Compliance For Coding Billing Reimbursement 2nd Edition

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Compliance for Coding, Billing & Reimbursement, 2nd Edition

Author : Duane C. Abbey
Publisher : CRC Press
ISBN 13 : 1563273683
Total Pages : 232 pages
Book Rating : 4.5/5 (632 download)

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Book Synopsis Compliance for Coding, Billing & Reimbursement, 2nd Edition by : Duane C. Abbey

Download or read book Compliance for Coding, Billing & Reimbursement, 2nd Edition written by Duane C. Abbey and published by CRC Press. This book was released on 2008-04-02 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: While the vast majority of providers never intend to commit fraud or file false claims, complex procedures, changing regulations, and evolving technology make it nearly impossible to avoid billing errors. For example, if you play by HIPAA’s rules, a physician is a provider; however, Medicare requires that the same physician must be referred to as a supplier. Even more troubling is the need to alter claims to meet specific requirements that may conflict with national standards. Far from being a benign issue, differing guidelines can lead to false claims with financial and even criminal implications. Compliance for Coding, Billing & Reimbursement, Second Edition: A Systematic Approach to Developing a Comprehensive Program provides an organized way to deal with the complex coding, billing, and reimbursement (CBR) processes that seem to force providers to choose between being paid and being compliant. Fully revised to account for recent changes and evolving terminology, this unique and accessible resource covers statutorily based programs and contract-based relationships, as well as ways to efficiently handle those situations that do not involve formal relationships. Based on 25 years of direct client consultation and drawing on teaching techniques developed in highly successful workshops, Duane Abbey offers a logical approach to CBR compliance. Designed to facilitate efficient reimbursements that don’t run afoul of laws and regulations, this resource – Addresses the seven key elements promulgated by the OIG for any compliance program Discusses numerous types of compliance issues for all type of healthcare providers Offers access to online resources that provide continually updated information Cuts through the morass of terminology and acronyms with a comprehensive glossary Includes a CD-ROM packed with regulations and information In addition to offering salient information illustrated by case studies, Dr, Abbey provides healthcare providers and administrators, as well as consultants and attorneys, with the mindset and attitude required to meet this very real challenge with savvy, humor, and perseverance.

Compliance for Coding, Billing & Reimbursement

Author : Duane C. Abbey
Publisher : McGraw-Hill Companies
ISBN 13 : 9780071353489
Total Pages : 261 pages
Book Rating : 4.3/5 (534 download)

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Book Synopsis Compliance for Coding, Billing & Reimbursement by : Duane C. Abbey

Download or read book Compliance for Coding, Billing & Reimbursement written by Duane C. Abbey and published by McGraw-Hill Companies. This book was released on 1999 with total page 261 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare providers have to cut through more red tape than ever to get paid for their services. What's more, a mountain of mandates from federal and state government is pressuring providers to be more astute about laws regarding taxes, health and safety, labor issues, antitrust, patient confidentiality and financial compliance.Compliance for Coding, Billing & Reimbursement gives readers the guidelines for the four factors that influence the compliance coding, billing and reimbursement process and how to follow the trends in these areas. The book also analyzes the status of different payment methodologies being used today and advises providers on how to adjust to the transition from a cost-based system to prospective payment and capitation.Compliance for Coding, Billing & Reimbursement also defines the confusing terminology used in the complex web of policies and procedures. By referring to the comprehensive glossary and acronym listing, readers have instant explanations at their fingertips. Topics addressed include: -- How to structure a CBR compliance program -- How to spot CBR problem/opportunity areas -- Investigation and problem solving -- Developing CBR policies and procedures -- Effective training programs and how to implement change -- Monitoring and corrective action -- How to conduct a baseline audit -- Integrating a CBR compliance plan in with a corporate compliance plan -- Appendices containing important internet addresses, synopses of healthcare fraud laws and compliance case studies

Correct Coding for Medicare, Compliance, and Reimbursement

Author : Belinda S. Frisch
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (139 download)

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Book Synopsis Correct Coding for Medicare, Compliance, and Reimbursement by : Belinda S. Frisch

Download or read book Correct Coding for Medicare, Compliance, and Reimbursement written by Belinda S. Frisch and published by . This book was released on 2007 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Health Care Finance and the Mechanics of Insurance and Reimbursement

Author : Michael K. Harrington
Publisher : Jones & Bartlett Learning
ISBN 13 : 1284169030
Total Pages : 344 pages
Book Rating : 4.2/5 (841 download)

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Book Synopsis Health Care Finance and the Mechanics of Insurance and Reimbursement by : Michael K. Harrington

Download or read book Health Care Finance and the Mechanics of Insurance and Reimbursement written by Michael K. Harrington and published by Jones & Bartlett Learning. This book was released on 2019-10-01 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Care Finance and the Mechanics of Insurance and Reimbursement stands apart from other texts on health care finance or health insurance, in that it combines financial principles unique to the health care setting with the methods and process for reimbursement (including coding, reimbursement strategies, compliance, financial reporting, case mix index, and external auditing). It explains the revenue cycle in detail, correlating it with regular management functions; and covers reimbursement from the initial point of care through claim submission and reconciliation. Thoroughly updated for its second edition, this text reflects changes to the Affordable Care Act, Managed Care Organizations, new coding initiatives, new components of the revenue cycle (from reimbursement to compliance), updates to regulations surrounding health care fraud and abuse, changes to the Recovery Audit Contractors (RAC) program, and more.

Understanding Hospital Coding and Billing: A Worktext

Author : Marsha S Diamond
Publisher : Cengage Learning
ISBN 13 : 9781111138158
Total Pages : 576 pages
Book Rating : 4.1/5 (381 download)

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Book Synopsis Understanding Hospital Coding and Billing: A Worktext by : Marsha S Diamond

Download or read book Understanding Hospital Coding and Billing: A Worktext written by Marsha S Diamond and published by Cengage Learning. This book was released on 2014-08-05 with total page 576 pages. Available in PDF, EPUB and Kindle. Book excerpt: Understanding Hospital Coding and Billing: A Worktext, Second Edition, is your complete guide to the world of hospital billing from patient intake through the entire billing process, covering inpatient and outpatient coding and billing. This resource presents concepts in an outline format, with room in the margins to take notes, and practice exercises and case studies to test your knowledge. An appendix of inpatient and outpatient case scenarios is available for use with SimClaim UB-04 practice software for electronic claims completion. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.

Chargemasters

Author : Duane C. Abbey
Publisher : HC Pro, Inc.
ISBN 13 : 9781578396306
Total Pages : 282 pages
Book Rating : 4.3/5 (963 download)

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Book Synopsis Chargemasters by : Duane C. Abbey

Download or read book Chargemasters written by Duane C. Abbey and published by HC Pro, Inc.. This book was released on 2005 with total page 282 pages. Available in PDF, EPUB and Kindle. Book excerpt:

CodeBusters

Author : Patricia T. Aalseth
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834213173
Total Pages : 60 pages
Book Rating : 4.2/5 (131 download)

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Book Synopsis CodeBusters by : Patricia T. Aalseth

Download or read book CodeBusters written by Patricia T. Aalseth and published by Jones & Bartlett Learning. This book was released on 1998-12 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicine

Provider-based Entities

Author : Gina M. Reese
Publisher : Hcpro, a Division of Simplify Compliance
ISBN 13 : 9781683081906
Total Pages : 0 pages
Book Rating : 4.0/5 (819 download)

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Book Synopsis Provider-based Entities by : Gina M. Reese

Download or read book Provider-based Entities written by Gina M. Reese and published by Hcpro, a Division of Simplify Compliance. This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book serves as a comprehensive guide to provider-based clinics, from qualifying under CMS, to unique billing and coding rules, and the business decisions behind owning or acquiring these clinics. It will help readers sort through the complex regulations relevant to this unique provider type, and provide insight into recent changes, such as the introduction of Modifier -PO. CMS is looking to implement the Section 603 provisions of the Bipartisan Budget Act of 2015 regarding off-campus, provider-based departments (PBD) by January 1, 2017, according to the 2017 OPPS proposed rule. The agency is proposing to pay the nonfacility or office Medicare Physician Fee Schedule (MPFS) amount to the performing/supervising physician and preclude hospitals from billing on a UB-04 form or receiving OPPS payment for services performed at these locations for 2017, but plans to explore other options for 2018 and beyond. Physicians would be paid at the higher nonfacility rate of the MPFS, but only hospitals that have employed or contracted physicians that reassign their billing to the hospital would get paid under the MPFS for these services. Hospitals would be able to bill claims on CMS-1500 forms for physicians who have already reassigned their billing to the hospital, as in the case of employed physicians. Otherwise, hospitals would have the option of enrolling the location as the type of provider or supplier it wishes to bill to meet the requirements of that payment system (e.g., ambulatory surgery center or group practice).

Emergency Department Coding and Billing

Author : Duane C. Abbey
Publisher : HC Pro, Inc.
ISBN 13 : 9781578395750
Total Pages : 238 pages
Book Rating : 4.3/5 (957 download)

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Book Synopsis Emergency Department Coding and Billing by : Duane C. Abbey

Download or read book Emergency Department Coding and Billing written by Duane C. Abbey and published by HC Pro, Inc.. This book was released on 2005 with total page 238 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Comprehensive Health Insurance + MyHealthProfessionsLab Access Code

Author : Deborah Vines Allen
Publisher : Prentice Hall
ISBN 13 : 9780133141320
Total Pages : 984 pages
Book Rating : 4.1/5 (413 download)

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Book Synopsis Comprehensive Health Insurance + MyHealthProfessionsLab Access Code by : Deborah Vines Allen

Download or read book Comprehensive Health Insurance + MyHealthProfessionsLab Access Code written by Deborah Vines Allen and published by Prentice Hall. This book was released on 2012-08-15 with total page 984 pages. Available in PDF, EPUB and Kindle. Book excerpt: COMPREHENSIVE HEALTH INSURANCE: BILLING, CODING & REIMBURSEMENT, 2/e provides students with the knowledge and skills needed to work in a variety of medical billing and coding positions in the medical field. Comprehensive in approach, it covers the foundations of insurance, billing, coding and reimbursement. Students learn not only the submission of claims to the insurance carrier, but also reviewing medical records, verifying patient benefits, submitting a secondary claim, posting payments and appealing the insurance carrier's decision. This edition includes new chapters devoted to HIPAA and ICD-10-CM Medical Coding, as well as outstanding coverage of electronic records. Numerous case studies and patient files are included throughout and demonstrate refunds and appeals, auditing and compliance, Medicare calculations and professionalism. 0133141322 / 9780133141320 Comprehensive Health Insurance: Billing, Coding & Reimbursement Plus NEW MyHealthProfessionsLab with Pearson eText Package consists of 0132966891 / 9780132966894 Comprehensive Health Insurance: Billing, Coding & 013297410X / 9780132974103 NEW MyHealthProfessionsLab with Pearson eText -- Access Card -- for Comprehensive Health Insurance: Billing, Coding, and

Lab Billing and Coding

Author : Dawn Runge
Publisher : HC Pro, Inc.
ISBN 13 : 9781578396764
Total Pages : 242 pages
Book Rating : 4.3/5 (967 download)

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Book Synopsis Lab Billing and Coding by : Dawn Runge

Download or read book Lab Billing and Coding written by Dawn Runge and published by HC Pro, Inc.. This book was released on 2005 with total page 242 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Medical Billing and Coding For Dummies

Author : Karen Smiley
Publisher : John Wiley & Sons
ISBN 13 : 1118982541
Total Pages : 368 pages
Book Rating : 4.1/5 (189 download)

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Book Synopsis Medical Billing and Coding For Dummies by : Karen Smiley

Download or read book Medical Billing and Coding For Dummies written by Karen Smiley and published by John Wiley & Sons. This book was released on 2015-04-27 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: Your complete guide to a career in medical billing and coding, updated with the latest changes in the ICD-10 and PPS This fully updated second edition of Medical Billing & Coding For Dummies provides readers with a complete overview of what to expect and how to succeed in a career in medical billing and coding. With healthcare providers moving more rapidly to electronic record systems, data accuracy and efficient data processing is more important than ever. Medical Billing & Coding For Dummies gives you everything you need to know to get started in medical billing and coding. This updated resource includes details on the most current industry changes in ICD-10 (10th revision of the International Statistical Classification of Diseases and Related Health Problems) and PPS (Prospective Payment Systems), expanded coverage on the differences between EHRs and MHRs, the latest certification requirements and standard industry practices, and updated tips and advice for dealing with government agencies and insurance companies. Prepare for a successful career in medical billing and coding Get the latest updates on changes in the ICD-10 and PPS Understand how the industry is changing and learn how to stay ahead of the curve Learn about flexible employment options in this rapidly growing industry Medical Billing & Coding For Dummies, 2nd Edition provides aspiring professionals with detailed information and advice on what to expect in a billing and coding career, ways to find a training program, certification options, and ways to stay competitive in the field.

Medical Billing & Coding For Dummies

Author : Karen Smiley
Publisher : John Wiley & Sons
ISBN 13 : 1119625440
Total Pages : 355 pages
Book Rating : 4.1/5 (196 download)

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Book Synopsis Medical Billing & Coding For Dummies by : Karen Smiley

Download or read book Medical Billing & Coding For Dummies written by Karen Smiley and published by John Wiley & Sons. This book was released on 2019-12-05 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: The definitive guide to starting a successful career in medical billing and coding With the healthcare sector growing at breakneck speed—it’s currently the largest employment sector in the U.S. and expanding fast—medical billing and coding specialists are more essential than ever. These critical experts, also known as medical records and health information technicians, keep systems working smoothly by ensuring patient billing and insurance data are accurately and efficiently administered. This updated edition provides everything you need to begin—and then excel in—your chosen career. From finding the right study course and the latest certification requirements to industry standard practices and insider tips for dealing with government agencies and insurance companies, Medical Billing & Coding For Dummies has you completely covered. Find out about the flexible employment options available and how to qualify Understand the latest updates to the ICD-10 Get familiar with ethical and legal issues Discover ways to stay competitive and get ahead The prognosis is good—get this book today and set yourself up with the perfect prescription for a bright, secure, and financially healthy future!

Medical Coding for Non-coders

Author : Karen S. Scott
Publisher : Amer Health Information Management
ISBN 13 : 9781584261858
Total Pages : 173 pages
Book Rating : 4.2/5 (618 download)

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Book Synopsis Medical Coding for Non-coders by : Karen S. Scott

Download or read book Medical Coding for Non-coders written by Karen S. Scott and published by Amer Health Information Management. This book was released on 2008-01-01 with total page 173 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Medical Billing & Coding Demystified, 2nd Edition

Author : Marilyn Burgos
Publisher : McGraw Hill Professional
ISBN 13 : 0071849335
Total Pages : 286 pages
Book Rating : 4.0/5 (718 download)

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Book Synopsis Medical Billing & Coding Demystified, 2nd Edition by : Marilyn Burgos

Download or read book Medical Billing & Coding Demystified, 2nd Edition written by Marilyn Burgos and published by McGraw Hill Professional. This book was released on 2015-11-22 with total page 286 pages. Available in PDF, EPUB and Kindle. Book excerpt: Completely updated to reflect the massive changes to healthcare law! Medical Billing and Coding Demystified clearly explains the practices used by medical offices, hospitals, and healthcare facilities to encode medical services in order to receive payment from government agencies and insurance companies. Like other entries in this bestselling series, this self-teaching guide uses a building-block approach that allows readers to learn at their own pace and test themselves along the way. No previous medical or accounting training or experience is necessary to benefit from Medical Billing and Coding Demystified, and the book can be used as a classroom textbook or as a complement to larger texts. This new edition offers detailed coverage of the sweeping revisions that have taken place in healthcare law, including the transition from ICD9 to ICD10 coding and the Patient Protection and Affordable Healthcare Acts. It also includes an important overview of medical billing software. Includes valuable learning aids such as end-of-chapter quizzes, a final exam, and key points Different from similar books on the market in that it explains basic medical concepts enabling the reader to actually understand the procedures and tests they are billing and coding for

Understanding Health Insurance: A Guide to Billing and Reimbursement - 2020

Author : Michelle Green
Publisher : Cengage Learning
ISBN 13 : 9780357378649
Total Pages : 688 pages
Book Rating : 4.3/5 (786 download)

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Book Synopsis Understanding Health Insurance: A Guide to Billing and Reimbursement - 2020 by : Michelle Green

Download or read book Understanding Health Insurance: A Guide to Billing and Reimbursement - 2020 written by Michelle Green and published by Cengage Learning. This book was released on 2020-01-02 with total page 688 pages. Available in PDF, EPUB and Kindle. Book excerpt: Prepare for a successful career in medical billing and insurance processing or revenue management with the help of Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2020 Edition. This comprehensive, inviting book presents the latest medical code sets and coding guidelines as you learn to complete health plan claims and master revenue management concepts. This edition focuses on today’s most important topics, including managed care, legal and regulatory issues, coding systems and compliance, reimbursement methods, clinical documentation improvement, coding for medical necessity, and common health insurance plans. Updates introduce new legislation that impacts health care. You also examine the impact on ICD-10-CM, CPT, and HCPCS level II coding; revenue cycle management; and individual health plans. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.

Comprehensive Health Insurance

Author : Deborah Vines
Publisher : Pearson
ISBN 13 : 9780132966894
Total Pages : 0 pages
Book Rating : 4.9/5 (668 download)

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Book Synopsis Comprehensive Health Insurance by : Deborah Vines

Download or read book Comprehensive Health Insurance written by Deborah Vines and published by Pearson. This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: For courses in Introduction to Healthcare Billing and Medical Coding. COMPREHENSIVE HEALTH INSURANCE: BILLING, CODING & REIMBURSEMENT, 2/e provides students with the knowledge and skills needed to work in a variety of medical billing and coding positions in the medical field. Comprehensive in approach, it covers the foundations of insurance, billing, coding and reimbursement. Students learn not only the submission of claims to the insurance carrier, but also reviewing medical records, verifying patient benefits, submitting a secondary claim, posting payments and appealing the insurance carrier's decision. This edition includes new chapters devoted to HIPAA and ICD-10-CM Medical Coding, as well as outstanding coverage of electronic records. Numerous case studies and patient files are included throughout and demonstrate refunds and appeals, auditing and compliance, Medicare calculations and professionalism.