Insurance Scams
This requirement obligates a healthcare provider to obtain approval from a patient's insurance company before a medication, procedure, or service will be covered.
Prior Auth
This tick transmits Ehrlichia chaffeensis, which classically causes a febrile illness with leukopenia and thrombocytopenia.
What is the lone star tick (Amblyomma americanum)?
“Sausage-shaped pancreas” is a classic imaging description of this disease.
What is autoimmune pancreatitis (IgG4-related disease)?
This transfusion reaction presents with sudden hypotension, bronchospasm, and angioedema, often in a patient with IgA deficiency and anti-IgA antibodies.
What is an anaphylactic transfusion reaction?
This organism is the most common cause of infective endocarditis overall.
What is Staphylococcus aureus?
This is a fixed dollar amount a patient pays for a covered service, such as a $30 office visit.
What is a copayment?
This is the most common route of HIV transmission worldwide.
What is heterosexual sexual contact?
"Apple-green birefringence” under polarized light identifies this pathologic finding.
What is amyloid deposition?
Fever, flank pain, hypotension, hemoglobinuria, and DIC occurring during a transfusion are classic findings of this reaction.
What is an acute hemolytic transfusion reaction?
(Accept ABO incompatibility)
This virus is the most common cause of epidemic viral gastroenteritis outbreaks in adults.
What is norovirus?
In the United States, this government-funded health insurance program primarily covers low-income individuals and families, including eligible pregnant women, children, and people with disabilities.
Medicaid
This mosquito genus transmits Plasmodium parasites to humans.
What is Anopheles?
“Punched-out” bone lesions are classically associated with this malignancy.
What is multiple myeloma?
This reaction causes fever and chills during or shortly after transfusion without evidence of hemolysis, often due to cytokines or recipient antibodies against donor leukocytes.
What is a febrile nonhemolytic transfusion reaction?
This is the most common cause of heart failure in the United States.
What is ischemic heart disease?
This is the amount you must pay out of pocket for covered healthcare services before your health insurance begins paying its share of costs.
Deductible
This mosquito genus transmits dengue, chikungunya, and Zika viruses.
What is Aedes?
“Starry-sky” appearance on histology is associated with this lymphoma.
What is Burkitt lymphoma?
This type of blood product is used to prevent transfusion-associated graft-versus-host disease in immunocompromised patients.
What are irradiated blood products?
This is the leading cause of cirrhosis worldwide.
What is chronic hepatitis B infection?
Name 2 of the 4 major criteria for who qualifies for medicare.
Age ≥65: Generally eligible based on age and work/residency requirements.
ALS: Eligible for Medicare when disability benefits begin; no 24-month waiting period.
ESRD: Eligible if other program requirements are met; timing depends on dialysis or transplant.
Disability: Generally after receiving Social Security disability benefits for 24 months.
This flea transmits Yersinia pestis from rodents to humans.
What is the rat flea (Xenopsylla cheopis)?
“Currant jelly” sputum is classically associated with this organism.
What is Klebsiella pneumoniae?
This type of blood product is used to reduce the risk of transfusion-transmitted CMV in high-risk patients.
What are leukoreduced blood products (or CMV-seronegative blood products)?
This is the most common overall cause of Cushing syndrome.
Exogenous (iatrogenic) glucocorticoid use.