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Revenue Cycle Management
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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)
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.
Book Synopsis Reinventing Revenue Cycle Management by : April Wilson
Download or read book Reinventing Revenue Cycle Management written by April Wilson and published by . This book was released on 2018-06-08 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt: While the industry continues to undergo growing pains, transitioning to value-based care from fee-for-service, hospitals and providers are also fielding new challenges that have emerged on the regulatory, technology, and patient-consumer fronts. Hospitals and providers are in a race against one another to find new ways to attract and retain patients. Now that patients are assuming greater financial responsibility for their healthcare costs, whether voluntarily or involuntarily, their expectations are high about having a positive clinical and financial experience. Therefore, the engagement of patients should begin before the actual clinical encounter. The RCM departments of forward-thinking organizations recognize that an active patient engagement strategy is an effective way of influencing positive patient payment behaviors.Revenue cycle plays an intrinsic role in the overall patient experience, and there are multiple touchpoints by which to engage patients before billing them. Some examples include being transparent with patients at the outset about their financial obligations, removing barriers to payment by providing flexible options and payment tools, such as an online payment portal, and enhancing the design of billing statements. Patient engagement that prioritizes consumer satisfaction can lead to good financial outcomes for healthcare organizations.This book will help RCM professionals navigate the changing environment successfully.
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.
Book Synopsis The Business Basics of Building and Managing a Healthcare Practice by : Neil Baum
Download or read book The Business Basics of Building and Managing a Healthcare Practice written by Neil Baum and published by Springer Nature. This book was released on 2019-11-20 with total page 209 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is intended to be a roadmap towards a successful practice for medical students, residents, fellows, and doctors. This roadmap focuses on how to build and manage a medical practice, and can be applied regardless if the reader is employed, joins a small group, or if they are a doctor who decides to start their own practice. Part I covers the basic business concepts that every physician needs to know. Chapters emphasize the benefits that accrue to a physician who understands the basics of business. Part II provides a guide for doctors who are beginning a medical practice. The chapters define the various options for doctors’ employment such as solo practice, group practice, and academic medicine. The section also includes the process of negotiating contracts, identifying the advisers who help physicians become successful, and secure within their field and practice. The final part emphasizes strategies on how to build and grow a successful practice by covering topics such as hiring staff, employee motivation, creating a brand, gaining recognition, online reputation and presence, crisis management, integrating new technology, and work/life balance. The Business Basics of Building and Managing a Healthcare Practice serves as a valuable resource that helps doctors make a difference in the lives of their patients, as well as help them make good financial decisions.
Book Synopsis Theory and Practice of Business Intelligence in Healthcare by : Khuntia, Jiban
Download or read book Theory and Practice of Business Intelligence in Healthcare written by Khuntia, Jiban and published by IGI Global. This book was released on 2019-12-27 with total page 322 pages. Available in PDF, EPUB and Kindle. Book excerpt: Business intelligence supports managers in enterprises to make informed business decisions in various levels and domains such as in healthcare. These technologies can handle large structured and unstructured data (big data) in the healthcare industry. Because of the complex nature of healthcare data and the significant impact of healthcare data analysis, it is important to understand both the theories and practices of business intelligence in healthcare. Theory and Practice of Business Intelligence in Healthcare is a collection of innovative research that introduces data mining, modeling, and analytic techniques to health and healthcare data; articulates the value of big volumes of data to health and healthcare; evaluates business intelligence tools; and explores business intelligence use and applications in healthcare. While highlighting topics including digital health, operations intelligence, and patient empowerment, this book is ideally designed for healthcare professionals, IT consultants, hospital directors, data management staff, data analysts, hospital administrators, executives, managers, academicians, students, and researchers seeking current research on the digitization of health records and health systems integration.
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.
Book Synopsis The Medical-Legal Aspects of Acute Care Medicine by : James E. Szalados
Download or read book The Medical-Legal Aspects of Acute Care Medicine written by James E. Szalados and published by Springer Nature. This book was released on 2021-04-02 with total page 694 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a comprehensive resource intended to provide a state-of-the-art overview of complex ethical, regulatory, and legal issues of importance to clinical healthcare professionals in the area of acute care medicine; including, for example, physicians, advanced practice providers, nurses, pharmacists, social workers, and care managers. In addition, this book also covers key legal and regulatory issues relevant to non-clinicians, such as hospital and practice administrators; department heads, educators, and risk managers. This text reviews traditional and emerging areas of ethical and legal controversies in healthcare such as resuscitation; mass-casualty event response and triage; patient autonomy and shared decision-making; medical research and teaching; ethical and legal issues in the care of the mental health patient; and, medical record documentation and confidentiality. Furthermore, this volume includes chapters dedicated to critically important topics, such as team leadership, the team model of clinical care, drug and device regulation, professional negligence, clinical education, the law of corporations, tele-medicine and e-health, medical errors and the culture of safety, regulatory compliance, the regulation of clinical laboratories, the law of insurance, and a practical overview of claims management and billing. Authored by experts in the field, The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a valuable resource for all clinical and non-clinical healthcare professionals.
Book Synopsis The Revenue Integrity Manager's Guidebook by : Rose T Dunn
Download or read book The Revenue Integrity Manager's Guidebook written by Rose T Dunn and published by . This book was released on 2018-04 with total page 140 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Revenue Operations by : Stephen G. Diorio
Download or read book Revenue Operations written by Stephen G. Diorio and published by John Wiley & Sons. This book was released on 2022-04-19 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: Crush siloes by connecting teams, data, and technologies with a new systems-based approach to growth. Growing a business in the 21st Century has become a capital intensive and data-driven team sport. In Revenue Operations: A New Way to Align Sales and Marketing, Monetize Data, and Ignite Growth, an accomplished team of practitioners, academics, and experts provide a proven system for aligning revenue teams and unlocking growth. The book shows everyone how to connect the dots across an increasingly complex technology ecosystem to simplify selling and accelerate revenue expansion. With Revenue Operations, you’ll understand what it takes to successfully transition to the new system of growth without killing your existing business. This practical and executable approach can be used by virtually any business - large or small, regardless of history or industry - that wants to generate more growth and value. By reading this book you will find: Real-world case studies and personal experiences from executives across an array of high technology, commercial, industrial, services, consumer, and cloud-based businesses. The six core elements of a system for managing your commercial operations, digital selling infrastructure, and customer data assets. Nine building-blocks that connect the dots across your sales and marketing technology ecosystem to generate more consistent growth and a better customer experience at lower costs. The skills and tools that next generation growth leaders will need to chart the roadmap for a successful career in any growth discipline for the next 25 years. An indispensable resource for anyone who wants to get more from their business – board members, CEOs, business unit leaders, strategists, thought leaders, analysts, operations professionals, partners, and front-line doers in sales, marketing, and service - Revenue Operations is based on over one thousand surveys of and interviews with business professionals conducted during 2020 and 2021. It also includes a comprehensive analysis of the sales and marketing technology landscape. As a perfectly balanced combination of academic insight and data-driven application, this book belongs on the bookshelves of anyone responsible for driving revenue and growth.
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:
Book Synopsis Medical Insurance: A Revenue Cycle Process Approach by : Nenna L. Bayes, BA, MEd
Download or read book Medical Insurance: A Revenue Cycle Process Approach written by Nenna L. Bayes, BA, MEd and published by McGraw-Hill Education. This book was released on 2019-01-24 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Eighth edition of Medical Insurance: A Revenue Cycle Process Approach emphasizes the revenue cycle—ten steps that clearly identify all the components needed to successfully manage the medical insurance claims process . The cycle shows how administrative medical professionals “follow the money .” Medical insurance specialists must be familiar with the rules and guidelines of each health plan in order to submit proper documentation, which then ensures that offices receive maximum, appropriate reimbursement for services provided . Learn the skills you need for your health professions career using multiple digital resources . Read and study the content more effectively—spending more time on topics you don’t know and less time on the topics you do by using SmartBook®, McGraw-Hill Education’s revolutionary adaptive learning technology
Book Synopsis The Complete Business Guide for a Successful Medical Practice by : Neil Baum
Download or read book The Complete Business Guide for a Successful Medical Practice written by Neil Baum and published by Springer. This book was released on 2015-01-02 with total page 281 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text provides physicians with the basic business skills in order for them to become involved in the financial aspect of their practices. The text will help the physician decide what kind of practice they would like to join (i.e. private practice, small group practice, solo practice, hospital employment, large group practice, academic medicine, or institutional\government practice) as well as understand the basics of contracting, restrictive covenants and how to navigate the road to partnership. Additional topics covered include, monthly balance sheets, productivity, overhead costs and profits, trend analysis and benchmarking. Finally, the book provides advice on advisors that doctors will need to help with the business of their professional and personal lives. These include accountants, bankers, lawyers, insurance agents and other financial advisors. The Complete Business Guide for a Successful Medical Practice provides a roadmap for physicians to be not only good clinical doctors but also good businessmen and businesswomen. It will help doctors make a difference in the lives of their patients as well as sound financial decisions for their practice.
Book Synopsis The Hospital Guide to Contemporary Utilization Review by : Stefani Daniels
Download or read book The Hospital Guide to Contemporary Utilization Review written by Stefani Daniels and published by . This book was released on 2015-04-16 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives
Book Synopsis Home Health Pocket Guide to Oasis-C, Revised Edition by : Melinda A. Gaboury
Download or read book Home Health Pocket Guide to Oasis-C, Revised Edition written by Melinda A. Gaboury and published by Beacon Health, a Division of Blr. This book was released on 2009-12-08 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Home Health Pocket Guide to OASIS-C: A Reference for Field Staff, Revised Edition Melinda A. Gaboury This handy resource puts all the critical, need-to-know information about OASIS-C completion and documentation at your fingertips. Conveniently sized, yet detailed, it offers concise advice to comply with the revisions that go into effect in January. This pocket guide delivers step-by-step instruction and details on this major overhaul to the data set. Save time with an item-by-item breakdown of OASIS-C Learn how it affects payment and outcomes Gain confidence from detailed instruction Ease the burden of OASIS, strengthen your supporting documentation, and get proper payment
Book Synopsis Core Functions of Revenue Integrity by : Valerie A. Rinkle
Download or read book Core Functions of Revenue Integrity written by Valerie A. Rinkle and published by . This book was released on 2017 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book DRG Expert written by Ingenix and published by . This book was released on 2010-09 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: THE DRG EXPERT has been a trusted and comprehensive reference to the DRG classification system for over 25 years. Organized by major diagnostic category (MDC), the convenient and innovative book layout follows the logical MS-DRG decision process. This is a must-have reference for those who need to verify DRG information and accurately assign MS-DRGs concurrently or retrospectively.
Book Synopsis The McPherson Principle by : Michael L. Duke
Download or read book The McPherson Principle written by Michael L. Duke and published by . This book was released on 2021 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: "Through reading this book, the reader will discover new approaches and concepts related to business rule-driven work tasking and automation, augmented analytics explicitly designed to solve root cause issues within revenue cycle operations, natural language"--
