Month: August 2017
Cartier-Bresson’s Distant India
Henri Cartier-Bresson is perhaps the most well-known photographer in India, or rather—an important distinction—the photographer whose work is most well-known. In “Henri Cartier-Bresson: India in Full Frame,” the Rubin Museum brings together selections from his trips between 1947 and 1980. It’s hard not to detect a sense of social estrangement here. In fact, Bresson made a style out of his outsider status.
These 2 companies control most of the sunglasses bought in the…
Practical and Functional Container Homes Designed by HonoMobo
These practical and functional containers have been designed by the Canadian architectural firm HonoMobo. The project consists of a container that has been converted and modified to create in its interior comfortable and perfectly conditioned spaces in order to serve as private residences. Said containers can be then sent anywhere in North America to serve as a home. These container homes vary in size, and so can measure anywhere from..
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Happy 101st birthday, National Park Service! For the last…
Photo of Lower Falls in the Grand Canyon of Yellowstone from Artist Point by Jeremy Stevens (http://ift.tt/18oFfjl).
Photo of two bison at Yellowstone’s Lamar Valley by Aidan Busch (http://ift.tt/18oFfjl).
Photo of Beehive eruption and a rainbow by Jacob W. Frank, National Park Service.
Happy 101st birthday, National Park Service!
For the last century, the National Park Service has protected America’s Best Idea, ensuring current and future generations can experience the country’s natural, cultural and historic treasures. Established 44 years before the National Park Service, Yellowstone was the world’s first national park and sparked a worldwide movement to protect special places.
Singular Residence Located in Ensuès-la-Redonne, France
This unique residence, located in Ensuès-la-Redonne, France, is made up of 205 square meters. It was designed in 2016 by the architectural firm Bonte & Migozzi Architectes. Facing north, with a triangular shape, the home is located at the top of the mountain and surrounded by lush vegetation. This provides some privacy to its spaces and freshness, and allowing us to further enjoy its wonderful views of the Mediterranean Sea…
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Unlocking Japan’s Secrets to Healthy Skin
If there’s one trait all Japanese women share, it’s their fresh, glowing skin. It doesn’t matter if she is 20 or 60 years old, every Japanese woman seems to have a flawless, radiant complexion.
This begs the question, what is their beauty secrets to having porcelain-like skin? How do they manage to look younger and more graceful as they age?
While there’s no magic formula for youthful skin, these lovely ladies do have certain beauty secrets that help them maintain their fair complexions.
Here are some of Japan’s most treasured beauty ingredients, which are used in most of their makeup and skin products:
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Tsubaki flower
Tsubaki, also known as camellia, is a flowering plant found in southern and eastern Asia. The tsubaki flower offers a range of benefits for the skin.
The oil extracted from camellia seeds is rich in omega-6 fatty acids and numerous polyphenol antioxidants. Its creamy, non-greasy nature makes it a great moisturizer for rough skin. The oil also has many properties that keep your skin fresh, supple and moist.
Tsubaki flower oil contains vast amounts of omega-9 oleic fatty acid, which increases the skin’s ability to retain moisture. It is absorbed into the skin as easily as water and it boosts cell growth. It lends flexibility and support to the skin, too.
The oil permeates right down to the inner layers of the skin, nourishing it from the inside and hydrating any dry patches. It is a natural transdermal carrier that transports essential proteins (elastin and collagen) and nutrients, replenishing skin cells and repairing damage caused by heat, dryness and aging.
Camellia oil is free from irritants and is suitable for use on sensitive skin. It opens up the pores and allows the body to remove harmful toxins naturally through sweat glands.
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Yuzu
Yuzu is an aromatic citrus fruit of Chinese and Tibetan origin. It was first introduced in Japan during the Tang dynasty. Both the pulp and the seeds are beneficial for your skin.
The fruit is known for its potent antioxidant and anti-inflammatory properties. It has vast stores of vitamin C and flavonoids. Because of that, this fruit can help combat the harmful radicals that can cause premature aging.
Yuzu fruit is a popular skin revitalizing and nourishing agent. It tones the skin naturally and adds to its firmness and vitality.
Regular use of yuzu moistens and refreshes the skin layers. The oil extracted from yuzu softens and nourishes the skin, giving it a supple and radiant appearance. During winter solstice, it is an ancient practice to take relaxing and rejuvenating yuzu baths at home or in onsens.
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Sakura
Sakura, also known as cherry blossom, is one of the two national flowers of Japan (the other is chrysanthemum). It is one of Japan’s best-kept beauty secrets and is used extensively in skin creams and perfumes.
The sakura flower is rich in antioxidants and helps cleanse the body of impurities and pollutants that damage the skin. Its store of essential fatty acids fortifies the skin’s natural barriers, making it smooth and supple.
Sakura extract promotes a firm, mature complexion, regenerating the skin from the inside out. Its anti-glycation properties promote collagen formation in fibroblast cells.
Sakura extract cleans and whitens the skin and combats signs of anti-aging. It inhibits the production of melanin, a dark-brown or black pigment, thereby restoring uneven skin pigmentation. The extract also promotes skin cell growth and combats cell death caused by advanced glycation-end products (AGE).
It has powerful anti-inflammatory properties that help to soothe and heal irritated skin. Furthermore, sakura flower reduces the oxidative damage that causes signs of anti-aging.
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Ume
Ume is a flowering plant used in Japan for its medicinal and cosmetic properties. The common name for ume is plum blossom. The fruit is a rich source of natural antioxidants called phytochemicals. These substances help to combat the effects of oxygen radicals in the body, keeping the internal systems functioning smoothly. It prevents signs of premature aging, including wrinkles and fine lines.
The ume fruit has abundant stores of vitamin C, which detoxifies the body of impure chemicals. This property helps promote a radiant and healthy skin complexion. Ume contains anti-aging nutrients that help to reduce wrinkles and dark spots. You can find it in various Japanese face masks and creams that can help soothe, hydrate and rejuvenate the skin.
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Rice bran
Rice bran is a byproduct of rice milling. It contains vast reserves of antioxidants, vitamins B and E and essential fatty acids that combat harmful radicals in the body. It is rich in tocotrienols, which are absorbed into the inner layers of the skin. They form the first line of defense against free radicals. Tocotrienols also restore damage caused by oxidative rays, repairing the skin and slowing the skin aging process.
Rice bran cleans the skin from the inside out, causing it to appear fresh and healthy. The phytonutrient and oryzanol in rice bran acts as an effective sunscreen, protecting the skin against lipid peroxidation caused by UV light. Gamma oryzanol contains ferulic acid, which has anti-aging properties.
See Also: 10 Best Skin Foods For Healthy Glowing Skin
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Algae
Algae refers to a diverse range of photosynthetic organisms known for their nutritive and medicinal value. They are rich in anti-inflammatory compounds, such as chlorophyll and omega-3 fatty acids. This makes them ideal for treating irritated skin. They have potent antioxidant properties that help to eradicate free radicals and pollutants from the body.
Algae also combat the effects of oxidative damage to plasma and red blood cells. They support skin cell repair and growth, healing your skin from the inside out and cancelling signs of aging caused by dead skin cells.
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Green tea
Green tea is an herbal drink made from steaming or roasting fresh Camellia sinensis leaves. It’s a popular component of traditional Japanese medicine. Today, you can find it in skin creams and beauty masks.
Green tea is very beneficial for skincare. It contains a store of antioxidants that help in flushing out toxins from the skin. It has strong anti-inflammatory properties, making it ideal for soothing itchy skin and healing blemishes and scars.
Green tea is rich in tannin, an astringent that works really well in treating dark circles and puffy eyes. Its reserves of antioxidants and astringents help to soothe inflamed blood vessels under the eyes, thereby reducing swelling or ‘bags’.
The free radicals floating in the body cause the skin to sag, wrinkle and age prematurely. Green tea contains powerful antioxidants, such as vitamin C and catechins, which combat the dermal damage caused by these radicals.
The catechins present in green tea act as a defense against acne-causing bacteria. They also regulate hormonal imbalance in the body, one of the main causes of acne.
Furthermore, green tea acts as a natural skin toner that cleanses impurities, reduces large pores and hydrates the skin. Using it regularly can give the skin a fresh and healthy appearance.
See Also: How To Reduce Caffeine In Green Tea
These ingredients are some of Japan’s biggest beauty secrets. Using them regularly will keep your skin healthy and radiant as you age.
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Restaurant Interior design by YOD Design Lab in the Ukraine
The restaurant’s building, as well as the whole architectural ensemble that is the street where it is located, is a clear example of Soviet Constructivism. It was designed by architects Maxim Netreba, Dmitro Chukhleb and Sergiy Andriyenko who make up the team of the architectural firm YOD design lab. It is located in Kharkivs’ka Street, in Sums’ka oblast, Ukraine and covers an area of 330 square meters. This project was..
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When the Doctor is Away, Incident-To Billing is Out of Play
You’re reading When the Doctor is Away, Incident-To Billing is Out of Play, originally posted on Pick the Brain | Motivation and Self Improvement. If you’re enjoying this, please visit our site for more inspirational articles.
When your physicians are out of the office, it’s easy to forget taking incident-to billing out of the lineup. Failure to do so, however, is a violation that can land your medical practice in hot water.
What is Incident-To Billing?
Incident-to billing refers to billing services provided by a nonphysician practitioner (NPP), such as a physician assistant, nurse practitioner, midwife, therapist, etc. Qualified NPPs can perform services under the name and National Provider Identifier (NPI) of the supervising physician—providing that the supervising physician is in the office. In this sense, the patient is under the physician’s care, with the NPP serving as a physician extender.
With the supervising physician in the office suite—and immediately available if called upon—medical practices can claim incident-to services performed by a NPP, code the services under the supervising physician’s NPI, and receive maximum allowed payout. The NPP, of course, must have an employment relationship with the physician or the physician’s employing agency.
When the physician is out of the office, services provided by the NPP must be reported under the NPP’s NPI. In this instance, the medical practice will receive only 85% of the allowed payout—which, tongue-in-cheek, is why it’s easy to forget to adjust NPP billing when the physician is away. It is definitely why the OIG, armed with penalties, is vigilant.
New Patient, New Problem
Other stipulations that limit NPP billing involve seeing a patient for the first time, which includes seeing an established patient with a new problem. Incident-to guidelines do not allow a NPP to file incident-to services under a physician’s NPI when a new patient or new problem is addressed. The NPP may see the new patient or attend to the new problem, but the visit must be filed under his or her NPI. Only after a supervising physician has establish a plan of care from a prior visit can the NPP serve as a physician extender.
NPP Services
Is the NPP limited in terms of the incident-to services he or she can provide? No, not if the NPP is qualified to perform the services. NPPs aren’t constrained to taking vitals and medical histories. As physician extenders, they can provide and bill incident-to services ordinarily performed by the supervising physician, so long as the supervising physician is on site. Some examples from Medicare’s Internet-Only-Manual (IOM) include reading X-rays, setting casts, minor surgeries… activities required for effective evaluation and/ or treatment of a patient’s condition.
A Final Caveat
Incident-to guidelines were developed by Medicare. Though Medicare tends to set the standard in the billing and reimbursement realm, not all payers follow suite. Some payers have state by state policies, as well, and may require all providers, NPPs included, to bill under their own NPI.
Always check with your insurance carriers before billing incident-to services.
Author bio: Deborah Marsh, JD, MA, CPC, CHONC, is a senior content specialist for TCI SuperCoder, working on everything from online tool enhancements and data updates to social media and blog posts. Deborah joined TCI in 2004 as a member of TCI’s respected Coding Alert editorial team.
You’ve read When the Doctor is Away, Incident-To Billing is Out of Play, originally posted on Pick the Brain | Motivation and Self Improvement. If you’ve enjoyed this, please visit our site for more inspirational articles.
A List of Fears: Megan Stielstra and “The Wrong Way to Save Your Life”
Talk with Megan Stielstra about the art of writing essays and you’ll end up in a conversation about the art of living instead. It’s not a change of subject, just recognition that, in many ways, the activities are interwoven on the most intimate of terms. “The thing about creative nonfiction,” she says over the phone from Chicago, where she lives with her husband and young son and teaches writing at Northwestern, “is that our experience runs parallel to our pages.” I know exactly what she means. How do we make art out of a life we are in the midst of living? “The biggest question,” she acknowledges, “is the stopping point.”
Stielstra is referring to her new book, The Wrong Way to Save Your Life, a collection of loosely linked essays that add up — bit by bit — to a memoir. The title comes from a reader’s comment on a piece she wrote for the New York Times about a fire in her building; the implication is that she somehow responded incorrectly. But who’s to say, Stielstra wants to know, what’s right or wrong? And how can we help doing it our way when we have no choice but to make it up as we go? This, of course, is what the essayist does. “We have to get into it,” she writes in the introductory pastiche that opens the book. “Throw it against the wall, stand back and take a good close look. It’s ugly: heavy, dark, and centuries in the making. You might want to move on, to turn it off, watch something else, but wait — look again. Look closer. How was it made? When was it made? What was happening when it was made? What are you going to do about it? And when are you going to start?”
The Wrong Way to Save Your Life covers material that will be familiar to anyone who has read Stielstra’s 2014 volume of essays, Once I Was Cool. (She’s also the author of the 2013 short story collection Everyone Remain Calm.) Both of her nonfiction books revolve around the rigors of work and family, the question of identity, the challenges of being an adult when there are no road maps, and we slip from one moment to the next without any clear demarcation between where we’re going and where we’ve been. The echoing, she says, is “absolutely intentional; I wanted the essays in this book to talk to one another, which led me to think about how this book might talk to the last one, or to other essays I have written.” To highlight that intention — while also developing a kind of narrative spine for the project — Stielstra divides The Wrong Way to Save Your Life into four parts, each of which begins with a fragmentary meditation on a decade (ten, twenty, thirty, forty) of her life. “It was a happy accident,” she says about the structure. “When I started, I didn’t expect the book to be connected.” At the same time, the device allows for what she sees as a necessary double vision, a tension between present and past. “I’m interested,” Stielstra explains, “in narrative distance, in tracing how, as I age and live, my experience changes my perception. I’m interested in always telling the truth but also in telling you how I am telling you, in trying to be honest to who I am as I am writing, but also to who I was.”
As an example, look at the stunning “Here Is My Heart,” which anchors the opening section of The Wrong Way to Save Your Life. After her father has heart surgery, she starts dissecting deer hearts in her kitchen, as if by exposing the mechanics, some sort of deeper meaning will be revealed. “I tried to explain: blah blah metaphor blah,” she writes, when a friend asks what she is doing. “Randy waited patiently as I talked myself in circles, finally arriving tipsy at the truth: I’m afraid he will die. I’m afraid of the truth. I’m afraid for his heart.” The condition of his heart, as it turns out, proves less of a threat than Stielstra has anticipated; but the fear, once summoned, never goes away. Indeed, fear is a central motif of the collection, its métier, we might say. The book begins with an epigraph from Ben Okri: “Stories can conquer fear, you know. They can make the heart bigger.” There it is, love and terror, the conflict we cannot resolve. “The book began,” Stielstra recalls, “as a list of fears. I thought it would be five pages long. Sixty thousand words later, I called my agent.”
This is hardly new territory for her; “Channel B,” selected for The Best American Essays 2013 and republished in Once I Was Cool, highlights Stielstra’s fear of becoming a mother and her experience with postpartum depression, material that emerges in the new collection as well. “I hadn’t been aware of the constant buzzing,” she says, “until my son was born, but once I became aware, it was everywhere. I was unhappy at my job, but I was scared to leave. And when the building caught on fire, it was the greatest moment of fear ever. I wanted to write about it. I still want to write about it.” The trick, the transference, is that in addressing her own most vivid fears and emotions, she gives voice to everyone’s. “This is what happens,” Stielstra points out, “when we write personal essays. The works connects to others through ourselves.”
Such a process has to do with empathy, which is, as it has ever been, a key factor in how narrative engages us. At the same time, she wants to push it further, beyond mere identification into proximity. One word that comes up often for her is shame, not as an impediment, but rather as something that must be faced, and to the extent that we are able, overcome. “Enough,” she writes, “of shame — I’m done with it.” Another is privilege, which she explores throughout The Wrong Way to Save Your Life, invoking her students, family, and friends. In one of the book’s most powerful sequences, she remembers being asked, during a college writing class, to define her attitude toward her work. “If your writing is political,” her teacher told the students, “stand against that wall . . . If it doesn’t have anything to do with politics, stand against the other wall.” Stielstra opted for the latter, explaining, “I write love stories.” A gay student and a woman of color, standing at the opposing wall, responded that they did the same. “To this day,” Stielstra writes, “I struggle to explain what happened in that moment. All of the clichés apply: lightbulb, lightning, ton of bricks . . . It was the first time I’d considered how a person could be perceived differently based on their identity.”
This is not about guilt and it’s not about lip service, but consciousness instead. Art, Stielstra wants us to understand, can alter us, yet we must be open to the process, not only as observers but also as participants. “It’s interesting,” she suggests, “how hard it is to talk about privilege when, really, it’s responsibility. It’s overwhelming when you first discover systemic discrimination, systemic racism. There was so much I didn’t know. But in learning about it, it’s not possible not to be fundamentally changed.” Again, Stielstra cites her audience: “I have to earn it,” she says of their trust. On the one hand, this refers to her roots in spoken word; she has been affiliated for many years with the Chicago storytelling collective 2nd Story and debuted many of her essays from a stage. More to the point, though, is that notion of conversation, of collaboration — literature as an endeavor shared by author and reader, the art of writing essays and the art of living once again. “How does how we’re telling play into what we’re telling?” Stielstra wonders. “I have to be transparent in how I interrogate these issues. So much of writing personal essays means making space for someone else.”
Photo of Megan Stielstra by Joe Mazza – Brave Lux
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