 1, wherein the list of geographic areas comprises a ZIP code list.
3. The system of claim 1, wherein the billing modifier is a plurality of billing modifiers and the billing modifiers are applied.
4. The system of claim 3, wherein the billing modifiers are multiplicative.
5. The system of claim 1, wherein the billing modifier is based on a metropolitan statistical area.
6. The system of claim 5, wherein the metropolitan statistical area is determined by the federal government.
7. The system of claim 1, wherein the billing modifier is based on a geographic practice cost index.
8. The system of claim 7, wherein the geographic practice cost index is determined by the federal government.
9. The system of claim 1, wherein the billing modifier provides rural transportation providers a financial advantage to offset low volumes of work.
10. The system of claim 1, additionally comprising a billing module in communication with the medical emergency database, the billing module receiving data from the billing modifier module.
11. A method of billing modification for an integrated emergency medical transportation database system, the method comprising:
collecting at least clinical encounter information and transport information into a medical emergency database, wherein the transport information is associated with the clinical encounter information by at least including a location of a patient medical emergency;
accessing the clinical encounter location stored in the medical emergency database;
comparing the clinical encounter location to a list of geographic areas;
determining a billing modifier based on the comparison; and
applying the billing modifier to the medical charges associated with the medical emergency.
12. The method of claim 11, wherein the list of geographic areas is determined by the federal government.
13. The system of claim 1, wherein the clinical encounter information is indicative of medical transportation.
14. The method of claim 11, wherein the clinical encounter information is indicative of medical transportation.
15. The method of claim 11, wherein two or more billing modifiers are applied.
16. The method of claim 15, wherein the billing modifiers are multiplicative.
17. The method of claim 11, wherein the billing modifier is based on a metropolitan statistical area.
18. The method of claim 11, wherein the billing modifier is based on a geographic practice cost index.
19. The system of claim 1, wherein the clinical encounter location is a location remote from the location of the office of the patient’s primary care physician.
20. The system of claim 1, wherein the billing modifier module is further configured to calculate one or more enhancement factors based on the clinical encounter location and to apply the one or more enhancement factors to the medical charges.
21. The system of claim 1, wherein the transport information comprises airborne emergency vehicle data.
22. The system of claim 1, wherein the transport information comprises patient pickup data used for purposes of billing.
23. The system of claim 1, wherein the location of the patient medical emergency includes geolocation coordinates.
24. The system of claim 1, wherein the comparison includes indexing into a geographic area with geolocation boundaries.
25. The system of claim 1, wherein the medical emergency database is associated with an emergency medical transportation entity.
26. The system of claim 1, wherein the determining is done via calculation.
27. The method of claim 11, wherein the clinical encounter location is a location remote from the location of the office of the patient’s primary care physician.
28. The method of claim 11, wherein determining the billing modifier comprises calculating one or more enhancement factors based on the clinical encounter location.
29. The method of claim 28, wherein applying the billing modifier to the medical charges associated with the medical emergency comprises applying the one or more enhancement factors to the medical charges.
30. The method of claim 11, wherein the transport information comprises patient pickup data used for purposes of billing.
31. The method of claim 11, wherein the comparing includes indexing into a geographic area with geolocation boundaries.
32. The method of claim 11, wherein the medical emergency database is associated with an emergency medical transportation entity.
33. An integrated emergency medical transportation database system having a billing modifier module, the system comprising:
a medical emergency database configured to store at least clinical encounter information and transport information, wherein the transport information is associated with the clinical encounter information by at least including a location of a patient medical emergency; and
a billing modifier module configured to access the clinical encounter location stored in the medical emergency database and configured to compare the clinical encounter location to a list of geographic areas, and further configured so that the result of the comparison is used to determine at least one enhancement factor to be applied to the medical charges associated with the medical emergency.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
1. An introducer for deploying a stent graft in a curved lumen, the introducer including:
a carrier for a stent graft;
a withdrawable sheath for retaining a stent graft in a compressed condition;
a release mechanism including a constraining mechanism, wherein the constraining mechanism includes at least one release wire;
a substantially cylindrical stent graft, including a plurality of stents, mounted on the carrier, the stent graft including at least one wire-receiver co-operating with the at least one release wire of the release mechanism, wherein the at least one wire-receiver and the at least one release wire radially constrain at least a portion of at least one constrainable stent of the plurality of stents of the stent graft to form a constrained stent portion of a constrained stent that is radially constrained substantially entirely therearound, wherein at least an adjacent portion of an adjacent stent of the plurality of stents of the stent graft is not radially constrained by the at least one release wire and forms an expanded portion of the stent graft when not compressed by the sheath whilst the constrained stent portion is simultaneously maintained in its radially constrained configuration by the at least one wire-receiver and the at least one release wire, wherein at least the most proximal stent of the stent graft and at least the most distal stent of the stent graft are not constrained by the at least one wire-receiver and the at least one release wire while the constrained stent portion is maintained in its radially constrained configuration;
the at least one release wire and the at least one wire-receiver together being releasable to enable the constrained stent portion to expand so as to overlap with the interior of the adjacent portion of the adjacent stent in an the expanded portion of the stent graft, thereby to enable the stent graft to be deployed in a curved lumen without the need to match the curve of the stent graft to the lumen either prior to, or during deployment.
2. An introducer as claimed in claim 1, wherein at least a portion of more than one stent is constrained by the at least one wire-receiver and the at least one release wire.
3. An introducer as claimed in claim 1, wherein the at least one wire-receiver is a loop of material.
4. An introducer as claimed in claim 3, wherein the loop of material is a thread.
5. An introducer as claimed in claim 1, wherein the at least one wire-receiver is provided only at one end of the constrained stent, and wherein another end of the constrained stent is not provided with any wire-receiver.
6. An introducer as claimed in claim 1, wherein the at least one wire-receiver is provided at both a proximal end and a distal end of the constrained stent.
7. An introducer claimed in claim 1, wherein more than one stent of the stent graft is constrained.
8. An introducer as claimed in claim 7, including at least one constrained stent in which a wire-receiver is provided only at one of its ends and at least one constrained stent in which a wire-receiver is provided at both its proximal end and its distal end.