US Heart & Vascular

Role Description - Establish and maintain strong relationships with referring physicians and medical practices. - Act as a trusted advisor and resource for physicians, answering questions about the facility, services, and capabilities. - Conduct regular visits to physician offices to build rapport and address concerns. - Promote the organization's services and capabilities to drive patient referrals. - Identify and develop strategic opportunities to increase referrals. - Work with physicians to streamline the referral process. - Provide continuous relationship management with current referral sources. - Develop and implement physician outreach strategies, including events, presentations, and written materials. - Respond to physician inquiries promptly and professionally. Participate in the referral process as necessary. - Facilitate communication between the organization and referring physicians. - Track and analyze referral data to identify trends and areas for improvement. - Report on referral performance and other key metrics to management. - Contribute to the development and implementation of physician relations strategies. - May be involved in training and onboarding new physician liaisons. - May assist with the management of operations, projects, or social media campaigns. - May provide input and assistance with the evaluation and management of support roles. Qualifications - Minimum 5 years' experience with Physician relations, healthcare marketing, or business development. - Minimum 5 years' experience working in or with hospitals, medical groups, or health systems. - Bachelor’s degree in business, Marketing, Healthcare Administration, Communications, or related field. - Excellent verbal and written communication skills. - Strong relationship-building and interpersonal abilities. - Comfortable with strategic planning and execution. - Knowledge of healthcare operations, service lines, and provider dynamics. - Willingness to travel within the assigned region. - High level of professionalism, diplomacy, and discretion. Requirements - Minimum 5 years' experience with Physician relations, healthcare marketing, or business development. - Minimum 5 years' experience working in or with hospitals, medical groups, or health systems. - Bachelor’s degree in business, Marketing, Healthcare Administration, Communications, or related field. - Excellent verbal and written communication skills. - Strong relationship-building and interpersonal abilities. - Comfortable with strategic planning and execution. - Knowledge of healthcare operations, service lines, and provider dynamics. - Willingness to travel within the assigned region. - High level of professionalism, diplomacy, and discretion. Company Description US Heart and Vascular is in need of a Senior Market Development Liaison to join our team in Houston, TX.

Role Description Leads and performs coding of medical records, diagnoses, and procedures for accurate billing and insurance claims processing. Translates medical information into standardized codes, ensuring compliance with regulatory requirements and quality standards. Responsibilities & Duties - Reviews and analyzes medical records, including patient charts, to assign appropriate codes for diagnoses, procedures, and services using ICD-10 and other coding systems. - Enters coded information into electronic health record (EHR) systems and billing software accurately and in a timely manner. - Verifies the completeness and accuracy of medical documentation to ensure that all services are properly coded and supported by the patient’s medical records. - Ensures that coding practices comply with federal, state, and payer regulations, as well as healthcare coding guidelines and standards. - Assists in the preparation and submission of insurance claims, ensuring all required information is included and addressing any issues or denials promptly. - Participates in coding audits and quality assurance reviews to identify and resolve discrepancies or coding errors. - Addresses patient and provider inquiries related to coding and billing issues in a professional and courteous manner. - Leads, trains, and assists other medical coders and staff engaged in medical records to maintain coding accuracy and compliance. - Participates in mentoring, coaching, counseling, and termination of employees, as needed. - Works closely with healthcare providers, billing staff, and insurance companies to resolve any issues related to coding or claims processing. - Maintains a safe workplace by following established safety protocols, reporting hazards, and participating in required safety training. - Fosters a team-oriented environment by encouraging cooperation, providing support, and resolving conflicts constructively. - Demonstrates integrity, professionalism, and respect in all interactions. - Follows processes and policies for the organization. - Adapts to changing priorities, processes, and business needs. - Performs other duties as assigned. Qualifications - Knowledge and understanding of electronic health records, preferably in a clinical or hospital setting. - Proficiency in using electronic health record (EHR) systems and coding software. - Strong knowledge of ICD-10, CPT, and HCPCS coding systems and guidelines. - Attention to detail and accuracy in coding and data entry. - Analytical skills and ability to interpret medical documentation effectively. - Excellent communication skills, with the ability to work collaboratively with healthcare providers and administrative staff. - Ability to handle sensitive information with confidentiality and professionalism. - Knowledge of federal, state, and local laws, statutes, regulations, codes, and standards related to the area of responsibility. - Knowledge of the principles, concepts, and theories relevant to the assigned functional area. - Skill in completing assignments accurately and with attention to detail. - Ability to communicate clearly and concisely both orally and in writing in English, to various audiences. - Ability to manage time, organize work, set priorities, meet deadlines, and follow up on work assignments with minimal supervision. - Ability to work independently, and as a team, to complete daily activities according to the work schedule. - Working knowledge of Office 365 programs such as Excel, Outlook, Word, PowerPoint, etc. Requirements - High School diploma or GED from an accredited institution. - Certification as a Medical Coder from a recognized professional organization.

Role Description Responsible for the healthy management of the revenue cycle for the practice. This position is responsible for managing and coordinating team efforts. - Identifies payer trends or issues to provide timely solutions and determines appropriate levels of escalation. - Monitors accounts receivable aging, billing, collections, post payment review, and correspondence activities to ensure timely completion and identify improvement. - Maintains optimal accounts receivable billing codes and fee schedules in EMR. - Develops relationships with provider representatives for effective problem-solving. - Trains and supervises the work of AR employees by empowering, coaching, giving guidance & feedback; leads by example. - Communicates effectively and professionally within the organization. - Performs any other tasks or projects deemed reasonable by physician or supervisor. Qualifications - College degree and/or minimum of 4 years healthcare supervisory experience. - Exhibits understanding of relevant CPT, HCPCS and ICD10 coding regulations and guidelines. - Maintains knowledge of debt collection laws, Medicare & Medicaid guidelines and managed care contracting requirements. - MS Office Applications. - Understanding of Revenue Cycle. - Ability to lead teams, mentor and support development of resources. - Must have professional and courteous skills. - Must have ability to make independent decisions that are generally guided by established procedures and/or collection process. - Excellent Communication Skills. - Results Oriented. Requirements - College degree and/or minimum of 4 years healthcare supervisory experience. - Exhibits understanding of relevant CPT, HCPCS and ICD10 coding regulations and guidelines. - Maintains knowledge of debt collection laws, Medicare & Medicaid guidelines and managed care contracting requirements. - MS Office Applications. - Understanding of Revenue Cycle. - Ability to lead teams, mentor and support development of resources. - Must have professional and courteous skills. - Must have ability to make independent decisions that are generally guided by established procedures and/or collection process. - Excellent Communication Skills. - Results Oriented.

Role Description US Heart and Vascular is in need of a Remote Accounts Receivable Specialist to join our team. - Responsible for billing all patient claims in a timely manner. - Perform basic claims follow up activities to include claim status checks, basic claim edits corrections and rebills. - Work daily claims rejection lists including but not limited to, eligibility, coordination of benefits, clearinghouse smart edits, etc. - Utilize clinical applications, payer websites and other systems as a research tool to retrieve medical documentation, patient eligibility information, billing guidelines, patient referrals, and hospital or procedure code authorizations to substantiate corrected claims submissions. - Establish and maintain effective working relationships with carrier representatives and internal and external clients. - Remain abreast of carrier/payer updates as it relates to Billing and Collections guidelines including claim submissions, claim appeals, grievance procedures and policy changes. - Responsible for compliance with all regulatory requirements and/or guidelines, including but not limited to: OSHA, HIPAA, Federal Fraud and Abuse laws. Qualifications - High School Diploma or equivalent required. - Knowledge of the accounts receivables (A/R) process. - Bachelor's Degree in a related field preferred but not required. - Minimum of 3 years of healthcare or insurance billing processing experience required. - Knowledge of medical terminology, CPT, ICD-10-CM, HCPC codes, CCI edits and HIPAA regulations. - eClinicalWorks experience preferred but not required. - Proficient in medical terminology, anatomy, and physiology. - Strong knowledge of ICD-10 coding. - Familiarity with medical office procedures and billing practices. Requirements - High School Diploma or equivalent required. - Knowledge of the accounts receivables (A/R) process. - Bachelor's Degree in a related field preferred but not required. - Minimum of 3 years of healthcare or insurance billing processing experience required. - Knowledge of medical terminology, CPT, ICD-10-CM, HCPC codes, CCI edits and HIPAA regulations. - eClinicalWorks experience preferred but not required. - Proficient in medical terminology, anatomy, and physiology. - Strong knowledge of ICD-10 coding. - Familiarity with medical office procedures and billing practices.

Role Description - Take customer calls and provide accurate, satisfactory answers to patient inquiries and concerns. - Receives and returns phone calls from patients and other external sources. Receives and returns portal messages. - De-escalate situations involving dissatisfied customers, offering patient assistance and support. - Takes Pharmacy phone calls, reviews charts and processes prescription refills. - Guide callers through troubleshooting, navigating the company site or using the products or services. - Actively demonstrates teamwork at all times. - At all times protects the confidentiality of protected health information (PHI) of patients per HIPAA regulations; does not normally have business need for seeing PHI of employees. - May also be responsible for insurance pre-certification, prior authorization, procedure/surgery scheduling and coordinating transfers and admissions. - Escalates emergent patient care concerns to the appropriate entity as directed in protocols. - Collaborate with other call center professionals to improve customer service. - Help to train new employees and inform them about the company’s customer management policies. - Maintains current CPR and Medical Assistant certification. - Performs other duties as required. Qualifications - High School diploma or equivalent. - Graduation from an accredited program for Medical Assistants. - Current Medical Assistant Certification or must obtain within 90 days of hire date. - Current BCLS certification. - Minimum one-year medical assistant experience. Cardiology practice experience preferred but not required. - Strong communication skills, both written and verbal. - Ability to work nights, weekends, and holidays. - Phone skills, including familiarity with complex or multi-line phone systems. - Understanding of OSHA requirements in a clinical setting. Company Description Dallas/Fort Worth, known as the Metroplex, offers a vibrant urban life and peaceful suburban living, making it an enticing place to reside. Spanning across ten major cities and thirteen counties, it stands as the largest metroplex in the south. With its extensive range of recreational parks, renowned dining scene, five professional sports teams to root for, and two bustling airports facilitating over 2,000 daily flights, Dallas/Fort Worth provides residents with a multitude of reasons to consider it an excellent place to call home.

Role Description As our Cardiology Group continues to grow and expand into new locations, we are seeking a Physician & APP Recruiter to lead the sourcing, screening, and contracting of top-tier cardiologists, physician assistants, and nurse practitioners. This role is critical in building and maintaining a high-quality provider team to support our mission of delivering exceptional cardiac care. - Physician & APP Recruitment – Source, screen, and negotiate contracts with cardiologists, physician assistants, and nurse practitioners to staff expanding locations, including outpatient clinic cardiology programs. - Contract Negotiation & Management – Negotiate and re-negotiate contracts with existing and new providers, ensuring competitive and mutually beneficial agreements. - Market & Networking Strategy – Establish relationships within the geographic market to build brand recognition and recruit top talent. This includes attending networking events, conferences, and making strategic outreach efforts. - Cold Outreach & Candidate Identification – Proactively reach out to potential candidates through cold calls, direct outreach, and digital networking to meet recruitment goals. - Stakeholder Communication – Maintain open and effective communication with Regional Presidents, Hiring Managers, and Cardiology Leadership to ensure alignment on staffing needs and satisfaction. - Market Analysis & Compensation Research – Conduct financial surveys to assess physician compensation trends and distribute insights to leadership to ensure competitive recruitment strategies. - Academic & Fellowship Outreach – Engage with cardiology fellows and medical students through educational programs, on-site presentations, and networking efforts to cultivate a pipeline of future candidates. - Physician & APP Retention – Serve as a liaison between providers and leadership, addressing concerns and ensuring high retention rates by fostering a supportive work environment. - Staffing Strategy & Planning – Develop and update provider staffing plans to meet both immediate and future needs across our growing cardiology footprint. - Credentialing & Compliance Support – Coordinate with internal departments (Credentialing, Legal, HR, and Finance) to facilitate a seamless onboarding experience for new hires. - Interview Coordination – Arrange and participate in interviews, ensuring an efficient and positive candidate experience. Qualifications - Experience in Physician and APP recruitment, ideally in a specialty setting such as cardiology or other hospital-based practices. - Strong ability to build relationships, negotiate contracts, and assess candidate fit within a growing healthcare organization. - Knowledge of compensation structures, industry trends, and compliance requirements for medical providers. - Exceptional communication and networking skills to engage top cardiology talent. - Ability to strategically plan for current and future recruitment needs in alignment with organizational growth. Company Description

Job DetailsJob Location: HeartPlace PLLC - Dallas, TX 75248Position Type: Full TimeEducation Level: High School Diploma/GEDTravel Percentage: NoneJob Category: Other PositionsUS Heart and Vascular is in need of a Remote Medical Front Office Specialist to join our team at HeartPlace clinics in the DFW area. Responsibilities: Registers all new patients at time of check-in and enters data in computer system. Ensures all established patients have updated and accurate demographic information. Requests co-pays, patient balances and coinsurance from patients at time of arrival. Provide support for all in-coming calls to the clinic. Communicates the arrival of patients to the clinical area. Successfully completes the pre-certification/pre-authorizations process prior to the patient arrival. Prepares charts/paperwork for next day’s patients. Supports the check-out process of the clinic. Calculates and totals charge amount; collects co-pays and deductibles, informs patient of the charge for services. Supports the scheduling process of the clinic. Performs all other duties as required. Required to move between locations as needed. Requirements: 1 year of medical front desk and customer service experience is required Medical assistant experience preferred but not required 6 months of EMR experience is required. ECW or Athena preferred. 6 months of obtaining prior authorization experience is required About Dallas/Fort Worth, TX: Dallas/Fort Worth, known as the Metroplex, offers a vibrant urban life and peaceful suburban living, making it an enticing place to reside. Spanning across ten major cities and thirteen counties, it stands as the largest metroplex in the south. With its extensive range of recreational parks, renowned dining scene, five professional sports teams to root for, and two bustling airports facilitating over 2,000 daily flights, Dallas/Fort Worth provides residents with a multitude of reasons to consider it an excellent place to call home. . Qualifications

Job DetailsJob Location: USHV - Corporate Main - Franklin, TN 37067Position Type: Full TimeEducation Level: Bachelors DegreeTravel Percentage: Up to 10%Job Category: Other Positions US Heart and Vascular is looking for a Remote Benefits and Compensation Manager to join our team. Position Summary The Manager, Benefits & Compensation is responsible for the administration, governance, and continuous improvement of the organization's compensation and benefits programs across a growing, multi‑state healthcare MSO. Reporting to the VP, HR Systems & Processes, this role partners closely with HR Business Partners, Finance, and operational leaders to ensure total rewards programs are competitive, compliant, cost‑effective, and scalable. This role is both hands‑on and analytical, with accountability for program execution, vendor management, data integrity, and complex case oversight, while contributing recommendations and analysis to broader total rewards strategy. Responsibilities & Duties Benefits Administration Manages the administration of associate benefit programs, including medical, dental, vision, life and disability insurance, retirement plans, paid time off, and voluntary benefits. Partners with benefits brokers, carriers, and third‑party administrators to ensure effective service delivery, issue resolution, and regulatory compliance. Supports annual benefits renewals by preparing utilization analysis, benchmarking, cost modeling, and recommendation materials. Leads operational execution of annual open enrollment, including systems configuration, vendor coordination, and associate communications. Ensures benefit programs comply with all applicable federal, state, and local regulations, including ACA and ERISA requirements. Prepares, reviews, and submits required benefits‑related filings and reports in coordination with internal and external partners. Maintains accurate benefits records and ensures data integrity within HR systems. Leave and Absence and Workplace Accommodations Provides oversight and governance for leave of absence and workplace accommodation programs to ensure consistent, compliant application across the organization. Serves as the primary escalation point for complex, sensitive, or high-risk leave, ADA, and return-to-work cases. Partners with the Benefits Administrator, HR Business Partners, managers, and third-party administrators to support timely and accurate handling of leave and accommodation requests.​​​​​​ Provides guidance on the interactive process for employee accommodations in compliance with the Americans with Disabilities Act (ADA) and applicable state and federal regulations Provides backup support for leave administration as needed to ensure continuity during peak periods or coverage gaps. Monitors regulatory changes related to leave and accommodation and recommend policy or process updates as appropriate. Compensation Administration Administers and supports the organization's compensation programs in alignment with established compensation philosophy, policies, and governance. Conducts market pricing and benchmarking using external survey data to support competitiveness and internal equity. Partners with HR and Finance to support annual merit, incentive, and budget planning cycles. Produces regular compensation reports and ad hoc analyses for HR leadership and business stakeholders. Ensures compensation programs and practices comply with FLSA, state wage and hour laws, and healthcare-specific compensation considerations. Maintains a safe workplace by following established safety protocols, reporting hazards, and participating in required safety training. When position requires travel to/from other locations, ensures vehicles are operated and maintained in compliance with all safety, regulatory, and company requirements. Fosters a team-oriented environment by encouraging cooperation, providing support, and resolving conflicts constructively. Demonstrates integrity, professionalism, and respect in all interactions. Follows processes and policies for the organization. Reports to work as scheduled, ready to perform duties, and promptly notifies their supervisor of any attendance issues Adapts to changing priorities, processes, and business needs. Performs other duties as assigned. Knowledge, Skills and Abilities Required Knowledge of employee benefits administration, including health and welfare plans, retirement programs, and paid time off policies. Knowledge of federal, state, and local laws and regulations impacting benefits, compensation, leave of absence, and workplace accommodations, including ACA, ERISA, ADA, FMLA, FLSA, and applicable state requirements. Knowledge of compensation fundamentals, including job architecture, market pricing, internal equity, and incentive program administration. Knowledge of healthcare or multi-state employment environments and the regulatory considerations that accompany them. Skill in analyzing benefits utilization, costs, and trends to support renewals, vendor evaluations, and program improvements. Skill in preparing compensation analyses related to hiring, promotions, equity assessments, and annual pay programs. Skill in managing vendor relationships, including brokers, carriers, and third-party administrators. Skill in developing clear, effective employee communications related to benefits, compensation, leave, and accommodations. Skill in using HRIS and related systems to manage benefits and compensation data accurately and efficiently. Ability to apply policies and programs consistently while exercising sound judgment in complex or sensitive situations. Ability to interpret regulations and translate requirements into compliant, practical processes. Ability to manage multiple priorities and deadlines in a fast-paced, high-growth environment. Ability to partner effectively with HR Business Partners, Finance, system owners, and operational leaders. Ability to maintain confidentiality and handle sensitive information with discretion and professionalism. Ability to communicate complex compensation and benefits concepts clearly to employees, managers, and leadership. Ability to identify process improvements that enhance compliance, scalability, and operational efficiency. Knowledge of federal, state, and local laws, statutes, regulations, codes, and standards related to the area of responsibility. Knowledge of the principles, concepts, and theories relevant to the assigned functional area. Skill in completing assignments accurately and with attention to detail. Ability to communicate clearly and concisely both orally and in writing in English, to various audiences. Ability to manage time, organize work, set priorities, meet deadlines, and follow up on work assignments with minimal supervision. Ability to work independently, and as a team, to complete daily activities according to the work schedule. Working knowledge of Office 365 programs such as Excel, Outlook, Word, PowerPoint, etc. Supports the Mission, Vision and Values of USHV and the practices. Minimum Qualifications Bachelor's degree in human resources, Business Administration, or a related field Five (5) years of progressively responsible experience in benefits administration, compensation, or total rewards. Experience supporting multi-state employee populations. Current valid state driver's license and required minimum auto insurance coverage. Preferred Qualifications Healthcare, MSO, or professional services experience. Experience in a private equity-backed or high-growth organization. Exposure to acquisition integration activities. Experience working with HRIS compensation and benefits modules. Qualifications

Job DetailsJob Location: Remote, LA - Franklin, TN 37067Position Type: Full TimeEducation Level: High School Diploma/GEDJob Category: Other PositionsUS Heart and Vascular is in need of a Remote Cardiology Prior Authorizations Specialist. If you have a passion for obtaining prior authorizations for Veins, Structural Heart and CT Studies, please join our US Heart and Vascular team Responsibilities: • Ensures timely and accurate insurance authorizations are in place prior to services being rendered. • Verifies insurance eligibility and benefit levels to ensure adequate coverage for identified services prior to receipt. • Responsible for verification and investigation of pre-certification, authorization, and referral requirements for services. • Coordinates and supplies information to the review organization (payer) including medical record information and/or letter of medical necessity for determination of benefits. • Collaborates with designated clinical contacts regarding encounters that require escalation to peer-to-peer review. • Communicates with patients, clinical partners, financial counselors, and others as necessary to facilitate the authorization process. • Appropriately prioritizes workload to ensure the most urgent cases are handled in a timely manner. • Completes accurate documentation in all applications. • Follows departmental policies and procedures, when necessary, authorization is not obtained before the service date. • Answers provider, staff, and patient questions surrounding insurance authorization requirements. • Handles escalated authorization requests as needed. • Provides team mentorship as needed. • Works other departmental tasks as needed. Requirements: • Familiarity with medical office procedures and billing practices • Proficient in clinical documentation review for alignment with insurance authorization requirements • Responsible for compliance with all regulatory requirements and/or guidelines. These requirements/guidelines include, but are not limited to: OSHA, HIPAA, Federal Fraud and Abuse laws. • High School Diploma or equivalent required • Associate’s degree in healthcare administration or business administration preferred • A minimum of 3-5 years' experience in the same role, or related field in a healthcare setting is required. • ECW experience is preferred. Qualifications

Job DetailsJob Location: USHV - Corporate Main - Franklin, TN 37067Position Type: Full TimeEducation Level: High School Diploma/GEDTravel Percentage: NoneJob Shift: DayJob Category: Other PositionsUS Heart and Vascular is in need of a Remote Provider Enrollment & Credentialing Specialist to join our team Position Summary Be the first point of contact to staff; resolve enrollment & credentialing issues by answering questions, making recommendations for resolution and escalation, checking enrollment status, verifying payer enrollment requirements and system implementation, appropriately follow-up on Provider Issue Forms; facilitates group and individual enrollment with commercial and government payers. Responsibilities: Resolves issues and concerns by correctly answering questions from staff and providing appropriate follow-up on issues, escalating to Team Manager, when appropriate Provides the team with coaching, training, and auditing on assigned tasks. Partner with Team Manager to evaluate team’s performance to improve overall production and facilitate continuous improvement. Assists Team Manager in monitoring inventory and production and facilitates the escalation process as needed. Become proficient in discussions with payors to facilitate closure of any identified issues. Research and review individual Provider Issue Forms for appropriate follow-up and resolution. Maintain Matrices - payer enrollment, matrix, SOPs, new site sheets, email templates, welcome letters, etc. Create and distribute reports containing provider credentialing and enrollment data for various departments within the organization. Research new state enrollment requirements for group and individual provider enrollment. Assists Contract Implementation staff with accurately documenting enrollment and billing requirements for payer contracts. Maintain and complete new entries in Veritystream. Facilitate completion and submission of payer enrollment applications for government and commercial payers. Monitor application status process to identify emerging issues and communicate them to Team Manager. Monitor enrollment status for groups and individuals. Monitor license and credential expiration dates and advise staff members of required “renew” by dates. Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases. Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications. Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance Complete revalidation requests issued by government payers. Credential new providers and re-credential current providers with hospitals at which they hold staff privileges. Work closely with the Director of Revenue Cycle and billing staff to identify and resolve any denials or authorization issues related to enrollment & credentialing. Performs and assists with other department duties as required. Knowledge, Skills and Abilities Required: Meticulous follow-through of delegated tasks, including follow-up with staff to ensure completion, quality, and meeting deadlines. Ability to exhibit leadership by demonstrating commitment to team development, adapting to change in a positive manner, and supporting alignment with organizational goals including continuous improvement efforts. Ability to pay close attention to detail and produce extremely accurate work. Strong analytical and problem-solving skills. Ability to organize and prioritize job tasks and requirements. Excellent organizational skills with the ability to prioritize assigned duties in an efficient amount of time. Ability to effectively perform in a multi-task work environment. Strong communication and interpersonal skills. Ability to effectively use oral and written communication skills with clinicians, external agencies and management in a courteous and professional manner. Must have knowledge of correct English, proper grammar and spelling. Knowledge and skills in using personal computers (Windows) with a strong emphasis on Microsoft Office Programs- Outlook, Word, Excel and Adobe Acrobat Education & Experience: High school diploma or equivalent Two (2) years office experience or college course work preferred. Knowledge of health plan billing and enrollment preferred. PECOS and CAQH experience preferred. Veritystream experience a plus. Qualifications