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Seminars in Neurology最新文献

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Navigating Insurance Contract Negotiations: A Practical Guide for Neurologists. 导航保险合同谈判：神经科医生的实用指南。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-05-30 DOI: 10.1055/a-2596-5978
Jose M Rocha
{"title":"Navigating Insurance Contract Negotiations: A Practical Guide for Neurologists.","authors":"Jose M Rocha","doi":"10.1055/a-2596-5978","DOIUrl":"https://doi.org/10.1055/a-2596-5978","url":null,"abstract":"<p><p>Effective negotiation with health insurance payers is crucial for neurology practices to maintain financial sustainability and optimal patient care. This paper outlines strategic approaches to payer negotiations, emphasizing the importance of clearly defining practice strengths, understanding market conditions, and leveraging detailed contextual data to counter incomplete or misleading payer analytics. Specific considerations discussed include customer service efficiency, claims management, provider-payer relationships, clinical management policies, contract terms, and fee schedule clarity. We present actionable negotiation strategies illustrated by a case study, highlighting tactics such as targeted utilization reports, social media advocacy, and data-driven reimbursement proposals. Additionally, practical advice is provided on managing payer interactions, addressing common administrative inefficiencies, and strategically limiting patient volumes when negotiations stall. This structured negotiation approach empowers neurologists to effectively align clinical value with payer objectives, ensuring fair reimbursement and enhanced practice viability.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurologic Practice in Canada. 加拿大的神经病学实践。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-05-26 DOI: 10.1055/a-2619-2397
Nathalie Jette, Amy Xy Yu, Celine Odier, Julian Alejandro Rivillas, Alice Schabas, Michael D Hill
{"title":"Neurologic Practice in Canada.","authors":"Nathalie Jette, Amy Xy Yu, Celine Odier, Julian Alejandro Rivillas, Alice Schabas, Michael D Hill","doi":"10.1055/a-2619-2397","DOIUrl":"https://doi.org/10.1055/a-2619-2397","url":null,"abstract":"","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurologists and Clinical Informatics: Realizing the Potential of Digital Medicine. 神经科医生和临床信息学：实现数字医学的潜力。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-05-26 DOI: 10.1055/a-2601-9070
Allan D Wu, Benjamin R Kummer
{"title":"Neurologists and Clinical Informatics: Realizing the Potential of Digital Medicine.","authors":"Allan D Wu, Benjamin R Kummer","doi":"10.1055/a-2601-9070","DOIUrl":"10.1055/a-2601-9070","url":null,"abstract":"<p><p>Clinical informatics (CI) is an emerging field within biomedical informatics that sits at the intersection of clinical care, health systems, and health information technology (IT). CI emphasizes how individuals (neurologists, patients, staff) interact with health IT (HIT), with a focus on designing systems that support optimal neurologic care. As neurology becomes more complex-expanding diagnostics, treatments, and subspecialties-there is a growing need for usable, efficient electronic health record systems that enhance, rather than burden, care delivery. This paper reviews roles CI neurologists can play, as translators, architects, advocates, and leaders across clinical, operational, and strategic domains. We highlight examples where CI expertise addresses challenges in neurology, including access to care, documentation burden, burnout, quality improvement, patient engagement, artificial intelligence, research registries, and precision health. With projected workforce shortages in neurology and CI, neurologists with CI expertise will ensure that HIT will effectively support high-quality neurologist-led care.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of AI in the Management of Movement Disorders. 人工智能在运动障碍管理中的作用。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-05-26 DOI: 10.1055/a-2596-5950
Andres Deik
{"title":"The Role of AI in the Management of Movement Disorders.","authors":"Andres Deik","doi":"10.1055/a-2596-5950","DOIUrl":"10.1055/a-2596-5950","url":null,"abstract":"<p><p>Artificial intelligence (AI) has emerged as a transformative force in the management of movement disorders. This review explores the various applications of AI across the spectrum of care, from diagnosis to clinical workflows, treatment, and monitoring. Recent advancements include deep phenotyping tools like the Next Move in Movement Disorders (NEMO) project for hyperkinetic disorders, diagnostic platforms such as DystoniaNet, and biomarker identification systems for early Parkinson's disease detection. AI may revolutionize treatment selection through technologies like DystoniaBoTXNet and adaptive deep brain stimulation systems. For symptom monitoring, innovations like the Emerald device and smartphone-based assessment tools enable continuous, objective evaluation. AI may also enhance patient care through improved telemedicine capabilities and ambient listening. Despite these promising developments, recent critiques highlight methodological concerns in AI research, emphasizing the need for rigorous validation and transparency. The future of AI in movement disorders requires balancing technological innovation with clinical expertise to improve patient outcomes.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurological Advocacy. 神经系统的宣传。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-05-16 DOI: 10.1055/a-2595-3422
Kara Stavros, Amy Guzik
{"title":"Neurological Advocacy.","authors":"Kara Stavros, Amy Guzik","doi":"10.1055/a-2595-3422","DOIUrl":"https://doi.org/10.1055/a-2595-3422","url":null,"abstract":"<p><p>Advocacy is an important part of the practice of neurology integral to optimal patient care and research. Opportunities exist for neurologists to further their engagement in advocacy outside of the office, and neurologists are well-positioned to share their knowledge and expertise as advocates. Many barriers to care, such as the cost of and access to prescription drugs, have an outsized impact on patients with neurological conditions, which underscores the importance of neurological advocacy. Advocacy opportunities span many different forms and range from local to global in scale. The benefits to a neurology career can be vast, from improved knowledge of health care systems to leadership opportunities, to networking among colleagues and community leaders, and enhanced academic profiles. Numerous resources are available for neurologists seeking further engagement in advocacy for their patients and profession.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing the Management of Hypersomnia: Examining the Role of the Orexin System. 加强对嗜睡症的管理：对食欲素系统作用的考察。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-05-12 DOI: 10.1055/a-2589-3825
Anne Marie Morse
{"title":"Enhancing the Management of Hypersomnia: Examining the Role of the Orexin System.","authors":"Anne Marie Morse","doi":"10.1055/a-2589-3825","DOIUrl":"https://doi.org/10.1055/a-2589-3825","url":null,"abstract":"<p><p>Excessive daytime sleepiness (EDS) is common. However, clinical features of excessive sleepiness can have broad and variable presentations. In addition, there can be an increased likelihood of medical or psychiatric comorbidity. Examination of the networks that regulate sleep-wake and circadian control reveals a complex and intricately designed integration system. Dysregulation in the coordination, effectiveness, or efficiency of these systems can contribute to developing EDS, and inform on the endotypes observed and pharmacologic considerations for treatment. The discovery and characterization of the diurnal expression and function of orexin (hypocretin) have led to a transformed understanding of sleep-wake control and EDS, as well as its role beyond sleep. As a result, a novel drug class, orexin agonists, is anticipated to emerge for clinical use in the near future. An understanding of orexin physiology and its transdisciplinary impact is necessary to best prepare for patient selection, use, and anticipated benefit and monitoring of both expected benefits and any other health change. This study provides a review of the range of clinical features and impact of EDS, the relationship between sleep-wake, circadian and other health networks, and an examination of orexin physiology with anticipatory guidance on the potential transdisciplinary role and impact of orexin agonists.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reimagining Neurological Care: A Value-Based Approach. 重塑神经护理：基于价值的方法。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-05-01 DOI: 10.1055/a-2576-5561
Janine M Moore, Tim D Phillips, Aiesha Ahmed
{"title":"Reimagining Neurological Care: A Value-Based Approach.","authors":"Janine M Moore, Tim D Phillips, Aiesha Ahmed","doi":"10.1055/a-2576-5561","DOIUrl":"10.1055/a-2576-5561","url":null,"abstract":"<p><p>Value-based care has been impactful in primary care, but specialty care has not been a large focus area. This manuscript provides neurologists with an overview of value-based payment (VBP) models and offers practical suggestions for engaging in these models using example conditions of migraine and dementia. The article discusses various VBP models, from low-risk pay-for-performance to high-risk shared risk models, and emphasizes the importance of data infrastructure, patient outcomes, quality improvement, and cost reduction for success in value. By adopting a value-based approach, neurologists can improve care for complex neurological conditions, enhance patient satisfaction, and achieve sustainable health care excellence. The conclusions highlight the transformative potential of VBP models in neurology, encouraging neurologists to take small steps toward value-based care to achieve quadruple aim benefits.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Documentation, Coding, and Billing for Neurologic Services and Procedures. 神经系统服务和程序的文件、编码和计费。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-28 DOI: 10.1055/a-2576-4291
Neil A Busis, Robert Montgomery, Bruce H Cohen
{"title":"Documentation, Coding, and Billing for Neurologic Services and Procedures.","authors":"Neil A Busis, Robert Montgomery, Bruce H Cohen","doi":"10.1055/a-2576-4291","DOIUrl":"https://doi.org/10.1055/a-2576-4291","url":null,"abstract":"<p><p>Documentation, coding, and billing (claims submission) are foundational to neurologic practice in the United States, enabling accurate reimbursement, effective communication, and data-driven advancements in patient care, research, and education. Neurologists navigate complex regulatory frameworks and evolving payer guidelines, requiring meticulous attention to diagnostic coding, evaluation and management (E/M) services, and procedure-specific requirements. This chapter examines critical aspects of neurologic billing and coding, including ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) for diagnostic accuracy, updated E/M guidelines emphasizing medical decision-making and time, and new telemedicine codes. It highlights the best practices for procedure coding and the use of digital health technologies. The challenges posed by prior authorization are explored, alongside potential solutions like artificial intelligence-driven tools and policy reform. By prioritizing precision, compliance, and technological adaptation, neurologists can enhance patient outcomes, support practice sustainability, and contribute to the broader goals of equitable, efficient, and innovative neurologic care.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep as the Foundation of Brain Health. 睡眠是大脑健康的基础。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-25 DOI: 10.1055/a-2566-4073
Abubaker Ibrahim, Birgit Högl, Ambra Stefani
{"title":"Sleep as the Foundation of Brain Health.","authors":"Abubaker Ibrahim, Birgit Högl, Ambra Stefani","doi":"10.1055/a-2566-4073","DOIUrl":"10.1055/a-2566-4073","url":null,"abstract":"<p><p>Sleep is a vital function, taking about one-third of a human lifetime, and is essential for achieving and maintaining brain health. From homeostatic neurophysiology to emotional and procedural memory processing to clearance of brain waste, sleep and circadian alignment remain paramount. Yet modern lifestyles and clinical practice often dismiss sleep, resulting in profound long-term repercussions. This chapter examines the roles of sleep and circadian rhythms in memory consolidation, synaptic plasticity, and clearance of metabolic waste, highlighting recent advances in neuroscience research. We explore how insufficient and disordered sleep-a public health concern-can impair cognition, escalate neurodegenerative risks, and compromise neurovascular integrity, thereby impacting brain health. These findings underscore the need for comprehensive screening for disturbed sleep and targeted interventions in clinical practice. Emerging interventions and AI-driven technologies may allow early detection and personalized and individualized treatments and improve outcomes. Overall, this chapter reaffirms that healthy sleep is indispensable at any level of neurological disease prevention-on par with the role of diet and exercise in cardiovascular health-and represents the foundation of brain health.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current Perspectives on Nonrapid Eye Movement Parasomnias. 非快速眼动异动症的研究现状。
IF 1.8 4区 医学
Seminars in Neurology Pub Date : 2025-04-24 DOI: 10.1055/a-2565-3317
Muna Irfan, Carlos H Schenck
{"title":"Current Perspectives on Nonrapid Eye Movement Parasomnias.","authors":"Muna Irfan, Carlos H Schenck","doi":"10.1055/a-2565-3317","DOIUrl":"10.1055/a-2565-3317","url":null,"abstract":"<p><p>Non-REM (NREM) parasomnias comprise abnormal sleep-related behaviors, autonomic nervous system function, and emotional experiences that typically arise out of deep NREM sleep. Categorized broadly as disorders of arousal (DoA), confusional arousals (CoA), sleepwalking (SW), and sleep terrors (ST) share common pathophysiological mechanisms and contributing factors. Sexsomnia is classified as a variant of CoA and SW, while sleep-related eating disorder is classified as a separate NREM parasomnia. These parasomnias emerge due to incomplete dissociation of wakefulness from NREM sleep, resulting in partial arousal characterized by decreased consciousness during motor and emotional manifestations. The behaviors emerge as a result of the interplay of various predisposing and priming factors with the additional layer of precipitating conditions. Cyclic alternating patterns and abnormal slow wave synchronization increase susceptibility to developing these behaviors in the background of genetic predisposition. We will discuss current diagnostic criteria, differential diagnoses, implications, and management of these parasomnias. Recent scientific developments in this area will be discussed, especially in reference to etiopathogenesis and treatment strategies of lesser-studied subtypes such as sexsomnia. The mainstay of treatment comprises alleviating the contributing factors and treating any comorbid sleep disorders that may curtail sleep duration and also increase abnormal arousal. Behavioral interventions can be beneficial, although sometimes less established pharmacotherapy is also utilized.</p>","PeriodicalId":49544,"journal":{"name":"Seminars in Neurology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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