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Mastering The Reimbursement Process
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Book Synopsis Mastering the Reimbursement Process by : L. Lamar Blount
Download or read book Mastering the Reimbursement Process written by L. Lamar Blount and published by American Medical Association Press. This book was released on 1998 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rev. ed. of: Mastering the reimbursement process / Curtis J. Udell, Susan E. Garrison, Deane R. Ferguson. 1996.
Book Synopsis Mastering the Reimbursement Process by : Curtis J. Udell
Download or read book Mastering the Reimbursement Process written by Curtis J. Udell and published by Amer Medical Assn. This book was released on 1996 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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 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 Denials Management & Appeals Reference Guide - First Edition by : AAPC
Download or read book Denials Management & Appeals Reference Guide - First Edition written by AAPC and published by AAPC. This book was released on 2020-03-17 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recoup lost time and revenue with denials management and appeals know-how. Claim denials can sink a profit margin. And given the cost of appeals, roughly $118 per claim, not all denials can be reworked. A practice submitting 50 claims a day at an average reimbursement rate of $200 per claim should bring in $10,000 in daily revenue. But if 10% of those claims are denied, and the practice can only appeal one, they lose $800 per day—upwards of $200K annually. Your medical claims are the lifeblood of operations. Don’t compromise your financial health. Learn how to preempt denials with the Denials Management & Appeals Reference Guide. This vital resource will equip you to get ahead of payers by simplifying the leading causes of denials and showing you how to address insufficient documentation, failing to establish medical necessity, coding and billing errors, coverage stipulations, and untimely filing. Rely on AAPC to walk you through the appeal process. We’ll help you establish protocols to avoid an appeals backlog and teach you how to identify and prioritize denials likely to win an appeal. What’s more, you’ll learn when a claim can be “reopened” to fix a problem. Collect the revenue your practice deserves with effective denials and appeals solutions: Know how to analyze your denials Defeat documentation and compliance issues for successful claims success Utilize payer policy for coverage clues Lock in revenue with face-to-face reimbursement guidance Refine efforts to avoid E/M claim denials Ace ICD-10 coding for optimum reimbursement Put an end to modifier confusion Stave off denials with CCI edits advice Navigate the appeals process like a pro And much more!
Author :Wolters Kluwer Law & Business Health Editorial Publisher :Wolters Kluwer ISBN 13 :0808040049 Total Pages :1642 pages Book Rating :4.8/5 (8 download)
Book Synopsis Master Medicare Guide 2015 by : Wolters Kluwer Law & Business Health Editorial
Download or read book Master Medicare Guide 2015 written by Wolters Kluwer Law & Business Health Editorial and published by Wolters Kluwer. This book was released on 2015-02-25 with total page 1642 pages. Available in PDF, EPUB and Kindle. Book excerpt: The 2015 Master Medicare Guide is a one-volume desk reference packed with timely and useful information for providers, attorneys, accountants, and consultants who need to stay on top of one of the most complex programs maintained by the federal government.
Book Synopsis The Master Guide to Controllers' Best Practices by : Elaine Stattler
Download or read book The Master Guide to Controllers' Best Practices written by Elaine Stattler and published by John Wiley & Sons. This book was released on 2020-07-08 with total page 565 pages. Available in PDF, EPUB and Kindle. Book excerpt: The essential guide for today’s savvy controllers Today’s controllers are in leadership roles that put them in the unique position to see across all aspects of the operations they support. The Master Guide to Controllers’ Best Practices, Second Edition has been revised and updated to provide controllers with the information they need to successfully monitor their organizations’ internal control environments and offer direction and consultation on internal control issues. In addition, the authors include guidance to help controllers carryout their responsibilities to ensure that all financial accounts are reviewed for reasonableness and are reconciled to supporting transactions, as well as performing asset verification. Comprehensive in scope the book contains the best practices for controllers and: Reveals how to set the right tone within an organization and foster an ethical climate Includes information on risk management, internal controls, and fraud prevention Highlights the IT security controls with the key components of successful governance Examines the crucial role of the controller in corporate compliance and much more The Master Guide to Controllers’ Best Practices should be on the bookshelf of every controller who wants to ensure the well-being of their organization. In addition to their traditional financial role, today’s controllers (no matter how large or small their organization) are increasingly occupying top leadership positions. The revised and updated Second Edition of The Master Guide to Controllers’ Best Practices provides an essential resource for becoming better skilled in such areas as strategic planning, budgeting, risk management, and business intelligence. Drawing on the most recent research on the topic, informative case studies, and tips from finance professionals, the book highlights the most important challenges controllers will face. Written for both new and seasoned controllers, the Guide offers a wide range of effective tools that can be used to improve the skills of strategic planning, budgeting, forecasting, and risk management. The book also contains a resource for selecting the right employees who have the technical knowledge, analytical expertise, and strong people skills that will support the controller’s role within an organization. To advance overall corporate performance, the authors reveal how to successfully align strategy, risk management, and performance management. In addition, the Guide explains what it takes to stay ahead of emerging issues such as healthcare regulations, revenue recognition, globalization, and workforce mobility. As controllers adapt to their new leadership roles and assume more complex responsibilities, The Master Guide to Controllers’ Best Practices offers an authoritative guide to the tools, practices, and ideas controllers need to excel in their profession.
Author :Deborah Walker Keegan Publisher :Medical Group Management Association/Center for Research in Ambulatory Health Care Administration ISBN 13 :9781568294940 Total Pages :421 pages Book Rating :4.2/5 (949 download)
Book Synopsis The Physician Billing Process by : Deborah Walker Keegan
Download or read book The Physician Billing Process written by Deborah Walker Keegan and published by Medical Group Management Association/Center for Research in Ambulatory Health Care Administration. This book was released on 2016 with total page 421 pages. Available in PDF, EPUB and Kindle. Book excerpt: This third edition of the MGMA bestseller on physician billing process and revenue cycle management is a completely revised, comprehensive manual. Delivering proven solutions to optimize your revenue cycle, this professional fee billing primer is business-critical whether you're new to managing the revenue cycle or a seasoned professional.
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 Mastering Medical Coding - E-Book by : Marsha Diamond
Download or read book Mastering Medical Coding - E-Book written by Marsha Diamond and published by Elsevier Health Sciences. This book was released on 2006-06-02 with total page 841 pages. Available in PDF, EPUB and Kindle. Book excerpt: Expansion of ICD-9-CM information. - Sample patient charts include explanatory notes. - A simulated medical practice (identified as Godfrey Regional) lets you study in a real-world scenario. - Key Terms lists highlight the most important vocabulary and content. - More exercises!
Book Synopsis Master Medicare Guide by : Wolters Kluwer Law & Business
Download or read book Master Medicare Guide written by Wolters Kluwer Law & Business and published by Wolters Kluwer. This book was released on 2015-02-25 with total page 1989 pages. Available in PDF, EPUB and Kindle. Book excerpt: The 2015 Master Medicare Guide is packed with timely and useful information to help you stay on top of one of the most complex programs administered by the federal government. The 2015 Edition includes: Over 500 explanation summaries for all aspects of the Medicare program coverage, eligibility, reimbursement, fraud and abuse, and administration Highlights of the Protecting Access to Medicare Act of 2014 (P.L. 113-93) and the Improving Medicare Post-Acute Care Transformation Act of 2014 (P.L. 113-185)""; the most recent physician fee schedule reimbursement fix; A focus on the continuing implementation of the Affordable Care Act as it relates to Medicare, including accountable care organizations and a tighter link between the quality of health care and Medicare reimbursement All discussions include cross-references to relevant laws, regulations, CMS manual sections, administrative and judicial decisions, and more!
Book Synopsis The Physician Billing Process by : Deborah L. Walker
Download or read book The Physician Billing Process written by Deborah L. Walker and published by Medical Group Management Assn. This book was released on 2004 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: Collect money owed to your practice. Improve your revenue cycle by maximizing key processes for professional fee billing. Written by industry experts, this book is a step-by-step guide to billing and collection processes, performance outcomes and advanced billing practices. It includes case studies, tools, checklists, resources, policies and procedures to help you diagnose problems and develop plans to attain optimal financial performance.
Book Synopsis Executing Data Quality Projects by : Danette McGilvray
Download or read book Executing Data Quality Projects written by Danette McGilvray and published by Academic Press. This book was released on 2021-05-27 with total page 378 pages. Available in PDF, EPUB and Kindle. Book excerpt: Executing Data Quality Projects, Second Edition presents a structured yet flexible approach for creating, improving, sustaining and managing the quality of data and information within any organization. Studies show that data quality problems are costing businesses billions of dollars each year, with poor data linked to waste and inefficiency, damaged credibility among customers and suppliers, and an organizational inability to make sound decisions. Help is here! This book describes a proven Ten Step approach that combines a conceptual framework for understanding information quality with techniques, tools, and instructions for practically putting the approach to work – with the end result of high-quality trusted data and information, so critical to today's data-dependent organizations. The Ten Steps approach applies to all types of data and all types of organizations – for-profit in any industry, non-profit, government, education, healthcare, science, research, and medicine. This book includes numerous templates, detailed examples, and practical advice for executing every step. At the same time, readers are advised on how to select relevant steps and apply them in different ways to best address the many situations they will face. The layout allows for quick reference with an easy-to-use format highlighting key concepts and definitions, important checkpoints, communication activities, best practices, and warnings. The experience of actual clients and users of the Ten Steps provide real examples of outputs for the steps plus highlighted, sidebar case studies called Ten Steps in Action. This book uses projects as the vehicle for data quality work and the word broadly to include: 1) focused data quality improvement projects, such as improving data used in supply chain management, 2) data quality activities in other projects such as building new applications and migrating data from legacy systems, integrating data because of mergers and acquisitions, or untangling data due to organizational breakups, and 3) ad hoc use of data quality steps, techniques, or activities in the course of daily work. The Ten Steps approach can also be used to enrich an organization's standard SDLC (whether sequential or Agile) and it complements general improvement methodologies such as six sigma or lean. No two data quality projects are the same but the flexible nature of the Ten Steps means the methodology can be applied to all. The new Second Edition highlights topics such as artificial intelligence and machine learning, Internet of Things, security and privacy, analytics, legal and regulatory requirements, data science, big data, data lakes, and cloud computing, among others, to show their dependence on data and information and why data quality is more relevant and critical now than ever before. - Includes concrete instructions, numerous templates, and practical advice for executing every step of The Ten Steps approach - Contains real examples from around the world, gleaned from the author's consulting practice and from those who implemented based on her training courses and the earlier edition of the book - Allows for quick reference with an easy-to-use format highlighting key concepts and definitions, important checkpoints, communication activities, and best practices - A companion Web site includes links to numerous data quality resources, including many of the templates featured in the text, quick summaries of key ideas from the Ten Steps methodology, and other tools and information that are available online
Book Synopsis Physician Practice Management by : Lawrence F. Wolper
Download or read book Physician Practice Management written by Lawrence F. Wolper and published by Jones & Bartlett Learning. This book was released on 2005 with total page 728 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Sciences & Professions
Book Synopsis Understanding Hospital Billing and Coding by : Debra P. Ferenc
Download or read book Understanding Hospital Billing and Coding written by Debra P. Ferenc and published by Elsevier Health Sciences. This book was released on 2013-02-26 with total page 626 pages. Available in PDF, EPUB and Kindle. Book excerpt: A basic guide to hospital billing and reimbursement, Understanding Hospital Billing and Coding, 3rd Edition helps you understand, complete, and submit the UB-04 claim form that is used for all Medicare and privately insured patients. It describes how hospitals are reimbursed for patient care and services, showing how the UB-04 claim form reflects the flow of patient data from the time of admission to the time of discharge. Written by coding expert Debra P. Ferenc, this book also ensures that you understand the essentials of ICD-10-CM and develop skills in both inpatient coding and outpatient/ambulatory surgery coding. UB-04 Claim Simulation on the companion Evolve website lets you practice entering information from source documents into the claim form. Over 300 illustrations and graphics bring important concepts to life. Detailed chapter objectives highlight what you are expected to learn. Key terms, acronyms, and abbreviations with definitions are included in each chapter. Concept Review boxes reinforce key concepts. Test Your Knowledge exercises reinforce lessons as you progress through the material. Chapter summaries review key concepts. Practice hospital cases let you apply concepts to real-life scenarios. Updated Claim Forms chapter covers the UB-04 claim form. Updated information covers diagnosis and procedural coding, with guidelines and applications. Updated claim forms and names are used throughout.
Book Synopsis U.S. Master State Tax Practice and Procedure Guide by : CCH State Tax Law Editors
Download or read book U.S. Master State Tax Practice and Procedure Guide written by CCH State Tax Law Editors and published by CCH. This book was released on 2007 with total page 2468 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Standard Finance System (STANFINS) by : U.S. Army Finance and Accounting Center
Download or read book Standard Finance System (STANFINS) written by U.S. Army Finance and Accounting Center and published by . This book was released on 1988 with total page 690 pages. Available in PDF, EPUB and Kindle. Book excerpt:
