Correct Coding for Medicare, Compliance, and Reimbursement PDF Download

Author: Belinda S. Frisch
Publisher: Delmar Thomson Learning
ISBN: 9781418015619
Category : Medicare
Languages : en
Pages : 0

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Book Description
Two CD-ROM discs in pocket.

Author: Duane C. Abbey
Publisher: CRC Press
ISBN: 1563273683
Category : Medical
Languages : en
Pages : 232

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

Author: Karen Smiley
Publisher: John Wiley & Sons
ISBN: 1119625440
Category : Medical
Languages : en
Pages : 355

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

Author: Duane C. Abbey
Publisher: CRC Press
ISBN: 1420087185
Category : Business & Economics
Languages : en
Pages : 232

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Book Description
While the vast majority of providers never intend to commit fraud or file false claims, complex procedures, changing regulations, and evolving technology make it nearly impossible to avoid billing errors. For example, if you play by HIPAA‘s rules, a physician is a provider; however, Medicare requires that the same physician must be referred to as a

Author: Beth Schrope
Publisher: McGraw Hill Professional
ISBN: 0071770003
Category : Medical
Languages : en
Pages : 289

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Book Description
All the guidance you need to enhance your understanding and clinical application of ultrasound Includes DVD with video of key techniques Surgical and Interventional Ultrasound offers a thorough survey of image-guided treatments in the OR, in the endoscopy suite, and at the bedside. This one-stop clinical companion spans virtually every kind of surgical and interventional specialty that utilizes ultrasound and delivers high-yield perspectives on using these techniques to ensure accurate clinical decision making. FEATURES: An all-in-one primer for ultrasound--packed with valuable how-to's and insights that take you through the basic exam and the full scope of interventions Essential content for residents that supplements training in surgery residency programs--from the Focused Assessment with Sonography for Trauma (FAST) exam, to intraoperative ultrasound and ultrasound-guided procedures such as breast biopsy or radiofrequency ablation Up-to-date, multidisciplinary focus on surgical and interventional ultrasound covers the array of procedures for which ultrasound is increasingly utilized Full-color illustrations with hundreds of ultrasound images Valuable opening chapter on the physics of ultrasound, which enables better quality images and a better understanding of image interpretation Important chapter on advanced technologies highlights 3D ultrasound imaging and contrast ultrasound, drawing attention to their safe and effective implementation in surgical practice Emphasis on ultrasound-guided anesthesia explains how ultrasound can enhance the precision of regional anesthetic procedures Instructive companion DVD features clips of key diagnostic and interventional techniques

Author: American Medical Association
Publisher: American Medical Association Press
ISBN: 9781622025510
Category : Medical
Languages : en
Pages : 0

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Book Description
The newest edition of this best-selling educational resource contains the essential information needed to understand all sections of the CPT codebook but now boasts inclusion of multiple new chapters and a significant redesign. The ninth edition of Principles of CPT(R) Coding is now arranged into two parts: - CPT and HCPCS coding - An overview of documentation, insurance, and reimbursement principles Part 1 provides a comprehensive and in-depth guide for proper application of service and procedure codes and modifiers for which this book is known and trusted. A staple of each edition of this book, these revised chapters detail the latest updates and nuances particular to individual code sections and proper code selection. Part 2 consists of new chapters that explain the connection between and application of accurate coding, NCCI edits, and HIPAA regulations to documentation, payment, insurance, and fraud and abuse avoidance. The new full-color design offers readers of the illustrated ninth edition a more engaging and far better educational experience. Features and Benefits - New content! New chapters covering documentation, NCCI edits, HIPAA, payment, insurance, and fraud and abuse principles build the reader's awareness of these inter-related and interconnected concepts with coding. - New learning and design features -- Vocabulary terms highlighted within the text and defined within the margins that conveniently aid readers in strengthening their understanding of medical terminology -- "Advice/Alert Notes" that highlight important information, exceptions, salient advice, cautionary advice regarding CMS, NCCI edits, and/or payer practices -- Call outs to "Clinical Examples" that are reminiscent of what is found in the AMA publications CPT(R) Assistant, CPT(R) Changes, and CPT(R) Case Studies -- "Case Examples" peppered throughout the chapters that can lead to valuable class discussions and help build understanding of critical concepts -- Code call outs within the margins that detail a code description -- Full-color photos and illustrations that orient readers to the concepts being discussed -- Single-column layout for ease of reading and note-taking within the margins -- Exercises that are Internet-based or linked to use of the AMA CPT(R) QuickRef app that encourage active participation and develop coding skills -- Hands-on coding exercises that are based on real-life case studies

Author: Joanne M. Waters
Publisher: American Medical Association Press
ISBN: 9781579473518
Category : Medical
Languages : en
Pages : 0

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Book Description
"Up-to-date information on proper medical billing reimbursement and the codes, third party payers, and laws that affect it"--Provided by publisher.

Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 36

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Author: Cynthia A. Richards
Publisher: Cengage Learning
ISBN: 9781111320737
Category : Health insurance claims
Languages : en
Pages : 0

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Book Description
Provides an overview of the medical office environment, CPT and ICD-9-CM coding, and the major health insurance entities; includes information on how to obtain entry-level employment as a reimbursement specialist.

Author: Gina M. Reese
Publisher: Hcpro, a Division of Simplify Compliance
ISBN: 9781683081906
Category : Hospitals
Languages : en
Pages : 0

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