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Author: Ela Bochenek Publisher: ISBN: 9781522178026 Category : Drugs Languages : en Pages : 319
Book Description
A robust compliance program is essential to protecting a company from running afoul of the myriad laws and regulations that have been enacted to combat fraud and waste. The second edition of the Pharmaceutical and Medical Device Compliance Manual includes guidance to help companies develop a compliance program tailored to today's complex enforcement and business environment. Study of this Manual will enable compliance professionals and lawyers to understand the government's expectations of an effective compliance program and ethical business practices, as well as: how the government discovers potential enforcement actions, its approach to pursuing such actions, what behaviors can constitute mitigating factors for a company in the event of a legal violation. Coverage includes new chapters covering:Pharmaceutical industry interactions with patient organizations Compliance 2.0: compliance analytics in the era of big dataThe art and science of health care compliance in the pharmaceutical and medical device industries The Manual will be a great tool for health and life sciences attorneys, compliance officers, and others in the pharmaceutical and medical devices industry
Author: Ela Bochenek Publisher: ISBN: 9781522178026 Category : Drugs Languages : en Pages : 319
Book Description
A robust compliance program is essential to protecting a company from running afoul of the myriad laws and regulations that have been enacted to combat fraud and waste. The second edition of the Pharmaceutical and Medical Device Compliance Manual includes guidance to help companies develop a compliance program tailored to today's complex enforcement and business environment. Study of this Manual will enable compliance professionals and lawyers to understand the government's expectations of an effective compliance program and ethical business practices, as well as: how the government discovers potential enforcement actions, its approach to pursuing such actions, what behaviors can constitute mitigating factors for a company in the event of a legal violation. Coverage includes new chapters covering:Pharmaceutical industry interactions with patient organizations Compliance 2.0: compliance analytics in the era of big dataThe art and science of health care compliance in the pharmaceutical and medical device industries The Manual will be a great tool for health and life sciences attorneys, compliance officers, and others in the pharmaceutical and medical devices industry
Author: Theodore L. Banks Publisher: Wolters Kluwer ISBN: 0735593817 Category : Business & Economics Languages : en Pages : 1812
Book Description
Corporate Compliance has changedand—stricter guidelines now impose criminal penalties for activities that were previously considered legal. The and“business judgmentand” rule that protected the decisions of officers and directors has been severely eroded. The Corporate Federal Sentencing Guidelines of the U.S. Sentencing Commission require an effective compliance program, but even if you follow their requirements to the letter, you wonand’t really know if your compliance program works or if you have created a corporate culture that supports compliance. Now, with the completely updated Second Edition of Corporate Legal Compliance Handbook, youand’ll have help in creating a complete compliance system that complies with federal regulations and meets your specific corporate needs. Unlike the complicated or incomplete resources available today, Corporate Legal Compliance Handbook, Second Edition provides explanatory text and background material in two convenient formats: print and electronic. The accompanying CD-ROM contains reference materials, forms, sample training materials and other items to support program development. Corporate Legal Compliance Handbook, Second Edition gives you a unique combination: the essentials of the key laws your corporation must address, specific compliance regulations, and practical insights into designing, implementing, and managing an effectiveand—and efficientand—legal compliance program. It will help you identify the risks your company faces, and devise a system to address those risks. It will help you create a targeted compliance program by examining the risks attached to job descriptions, creating the appropriate corporate policies, establishing control programs, communicating effectively, and testing the effectiveness of your program. Corporate Legal Compliance Handbook, Second Edition will show you: How to ensure that your company establishes an effective compliance program How to master practical risk assessment tools How to identify any special risks posed by you clientand’s type of business How to make sure that each employee involved in a business process understands his or her individual responsibility in the companyand’s legal compliance program
Author: Kathy Matzka Publisher: HC Pro, Inc. ISBN: 1578398835 Category : Medical Languages : en Pages : 197
Book Description
Now in its fifth edition, this book features completely updated information, tools, and insights that will help in understanding and preparing medical staff for survey under the new 2007 standards. with the Compliance Guide to the JCAHO Medical Staff Standards, Fifth Edition in your library, you'll save hours rifling through hundreds of pages of documents, trying to decipher ways to comply. All the standards that relate to you and all the procedures you need to implement are consolidated into this one convenient, easy-to-understand resource.
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: Frank Oemig Publisher: Springer ISBN: 3319448390 Category : Medical Languages : en Pages : 696
Book Description
This book focuses on the development and use of interoperability standards related to healthcare information technology (HIT) and provides in-depth discussion of the associated essential aspects. The book explains the principles of conformance, examining how to improve the content of healthcare data exchange standards (including HL7 v2.x, V3/CDA, FHIR, CTS2, DICOM, EDIFACT, and ebXML), the rigor of conformance testing, and the interoperability capabilities of healthcare applications for the benefit of healthcare professionals who use HIT, developers of HIT applications, and healthcare consumers who aspire to be recipients of safe and effective health services facilitated through meaningful use of well-designed HIT. Readers will understand the common terms interoperability, conformance, compliance and compatibility, and be prepared to design and implement their own complex interoperable healthcare information system. Chapters address the practical aspects of the subject matter to enable application of previously theoretical concepts. The book provides real-world, concrete examples to explain how to apply the information, and includes many diagrams to illustrate relationships of entities and concepts described in the text. Designed for professionals and practitioners, this book is appropriate for implementers and developers of HIT, technical staff of information technology vendors participating in the development of standards and profiling initiatives, informatics professionals who design conformance testing tools, staff of information technology departments in healthcare institutions, and experts involved in standards development. Healthcare providers and leadership of provider organizations seeking a better understanding of conformance, interoperability, and IT certification processes will benefit from this book, as will students studying healthcare information technology.
Author: Marilyn Fordney Publisher: Elsevier Health Sciences ISBN: 1455733253 Category : Medical Languages : en Pages : 683
Book Description
A complete guide to insurance billing and coding, Insurance Handbook for the Medical Office, 13th Edition covers all the plans that are most commonly encountered in clinics and physicians' offices. Its emphasis on the role of the medical insurance specialist includes areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. Learning to fill in the claim form accurately is made easier by the use of icons for different types of payers, lists of key abbreviations, and numerous practice exercises. This edition provides the latest on hot topics such as ICD-10, healthcare reform, the new CMS-1500 form, and electronic claims. Trusted for more than 30 years, this proven reference from Marilyn Fordney prepares you to succeed as a medical insurance professional in any outpatient setting. Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist in filing clean claims, solving problems, and collecting overdue payments.Key terms and key abbreviations are defined and emphasized, reinforcing your understanding of new concepts and terminology.Detailed tables, boxes, and illustrations call out key points and main ideas.Unique! Color-coded icons clarify information, rules, and regulations for different payers.An Evolve companion website enhances learning with performance checklists, self-assessment quizzes, and the Student Software Challenge featuring cases for different payer types and an interactive CMS-1500 form to fill in.A workbook contains learning tips, practice exercises for key terms and abbreviations, review questions, study outlines, performance objectives, a chapter with practice tests, and critical thinking activities for hands-on experience with real-world cases. Available separately. Updated coverage of key health insurance topics includes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, electronic claims, ICD-10, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, Meaningful Use, and CPT 2013.Updated ICD-10 coding information prepares you for the October 2014 ICD-10 implementation date.Updated content on claim forms includes block-by-block explanations and examples for the new CMS-1500 Claim Form.Updated guidelines for the filing and submission of electronic claims include sample screenshots and prepare you for the future of the medical office.
Author: American Society for Healthcare Risk Management (ASHRM) Publisher: John Wiley & Sons ISBN: 0470443715 Category : Medical Languages : en Pages : 672
Book Description
Risk Management Handbook for Health Care Organizations, Student Edition This comprehensive textbook provides a complete introduction to risk management in health care. Risk Management Handbook, Student Edition, covers general risk management techniques; standards of health care risk management administration; federal, state and local laws; and methods for integrating patient safety and enterprise risk management into a comprehensive risk management program. The Student Edition is applicable to all health care settings including acute care hospital to hospice, and long term care. Written for students and those new to the topic, each chapter highlights key points and learning objectives, lists key terms, and offers questions for discussion. An instructor's supplement with cases and other material is also available. American Society for Healthcare Risk Management (ASHRM) is a personal membership group of the American Hospital Association with more than 5,000 members representing health care, insurance, law, and other related professions. ASHRM promotes effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking, and interactions with leading health care organizations and government agencies. ASHRM initiatives focus on developing and implementing safe and effective patient care practices, preserving financial resources, and maintaining safe working environments.
Author: Marilyn Fordney Publisher: Elsevier Health Sciences ISBN: 0323226809 Category : Medical Languages : en Pages : 683
Book Description
A complete guide to insurance billing and coding, Insurance Handbook for the Medical Office, 13th Edition covers all the plans that are most commonly encountered in clinics and physicians’ offices. Its emphasis on the role of the medical insurance specialist includes areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. Learning to fill in the claim form accurately is made easier by the use of icons for different types of payers, lists of key abbreviations, and numerous practice exercises. This edition provides the latest on hot topics such as ICD-10, healthcare reform, the new CMS-1500 form, and electronic claims. Trusted for more than 30 years, this proven reference from Marilyn Fordney prepares you to succeed as a medical insurance professional in any outpatient setting. Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist in filing clean claims, solving problems, and collecting overdue payments. Key terms and key abbreviations are defined and emphasized, reinforcing your understanding of new concepts and terminology. Detailed tables, boxes, and illustrations call out key points and main ideas. Unique! Color-coded icons clarify information, rules, and regulations for different payers. An Evolve companion website enhances learning with performance checklists, self-assessment quizzes, and the Student Software Challenge featuring cases for different payer types and an interactive CMS-1500 form to fill in. A workbook contains learning tips, practice exercises for key terms and abbreviations, review questions, study outlines, performance objectives, a chapter with practice tests, and critical thinking activities for hands-on experience with real-world cases. Available separately. Updated coverage of key health insurance topics includes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, electronic claims, ICD-10, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, Meaningful Use, and CPT 2013. Updated ICD-10 coding information prepares you for the October 2014 ICD-10 implementation date. Updated content on claim forms includes block-by-block explanations and examples for the new CMS-1500 Claim Form. Updated guidelines for the filing and submission of electronic claims include sample screenshots and prepare you for the future of the medical office.
Author: Ela Bochenek
Author: Ela Bochenek
Author: 
Author: Theodore L. Banks
Author: Kathy Matzka
Author: United States. Federal Trade Commission. Bureau of Consumer Protection
Author: Duane C. Abbey
Author: Frank Oemig
Author: Marilyn Fordney
Author: American Society for Healthcare Risk Management (ASHRM)
Author: Marilyn Fordney