Compliance For Coding Billing Reimbursement 2nd Edition
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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.
Emergency Department Coding And Billing
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Author : Duane C. Abbey
language : en
Publisher: HC Pro, Inc.
Release Date : 2005
Emergency Department Coding And Billing written by Duane C. Abbey and has been published by HC Pro, Inc. this book supported file pdf, txt, epub, kindle and other format this book has been release on 2005 with Emergency medical services categories.
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
Correct Coding For Medicare Compliance And Reimbursement
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Author : Belinda S. Frisch
language : en
Publisher:
Release Date : 2007
Correct Coding For Medicare Compliance And Reimbursement written by Belinda S. Frisch and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2007 with Medicare categories.
Understanding Hospital Coding And Billing A Worktext
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Author : Marsha S Diamond
language : en
Publisher: Cengage Learning
Release Date : 2014-08-05
Understanding Hospital Coding And Billing A Worktext written by Marsha S Diamond and has been published by Cengage Learning this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-08-05 with Business & Economics categories.
Understanding Hospital Coding and Billing: A Worktext, Second Edition, is your complete guide to the world of hospital billing from patient intake through the entire billing process, covering inpatient and outpatient coding and billing. This resource presents concepts in an outline format, with room in the margins to take notes, and practice exercises and case studies to test your knowledge. An appendix of inpatient and outpatient case scenarios is available for use with SimClaim UB-04 practice software for electronic claims completion. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.
Auditing Evaluation And Management Services Second Edition
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Author : Joe Rivet
language : en
Publisher: Hcpro, a Division of Simplify Compliance
Release Date : 2011-06-15
Auditing Evaluation And Management Services Second Edition written by Joe Rivet and has been published by Hcpro, a Division of Simplify Compliance this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-06-15 with Medical audit categories.
Auditing Evaluation and Management Services: A Step-By-Step Guide to Accurate Coding, Reimbursement and Compliance, Second Edition Joe Rivet, CCS-P, CPC, CEMC, CPMA, CICA, CHRC, CHC Turn E/M audits into informative reports that minimize your compliance risk The government is increasing its scrutiny of physician E/M coding. Conducting your own E/M coding audits is best practice to effectively: Analyze complex code assignment options to select the appropriate code Assign an appropriate E/M code based on documentation in the record Identify opportunities for increased revenue and ways to reduce compliance risks Understand the rules and regulations that apply to E/M services billed to Medicare Auditing Evaluation and Management Services is an essential tool to ensure audit success and E/M compliance. This second edition goes beyond the fundamentals of E/M coding and delves into the gray, problematic compliance areas. Author Joe Rivet delivers step-by-step guidance from beginning to end of the E/M audit process. You'll learn how to Select an E/M code, Conduct an entire audit of your E/M services Report your E/M audit findings With this foundation, you'll be well prepared to enhance compliance and identify undercoding, underreporting, overcoding, revenue opportunities, and avenues for documentation improvement. Auditing Evaluation and Management Services, Second Edition, will help practices enhance existing auditing programs by explaining how to determine accurate E/M error rates and assess risk. You will learn how to: Determine proper E/M code selection Conduct risk assessments Structure audits, using the provided E/M audit tool, and package audits Create provider audit summary reports, practice audit summary reports, missed revenue reports, and an action plan Follow guidelines for facility E/M services and interpret the rules governing E/M services involving residents or fellows (including acceptable and unacceptable documentation) Develop a compliance plan and educate a variety of audiences from physicians to coding staff Take a look at the table of contents E/M Code Categories NEW! Selecting an E/M Code Conducting a Risk Assessment E/M Audit Structure Using an Audit Tool Packaging an Audit Facility E/M Services NEW! Teaching Physician Services NEW! Developing a Compliance Plan Education Techniques NEW! What's new? New chapters devoted to: E/M Code Categories Facility E/M Services Teaching Physicians Education Techniques Who will benefit from this book? Auditors and compliance officers in physician practices and hospitals Health systems that own physician practices Business managers Office managers Practice administrators Coding, billing, and reimbursement managers and staff Earn continuing education credits American Academy of Professional Coders This program has prior approval of the American Academy of Professional Coders (AAPC) for 3 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the Academy of the program, content, or the program sponsor. American Health Information Management Association This program has been approved for 4 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).
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
Medical Coding For Non Coders
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Author : Karen Scott
language : en
Publisher:
Release Date : 2013-10-09
Medical Coding For Non Coders written by Karen Scott and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-10-09 with Medical categories.
Medical Coding For Non-Coders delivers a valuable introduction to medical coding for those in healthcare who need to understand the process of coding, but do not need the level of specificity required to become a coding professional. In today's ever-growing, complex healthcare system, it is imperative that all healthcare professionals have a basic understanding of the coding process. This book explains how the documentation they supply impacts the coding process, healthcare data, and reimbursement as a whole. New to This Edition Provides information on the transition to ICD-10-CM and ICD-10 -PCS Updated for the most recent coding rules and regulations Updated appendices include the AHIMA code of ethics, and the process for querying physicians Key Features Presents a coding overview in an easy-to-understand format, detailing the impact of coding on reimbursement, compliance, and fraud and abuse. Provides a short overview of the coding systems, including information on the transition to ICD-10-CM and ICD-10-PCS. Provides an overview of the process of coding including what causes delays from patient admission to final billing of the visit. Addresses basic, yet critical questions such as: What does a coder require to provide accurate coded data? How is a medical record converted to coded data? How are codes assigned? How is coded data used?
Health Care Finance And The Mechanics Of Insurance And Reimbursement
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Author : Michael K. Harrington
language : en
Publisher: Jones & Bartlett Learning
Release Date : 2019-10-01
Health Care Finance And The Mechanics Of Insurance And Reimbursement written by Michael K. Harrington and has been published by Jones & Bartlett Learning this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-10-01 with Medical categories.
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.
Codebusters
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Author : Patricia T. Aalseth
language : en
Publisher: Jones & Bartlett Learning
Release Date : 1998-12
Codebusters written by Patricia T. Aalseth and has been published by Jones & Bartlett Learning this book supported file pdf, txt, epub, kindle and other format this book has been release on 1998-12 with Health insurance claims categories.
Medicine