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Third Party Reimbursement
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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.
Book Synopsis Improving the Quality of Long-Term Care by : Institute of Medicine
Download or read book Improving the Quality of Long-Term Care written by Institute of Medicine and published by National Academies Press. This book was released on 2001-02-27 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
Book Synopsis Third-party Reimbursement by : National Clearinghouse for Drug Abuse Information
Download or read book Third-party Reimbursement written by National Clearinghouse for Drug Abuse Information and published by . This book was released on 1977 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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.
Book Synopsis Pharmacy Technician Certification Exam (Ptce) by : National Learning Corporation
Download or read book Pharmacy Technician Certification Exam (Ptce) written by National Learning Corporation and published by Admission Test. This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Admission Test Series prepares students for entrance examinations into college, graduate and professional school as well as candidates for professional certification and licensure. The Pharmacy Technician Certification Exam (PTCE) Passbook(R) prepares you by sharpening the skills and abilities necessary to succeed on your upcoming entrance exam. It provides hundreds of questions and answers in the areas that will likely be covered on your upcoming exam, including but not limited to: pharmacy law and regulations; medication safety; inventory management; quality assurance; pharmacology; and more.
Author :United States. Congress. House. Committee on Veterans' Affairs. Subcommittee on Health Publisher : ISBN 13 : Total Pages :150 pages Book Rating :4.:/5 (327 download)
Book Synopsis H.R. 1362 and Draft Bills Regarding Third Party Reimbursement and Physicians' Special Pay Provisions by : United States. Congress. House. Committee on Veterans' Affairs. Subcommittee on Health
Download or read book H.R. 1362 and Draft Bills Regarding Third Party Reimbursement and Physicians' Special Pay Provisions written by United States. Congress. House. Committee on Veterans' Affairs. Subcommittee on Health and published by . This book was released on 1997 with total page 150 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Changing Economics of Medical Technology by : Institute of Medicine
Download or read book The Changing Economics of Medical Technology written by Institute of Medicine and published by National Academies Press. This book was released on 1991-02-01 with total page 225 pages. Available in PDF, EPUB and Kindle. Book excerpt: Americans praise medical technology for saving lives and improving health. Yet, new technology is often cited as a key factor in skyrocketing medical costs. This volume, second in the Medical Innovation at the Crossroads series, examines how economic incentives for innovation are changing and what that means for the future of health care. Up-to-date with a wide variety of examples and case studies, this book explores how payment, patent, and regulatory policiesâ€"as well as the involvement of numerous government agenciesâ€"affect the introduction and use of new pharmaceuticals, medical devices, and surgical procedures. The volume also includes detailed comparisons of policies and patterns of technological innovation in Western Europe and Japan. This fact-filled and practical book will be of interest to economists, policymakers, health administrators, health care practitioners, and the concerned public.
Book Synopsis Assessing Genetic Risks by : Institute of Medicine
Download or read book Assessing Genetic Risks written by Institute of Medicine and published by National Academies Press. This book was released on 1994-01-01 with total page 353 pages. Available in PDF, EPUB and Kindle. Book excerpt: Raising hopes for disease treatment and prevention, but also the specter of discrimination and "designer genes," genetic testing is potentially one of the most socially explosive developments of our time. This book presents a current assessment of this rapidly evolving field, offering principles for actions and research and recommendations on key issues in genetic testing and screening. Advantages of early genetic knowledge are balanced with issues associated with such knowledge: availability of treatment, privacy and discrimination, personal decision-making, public health objectives, cost, and more. Among the important issues covered: Quality control in genetic testing. Appropriate roles for public agencies, private health practitioners, and laboratories. Value-neutral education and counseling for persons considering testing. Use of test results in insurance, employment, and other settings.
Author :National Academies of Sciences Engineering and Medicine Publisher : ISBN 13 :9780309685061 Total Pages : pages Book Rating :4.6/5 (85 download)
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.
Author :American Bar Association. House of Delegates Publisher :American Bar Association ISBN 13 :9781590318737 Total Pages :216 pages Book Rating :4.3/5 (187 download)
Book Synopsis Model Rules of Professional Conduct by : American Bar Association. House of Delegates
Download or read book Model Rules of Professional Conduct written by American Bar Association. House of Delegates and published by American Bar Association. This book was released on 2007 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
Book Synopsis Music Therapy Reimbursement by : Judy Simpson
Download or read book Music Therapy Reimbursement written by Judy Simpson and published by . This book was released on 2004 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: The profession of music therapy is receiving more and more recognition as an effective intervention in a variety of healthcare settings. Given this increased attention, the question of how to fund music therapy services also is being asked more frequently by many key decision makers. Discovering potential ways to "reimburse" or "cover" music therapy services through public and private third party payment systems has become a critical component to the business of music therapy. In order for music therapists to be successful in their practices, they must demonstrate competency regarding the current healthcare market, the insurance industry, and where music therapy fits within this environment. This book is designed to provide music therapists and related professionals with a basic understanding of the reimbursement process. Students, clinicians, and educators will find this resource helpful as they explore opportunities in healthcare funding. In addition to providing valuable resources and outlining specific guidelines, this book also includes the results of surveys and interviews with member music therapists reporting the successes with third party payment. Clinicians also will find marketing tools, sample forms, and coding information as practical supports to implementing the reimbursement process in their own practices.
Book Synopsis Medicaid Hospital Payment by : Jennifer Baldwin
Download or read book Medicaid Hospital Payment written by Jennifer Baldwin and published by . This book was released on 1991 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Cost-Based, Charge-Based, and Contractual Payment Systems by : Duane C. Abbey
Download or read book Cost-Based, Charge-Based, and Contractual Payment Systems written by Duane C. Abbey and published by CRC Press. This book was released on 2012-08-07 with total page 186 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fourth book in the Healthcare Payment System series, Cost-Based, Charge-Based, and Contractual Payment Systems compares cost-based systems, charge-based payment approaches, and contractually-based payment processes with fee-schedule payment systems and prospective payment systems. Supplying readers with a clear understanding of important background material on the different types of healthcare providers, it covers the basics of cost-based, charge-based, and contractual payment systems. The book illustrates essential concepts with a series of simple case studies—making it ideal for anyone interested in learning more about the specific systems and processes used for payment in healthcare services. It discusses Medicare cost-based payment systems, Medicare payment approaches, and includes an appendix that outlines the various Medicare payment systems. Demystifying contractual language, it outlines managed care contracts and also: Delves into the intricacies involved with adjudication of claims Considers capitated payment systems Addresses healthcare costs and cost-based reimbursement systems Examines charge-based and contractual payment systems Describes where healthcare payment systems are headed in the future Since compliance is inherent throughout the process of providing services, filling claims, and receiving payment, the book examines the range of compliance concerns, including statutory, contractual, and overpayment issues. Using numerous examples to illustrate the processes used for capitated contract arrangements, the book includes coverage of claim adjustment, managed care contracts, and the various combinations of payment systems used by third-party administrators.
Book Synopsis Pharmacy Management by : Shane P. Desselle
Download or read book Pharmacy Management written by Shane P. Desselle and published by McGraw Hill Professional. This book was released on 2005 with total page 628 pages. Available in PDF, EPUB and Kindle. Book excerpt: Editors Desselle and Zgarrick have brought together 33 contributed chapters in their endeavor to prepare pharmacy students for the realities of managing a practice. After a section on why it's important to study management in pharmacy school, coverage includes the various ins-and-outs of managing oneself (understanding stress), operations, people,
Book Synopsis Encyclopedia of Health Economics by :
Download or read book Encyclopedia of Health Economics written by and published by Newnes. This book was released on 2014-02-21 with total page 1663 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Encyclopedia of Health Economics offers students, researchers and policymakers objective and detailed empirical analysis and clear reviews of current theories and polices. It helps practitioners such as health care managers and planners by providing accessible overviews into the broad field of health economics, including the economics of designing health service finance and delivery and the economics of public and population health. This encyclopedia provides an organized overview of this diverse field, providing one trusted source for up-to-date research and analysis of this highly charged and fast-moving subject area. Features research-driven articles that are objective, better-crafted, and more detailed than is currently available in journals and handbooks Combines insights and scholarship across the breadth of health economics, where theory and empirical work increasingly come from non-economists Provides overviews of key policies, theories and programs in easy-to-understand language
Book Synopsis Understanding Value Based Healthcare by : Vineet Arora
Download or read book Understanding Value Based Healthcare written by Vineet Arora and published by McGraw Hill Professional. This book was released on 2015-04-03 with total page 417 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today. Understanding Value-Based Healthcare is divided into three sections: Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives. The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis. .
Book Synopsis Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies by : OECD
Download or read book Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
