Abstract: A bipolar electrosurgical device including an outer shaft, an inner shaft, first and second electrode surfaces, and an irrigation channel. The outer shaft defines a lumen, a proximal end and a distal end forming a cutting window. The inner shaft is rotatably disposed within the outer shaft, and defines a distal portion forming a cutting tip. The cutting tip and the cutting window combine to define a cutting implement. The first and second electrode surfaces are electrically isolated, and are formed at the cutting implement. The irrigation channel extends parallel to the outer shaft, and terminates in at least one outlet port. The outlet port is proximally spaced from the cutting window and is located radially outside of the outer shaft. Fluid (e.g., saline) is emitted at the exterior surface of the device near the cutting window and is readily present for interacting with the electrode surfaces.

Abstract: A computerized expert system reviews and adjudicates medical health care payment requests made by physicians to payers, such as insurers, for procedures performed and services and materials rendered to patients in the course of treatment. The system adjudicates a payment request to minimize fraud and mistakes and to determine whether to honor the request and if the request is honored, the dollar amount of the payment. The expert system reviews the payment request based on user-specified review criteria. Such criteria reflects contractual arrangements between payers, providers and patients, current, locally acceptable medical practices and patient and provider payment request patterns.