Compliance For Coding Billing Reimbursement

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Compliance For Coding Billing Reimbursement 2nd Edition

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Author : Duane C. Abbey
language : en
Publisher: CRC Press
Release Date : 2008-04-02

Compliance For Coding Billing Reimbursement 2nd Edition written by Duane C. Abbey and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008-04-02 with Medical categories.

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.

Cost Based Charge Based And Contractual Payment Systems

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Author : Duane C. Abbey
language : en
Publisher: CRC Press
Release Date : 2018-06-28

Cost Based Charge Based And Contractual Payment Systems written by Duane C. Abbey and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-06-28 with Business & Economics categories.

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 backgr

Healthcare Payment Systems

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Author : Duane C. Abbey
language : en
Publisher: CRC Press
Release Date : 2010-10-25

Healthcare Payment Systems written by Duane C. Abbey and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-10-25 with Business & Economics categories.

For healthcare providers and patients alike, the ways of private third-party payer payment systems can be mysterious and oftentimes quite frustrating. Payment for hospital, nursing, or homecare services can be subject to a variety of payment systems including cost-based and charge-based or those with payments that are determined in advance. Knowing

Regulatory Compliance In The Healthcare Industry

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Author : Dr. Akash Sharma, Ms. Vriti Gamta, Mr. Gaurav Luthra
language : en
Publisher: Notion Press
Release Date : 2023-08-09

Regulatory Compliance In The Healthcare Industry written by Dr. Akash Sharma, Ms. Vriti Gamta, Mr. Gaurav Luthra and has been published by Notion Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023-08-09 with Medical categories.

Regulatory Compliance in the Healthcare Industry: Navigating the Complexities" is a comprehensive guide that equips healthcare professionals with the knowledge and strategies needed to ensure compliance with regulatory requirements. Authored by experts in healthcare compliance, this book covers key topics such as patient privacy, data security, quality of care and compliance program development. Real-world case studies, best practices and practical tools make this book an essential resource for healthcare professionals, compliance officers and administrators seeking to navigate the intricate landscape of regulatory compliance and promote ethical practices in the ever-evolving healthcare industry.

The Medicare Recovery Audit Contractor Program

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Author : Duane C. Abbey
language : en
Publisher: CRC Press
Release Date : 2017-11-15

The Medicare Recovery Audit Contractor Program written by Duane C. Abbey and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-11-15 with Business & Economics categories.

Medicare fraud is big business, but while only a few profit from intentional malfeasance, the Centers for Medicare and Medicaid Services is now taking a closer look at everyone. The Medicare Recovery Audit Contractor Program, already infamously known as the RAC, swings into full operation in 2010 and every healthcare provider that receives payment

Clinical Microbiology Procedures Handbook Multi Volume

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Author : Amy L. Leber
language : en
Publisher: John Wiley & Sons
Release Date : 2024-11-13

Clinical Microbiology Procedures Handbook Multi Volume written by Amy L. Leber and has been published by John Wiley & Sons this book supported file pdf, txt, epub, kindle and other format this book has been release on 2024-11-13 with Medical categories.

Gold Standard consensus-based procedures from the experts. The Clinical Microbiology Procedures Handbook, 5th edition, provides those engaged in microbial analysis of clinical specimens with procedures for the detection, identification, and characterization of microorganisms involved in human infections. This unique and valuable collection of step-by-step descriptions of the numerous testing modalities used in the clinical microbiology laboratory was written and edited by highly knowledgeable laboratorians. The 5th edition features two new sections, one on blood cultures and one on MALDI-TOF MS, and the sections on molecular diagnostics, virology, and serology were extensively revised and updated. Presented over multiple volumes, this handbook enables laboratory staff to perform all analyses, including appropriate quality control recommendations, from the receipt of the specimen through processing, testing, interpretation, presentation of the final report, and subsequent consultation. If you are looking for online access to the latest from this reference or site access for your lab, please visit www.wiley.com/learn/clinmicronow.

Prospective Payment Systems

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Author : Duane C. Abbey
language : en
Publisher: CRC Press
Release Date : 2018-06-28

Prospective Payment Systems written by Duane C. Abbey and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-06-28 with Business & Economics categories.

The third book in the Healthcare Payment Systems series, Prospective Payment Systems examines the various types of prospective payment systems (PPS) used by healthcare providers and third-party payers. Emphasizing the basic elements of PPS, it considers the many variations of payment for hospital inpatient and outpatient services, skilled nursing facilities, home health agencies, long-term hospital care, and rehabilitation facilities along with other providers. The book describes the anatomy of PPS, including cost reports, adjudication features and processes, relative weights, and payment processes. It outlines the features and documentation requirements for Medicare Severity Diagnosis Related Groups (MS-DRGs), the Medicare Ambulatory Payment Classifications (APCs), Medicare HHPPS, Medicare Skilled Nursing Resource Utilization Groups (RUGs), and private third-party payers.Provides a framework for understanding and analyzing the characteristics of any PPSDiscusses Medicare prospective payment systems and approachesIncludes specific references to helpful resources, both online and in printFacilitates a clear understanding of the complexities related to PPS covering specific topics at a high level and revisiting similar topics to reinforce understandingComplete with a detailed listing of the acronyms most-commonly used in healthcare coding, billing, and reimbursement, the book includes a series of case studies that illustrate key concepts. It concludes with a discussion of the challenges with PPS including compliance and overpayment issues to provide you with the real-world understanding needed to make sense of any PPS.

Clinical Microbiology Procedures Handbook

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Author :
language : en
Publisher: John Wiley & Sons
Release Date : 2020-08-06

Clinical Microbiology Procedures Handbook written by and has been published by John Wiley & Sons this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-08-06 with Medical categories.

In response to the ever-changing needs and responsibilities of the clinical microbiology field, Clinical Microbiology Procedures Handbook, Fourth Edition has been extensively reviewed and updated to present the most prominent procedures in use today. The Clinical Microbiology Procedures Handbook provides step-by-step protocols and descriptions that allow clinical microbiologists and laboratory staff personnel to confidently and accurately perform all analyses, including appropriate quality control recommendations, from the receipt of the specimen through processing, testing, interpretation, presentation of the final report, and subsequent consultation. If you are looking for online access to the latest from this reference or site access for your lab, please visit www.wiley.com/learn/clinmicronow.

Coding And Reimbursement For Hospital Inpatient Services

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Author : Karen S. Scott
language : en
Publisher: Ahima
Release Date : 2006

Coding And Reimbursement For Hospital Inpatient Services written by Karen S. Scott and has been published by Ahima this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006 with Medical categories.

The most comprehensive resource for hospital inpatient coding and reimbursement! Provides educators, students, and healthcare practitioners with the most authoritative guidance available for managing inpatient coding and reimbursement issues. This must-have resource was developed to give you easier access to the most up-to-date information you need for inpatient coding and reimbursement. You'll save time and make more effective decisions with this one-of-a-kind resource.Covers reimbursement methodologies for hospital inpatient services, the structure and organization of hte Medicare Inpatient Acute Care Prospective Payment System, the relationship between coding and DRG assignment, and data quality and coding compliance processes related to coding and reimbursement for inpatient services.

Compliance For Coding Billing Reimbursement

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Author : Duane C. Abbey
language : en
Publisher: McGraw-Hill Companies
Release Date : 1999

Compliance For Coding Billing Reimbursement written by Duane C. Abbey and has been published by McGraw-Hill Companies this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Medical categories.

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