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Author: Duane C. Abbey Publisher: CRC Press ISBN: 1563273683 Category : Medical Languages : en Pages : 232
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: Duane C. Abbey Publisher: CRC Press ISBN: 1563273683 Category : Medical Languages : en Pages : 232
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: Duane C. Abbey Publisher: McGraw-Hill Companies ISBN: 9780071353489 Category : Medical Languages : en Pages : 261
Book Description
Healthcare providers have to cut through more red tape than ever to get paid for their services. What's more, a mountain of mandates from federal and state government is pressuring providers to be more astute about laws regarding taxes, health and safety, labor issues, antitrust, patient confidentiality and financial compliance.Compliance for Coding, Billing & Reimbursement gives readers the guidelines for the four factors that influence the compliance coding, billing and reimbursement process and how to follow the trends in these areas. The book also analyzes the status of different payment methodologies being used today and advises providers on how to adjust to the transition from a cost-based system to prospective payment and capitation.Compliance for Coding, Billing & Reimbursement also defines the confusing terminology used in the complex web of policies and procedures. By referring to the comprehensive glossary and acronym listing, readers have instant explanations at their fingertips. Topics addressed include: -- How to structure a CBR compliance program -- How to spot CBR problem/opportunity areas -- Investigation and problem solving -- Developing CBR policies and procedures -- Effective training programs and how to implement change -- Monitoring and corrective action -- How to conduct a baseline audit -- Integrating a CBR compliance plan in with a corporate compliance plan -- Appendices containing important internet addresses, synopses of healthcare fraud laws and compliance case studies
Author: Joanne M. Waters Publisher: American Medical Association Press ISBN: 9781579473518 Category : Medical Languages : en Pages : 0
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: Deborah Vines Allen Publisher: Prentice Hall ISBN: 9780133141320 Category : Medical Languages : en Pages : 984
Book Description
COMPREHENSIVE HEALTH INSURANCE: BILLING, CODING & REIMBURSEMENT, 2/e provides students with the knowledge and skills needed to work in a variety of medical billing and coding positions in the medical field. Comprehensive in approach, it covers the foundations of insurance, billing, coding and reimbursement. Students learn not only the submission of claims to the insurance carrier, but also reviewing medical records, verifying patient benefits, submitting a secondary claim, posting payments and appealing the insurance carrier's decision. This edition includes new chapters devoted to HIPAA and ICD-10-CM Medical Coding, as well as outstanding coverage of electronic records. Numerous case studies and patient files are included throughout and demonstrate refunds and appeals, auditing and compliance, Medicare calculations and professionalism. 0133141322 / 9780133141320 Comprehensive Health Insurance: Billing, Coding & Reimbursement Plus NEW MyHealthProfessionsLab with Pearson eText Package consists of 0132966891 / 9780132966894 Comprehensive Health Insurance: Billing, Coding & 013297410X / 9780132974103 NEW MyHealthProfessionsLab with Pearson eText -- Access Card -- for Comprehensive Health Insurance: Billing, Coding, and
Author: Michael K. Harrington Publisher: Jones & Bartlett Learning ISBN: 1284169030 Category : Medical Languages : en Pages : 344
Book Description
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.
Author: Marilyn Burgos Publisher: McGraw Hill Professional ISBN: 0071849335 Category : Medical Languages : en Pages : 305
Book Description
Completely updated to reflect the massive changes to healthcare law! Medical Billing and Coding Demystified clearly explains the practices used by medical offices, hospitals, and healthcare facilities to encode medical services in order to receive payment from government agencies and insurance companies. Like other entries in this bestselling series, this self-teaching guide uses a building-block approach that allows readers to learn at their own pace and test themselves along the way. No previous medical or accounting training or experience is necessary to benefit from Medical Billing and Coding Demystified, and the book can be used as a classroom textbook or as a complement to larger texts. This new edition offers detailed coverage of the sweeping revisions that have taken place in healthcare law, including the transition from ICD9 to ICD10 coding and the Patient Protection and Affordable Healthcare Acts. It also includes an important overview of medical billing software. Includes valuable learning aids such as end-of-chapter quizzes, a final exam, and key points Different from similar books on the market in that it explains basic medical concepts enabling the reader to actually understand the procedures and tests they are billing and coding for
Author: Duane C. Abbey
Author: Duane C. Abbey
Author: Belinda S. Frisch
Author: Duane C. Abbey
Author: Belinda S. Frisch
Author: Patricia T. Aalseth
Author: 
Author: Joanne M. Waters
Author: Deborah Vines Allen
Author: Michael K. Harrington
Author: Marilyn Burgos