Principles Of Healthcare Reimbursement

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Hospital Reimbursement

Author : Kyle Herbert
Publisher : CRC Press
ISBN 13 : 1439898944
Total Pages : 275 pages
Book Rating : 4.4/5 (398 download)

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Book Synopsis Hospital Reimbursement by : Kyle Herbert

Download or read book Hospital Reimbursement written by Kyle Herbert and published by CRC Press. This book was released on 2012-06-05 with total page 275 pages. Available in PDF, EPUB and Kindle. Book excerpt: Due to the countless variables that affect revenue and cost, the hospital reimbursement process is by far the most complex of any industry. Requiring only a basic financial background and a working knowledge of accounting, Hospital Reimbursement: Concepts and Principles supplies a clear understanding of the concepts and principles that drive the revenue cycle within a hospital setting. The book explains the technical aspects of reimbursement in language that is easy to comprehend. It illustrates the complexities of the hospital revenue cycle and explains the Medicare and Medicaid financial models in detail. The text also addresses the Medicaid reimbursement methodology, the formulation of the Medicare blend rate, the computation of both DSH and IME, as well as other third-party payers. It also: Covers the full range of services and procedures for which a hospital can receive reimbursement Explains the difference between a for-profit and not-for-profit hospital Contains chapters devoted to Statements of Operations (Income Statement) and Statements of Financial Position (Balance Sheet) Examines governmental cost reporting—including Worksheets A, A-6, A-8, A-8-2, B-1, B Part 1, C Part 1, D-3, D-5, and E Part A Supplying readers with a foundation in coding principles, the text also includes a model for calculating the financial impact of variations in patient length of stay. It discusses the DRG and APC reimbursement models and details the computation of an outlier payment. In addition, it walks the reader step-by-step through the creation of a mock Medicare cost report for a sample hospital.

Principles of Healthcare Reimbursement and Revenue Cycle Management, Eighth Edition

Author : Anne Casto
Publisher :
ISBN 13 : 9781584269151
Total Pages : 0 pages
Book Rating : 4.2/5 (691 download)

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Book Synopsis Principles of Healthcare Reimbursement and Revenue Cycle Management, Eighth Edition by : Anne Casto

Download or read book Principles of Healthcare Reimbursement and Revenue Cycle Management, Eighth Edition written by Anne Casto and published by . This book was released on 2023-10-02 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.

Principles of Healthcare Reimbursement

Author : Anne B. Casto
Publisher : Ahima
ISBN 13 : 9781584266464
Total Pages : 364 pages
Book Rating : 4.2/5 (664 download)

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Book Synopsis Principles of Healthcare Reimbursement by : Anne B. Casto

Download or read book Principles of Healthcare Reimbursement written by Anne B. Casto and published by Ahima. This book was released on 2018-08 with total page 364 pages. Available in PDF, EPUB and Kindle. Book excerpt: The sixth edition of Principles of Healthcare Reimbursement gives educators, students, and healthcare professionals comprehensive, up-to-date information on healthcare reimbursement systems, and the impact each system has on the entire US healthcare delivery system and economy, in one trusted source. In addition to describing healthcare reimbursement methodologies and systems, this text discusses the impact of health insurance, coding and billing compliance and value-based purchasing initiatives. New and future healthcare professionals desiring to work in healthcare finance, revenue cycle, compliance and coding will gain the knowledge and training they need to succeed. Key Features include: New 4-color interior design! -- Covers accessing and using fee schedules, payment classification groups, exclusion lists, market baskets, and wage indexes required for accurate reimbursement -- Explains the various methods, plans, and programs that typify government-sponsored payment systems, commercial insurance, and managed-care -- Describes various types of healthcare cost-sharing and their effects on providers and consumers -- Illustrates specialized data collection instruments and electronic submission software used in postacute care -- Provided by publisher.

The Future of Nursing 2020-2030

Author : National Academies of Sciences Engineering and Medicine
Publisher :
ISBN 13 : 9780309685061
Total Pages : pages
Book Rating : 4.6/5 (85 download)

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Book Synopsis The Future of Nursing 2020-2030 by : National Academies of Sciences Engineering and Medicine

Download or read book The Future of Nursing 2020-2030 written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2021-09-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.

China's Healthcare System and Reform

Author : Lawton Robert Burns
Publisher : Cambridge University Press
ISBN 13 : 1316738396
Total Pages : 744 pages
Book Rating : 4.3/5 (167 download)

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Book Synopsis China's Healthcare System and Reform by : Lawton Robert Burns

Download or read book China's Healthcare System and Reform written by Lawton Robert Burns and published by Cambridge University Press. This book was released on 2017-01-26 with total page 744 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume provides a comprehensive review of China's healthcare system and policy reforms in the context of the global economy. Following a value-chain framework, the 16 chapters cover the payers, the providers, and the producers (manufacturers) in China's system. It also provides a detailed analysis of the historical development of China's healthcare system, the current state of its broad reforms, and the uneasy balance between China's market-driven approach and governmental regulation. Most importantly, it devotes considerable attention to the major problems confronting China, including chronic illness, public health, and long-term care and economic security for the elderly. Burns and Liu have assembled the latest research from leading health economists and political scientists, as well as senior public health officials and corporate executives, making this book an essential read for industry professionals, policymakers, researchers, and students studying comparative health systems across the world.

Health Economics from Theory to Practice

Author : Simon Eckermann
Publisher : Springer
ISBN 13 : 3319506137
Total Pages : 339 pages
Book Rating : 4.3/5 (195 download)

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Book Synopsis Health Economics from Theory to Practice by : Simon Eckermann

Download or read book Health Economics from Theory to Practice written by Simon Eckermann and published by Springer. This book was released on 2017-03-20 with total page 339 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a robust set of health economic principles and methods to inform societal decisions in relation to research, reimbursement and regulation (pricing and monitoring of performance in practice). We provide a theoretical and practical framework that navigates to avoid common biases and suboptimal outcomes observed in recent and current practice of health economic analysis, as opposed to claiming to be comprehensive in covering all methods. Our aim is to facilitate efficient health system decision making processes in research, reimbursement and regulation, which promote constrained optimisation of community outcomes from a societal perspective given resource constraints, available technology and processes of technology assessment. Importantly, this includes identifying an efficient process to maximize the potential that arises from research and pricing in relation to existing technology under uncertainty, given current evidence and associated opportunity costs of investment. Principles and methods are identified and illustrated across health promotion, prevention and palliative care settings as well as treatment settings. Health policy implications are also highlighted.

Evidence-Based Medicine and the Changing Nature of Health Care

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309113695
Total Pages : 202 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Evidence-Based Medicine and the Changing Nature of Health Care by : Institute of Medicine

Download or read book Evidence-Based Medicine and the Changing Nature of Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2008-09-06 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

The Future of the Public's Health in the 21st Century

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309133181
Total Pages : 536 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Future of the Public's Health in the 21st Century by : Institute of Medicine

Download or read book The Future of the Public's Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

Crossing the Quality Chasm

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309132967
Total Pages : 359 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Crossing the Quality Chasm by : Institute of Medicine

Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Redefining Health Care

Author : Michael E. Porter
Publisher : Harvard Business Press
ISBN 13 : 1422133362
Total Pages : 540 pages
Book Rating : 4.4/5 (221 download)

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Book Synopsis Redefining Health Care by : Michael E. Porter

Download or read book Redefining Health Care written by Michael E. Porter and published by Harvard Business Press. This book was released on 2006-04-24 with total page 540 pages. Available in PDF, EPUB and Kindle. Book excerpt: The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.

Revenue Cycle Management

Author : Kem Tolliver
Publisher : Medical Group Management Association/Center for Research in Ambulatory Health Care Administration
ISBN 13 : 9781568296777
Total Pages : 482 pages
Book Rating : 4.2/5 (967 download)

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Book Synopsis Revenue Cycle Management by : Kem Tolliver

Download or read book Revenue Cycle Management written by Kem Tolliver and published by Medical Group Management Association/Center for Research in Ambulatory Health Care Administration. This book was released on 2020-04-16 with total page 482 pages. Available in PDF, EPUB and Kindle. Book excerpt: It is easy to get lost in all the phases of revenue management, so how does a practice keep it all straight? Proven solutions to optimize revenue cycle are the key, and this primer is a business-critical resource to deliver just that.

Documentation for Health Records

Author : Cheryl Gregg Fahrenholz
Publisher :
ISBN 13 : 9781584262626
Total Pages : 744 pages
Book Rating : 4.2/5 (626 download)

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Book Synopsis Documentation for Health Records by : Cheryl Gregg Fahrenholz

Download or read book Documentation for Health Records written by Cheryl Gregg Fahrenholz and published by . This book was released on 2013-01-01 with total page 744 pages. Available in PDF, EPUB and Kindle. Book excerpt:

The Innovator's Prescription: A Disruptive Solution for Health Care

Author : Clayton M. Christensen
Publisher : McGraw Hill Professional
ISBN 13 : 0071592091
Total Pages : 496 pages
Book Rating : 4.0/5 (715 download)

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Book Synopsis The Innovator's Prescription: A Disruptive Solution for Health Care by : Clayton M. Christensen

Download or read book The Innovator's Prescription: A Disruptive Solution for Health Care written by Clayton M. Christensen and published by McGraw Hill Professional. This book was released on 2008-10-31 with total page 496 pages. Available in PDF, EPUB and Kindle. Book excerpt: A groundbreaking prescription for health care reform--from a legendaryleader in innovation . . . Our health care system is in critical condition. Each year, fewer Americans can afford it, fewer businesses can provide it, and fewer government programs can promise it for future generations. We need a cure, and we need it now. Harvard Business School’s Clayton M. Christensen—whose bestselling The Innovator’s Dilemma revolutionized the business world—presents The Innovator’s Prescription, a comprehensive analysis of the strategies that will improvehealth care and make it affordable. Christensen applies the principles of disruptive innovation to the broken health care system with two pioneers in the field—Dr. Jerome Grossman and Dr. Jason Hwang. Together, they examine arange of symptoms and offer proven solutions. YOU’LL DISCOVER HOW “Precision medicine” reduces costs and makes good on the promise of personalized care Disruptive business models improve quality, accessibility, and affordability by changing the way hospitals and doctors work Patient networks enable better treatment of chronic diseases Employers can change the roles they play in health care to compete effectively in the era of globalization Insurance and regulatory reforms stimulate disruption in health care

Principles and Practice of Hospital Medicine

Author : Sylvia McKean
Publisher : McGraw Hill Professional
ISBN 13 : 0071603905
Total Pages : 2351 pages
Book Rating : 4.0/5 (716 download)

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Book Synopsis Principles and Practice of Hospital Medicine by : Sylvia McKean

Download or read book Principles and Practice of Hospital Medicine written by Sylvia McKean and published by McGraw Hill Professional. This book was released on 2011-12-30 with total page 2351 pages. Available in PDF, EPUB and Kindle. Book excerpt: The definitive guide to the knowledge and skills necessary to practice Hospital Medicine Presented in full color and enhanced by more than 700 illustrations, this authoritative text provides a background in all the important clinical, organizational, and administrative areas now required for the practice of hospital medicine. The goal of the book is provide trainees, junior and senior clinicians, and other professionals with a comprehensive resource that they can use to improve care processes and performance in the hospitals that serve their communities. Each chapter opens with boxed Key Clinical Questions that are addressed in the text and hundreds of tables encapsulate important information. Case studies demonstrate how to apply the concepts covered in the text directly to the hospitalized patient. Principles and Practice of Hospital Medicine is divided into six parts: Systems of Care: Introduces key issues in Hospital Medicine, patient safety, quality improvement, leadership and practice management, professionalism and medical ethics, medical legal issues and risk management, teaching and development. Medical Consultation and Co-Management: Reviews core tenets of medical consultation, preoperative assessment and management of post-operative medical problems. Clinical Problem-Solving in Hospital Medicine: Introduces principles of evidence-based medicine, quality of evidence, interpretation of diagnostic tests, systemic reviews and meta-analysis, and knowledge translations to clinical practice. Approach to the Patient at the Bedside: Details the diagnosis, testing, and initial management of common complaints that may either precipitate admission or arise during hospitalization. Hospitalist Skills: Covers the interpretation of common “low tech” tests that are routinely accessible on admission, how to optimize the use of radiology services, and the standardization of the execution of procedures routinely performed by some hospitalists. Clinical Conditions: Reflects the expanding scope of Hospital Medicine by including sections of Emergency Medicine, Critical Care, Geriatrics, Neurology, Palliative Care, Pregnancy, Psychiatry and Addiction, and Wartime Medicine.

The Chargemaster Essentials Toolkit

Author : Valerie A. Rinkle
Publisher : Hcpro, a Division of Simplify Compliance
ISBN 13 : 9781683080862
Total Pages : 0 pages
Book Rating : 4.0/5 (88 download)

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Book Synopsis The Chargemaster Essentials Toolkit by : Valerie A. Rinkle

Download or read book The Chargemaster Essentials Toolkit written by Valerie A. Rinkle and published by Hcpro, a Division of Simplify Compliance. This book was released on 2016-12-19 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

CPT Professional 2022

Author : American Medical Association
Publisher :
ISBN 13 : 9781640160873
Total Pages : 1200 pages
Book Rating : 4.1/5 (68 download)

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Book Synopsis CPT Professional 2022 by : American Medical Association

Download or read book CPT Professional 2022 written by American Medical Association and published by . This book was released on 2021-09-17 with total page 1200 pages. Available in PDF, EPUB and Kindle. Book excerpt: CPT(R) 2022 Professional Edition is the definitive AMA-authored resource to help healthcare professionals correctly report and bill medical procedures and services.