Compliance For Coding Billing Reimbursement 2nd Edition

Author : Duane C. Abbey
Publisher : CRC Press
ISBN 13 : 1563273683
Total Pages : 232 pages
Book Rating : 4.81/5 ( download)

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Download or read book Compliance for Coding, Billing & Reimbursement, 2nd Edition written by Duane C. Abbey and published by CRC Press. This book was released on 2008-04-02 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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 13 : 9780071353489
Total Pages : 261 pages
Book Rating : 4.88/5 ( download)

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Download or read book Compliance for Coding, Billing & Reimbursement written by Duane C. Abbey and published by McGraw-Hill Companies. This book was released on 1999 with total page 261 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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 : Belinda S. Frisch
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.24/5 ( download)

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Download or read book Correct Coding for Medicare, Compliance, and Reimbursement written by Belinda S. Frisch and published by . This book was released on 2007 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : Michael K. Harrington
Publisher : Jones & Bartlett Learning
ISBN 13 : 1284169030
Total Pages : 344 pages
Book Rating : 4.34/5 ( download)

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Download or read book Health Care Finance and the Mechanics of Insurance and Reimbursement written by Michael K. Harrington and published by Jones & Bartlett Learning. This book was released on 2019-10-01 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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 : Gina M. Reese
Publisher : Hcpro, a Division of Simplify Compliance
ISBN 13 : 9781683081906
Total Pages : 0 pages
Book Rating : 4.00/5 ( download)

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Download or read book Provider-based Entities written by Gina M. Reese and published by Hcpro, a Division of Simplify Compliance. This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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).

Author : Patricia T. Aalseth
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834213173
Total Pages : 60 pages
Book Rating : 4.76/5 ( download)

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Download or read book CodeBusters written by Patricia T. Aalseth and published by Jones & Bartlett Learning. This book was released on 1998-12 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicine

Author : Duane C. Abbey
Publisher : HC Pro, Inc.
ISBN 13 : 9781578396306
Total Pages : 282 pages
Book Rating : 4.01/5 ( download)

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Download or read book Chargemasters written by Duane C. Abbey and published by HC Pro, Inc.. This book was released on 2005 with total page 282 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : Marsha S Diamond
Publisher : Cengage Learning
ISBN 13 : 9781111138158
Total Pages : 576 pages
Book Rating : 4.5X/5 ( download)

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Download or read book Understanding Hospital Coding and Billing: A Worktext written by Marsha S Diamond and published by Cengage Learning. This book was released on 2014-08-05 with total page 576 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Author : Duane C. Abbey
Publisher : HC Pro, Inc.
ISBN 13 : 9781578395750
Total Pages : 238 pages
Book Rating : 4.55/5 ( download)

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Download or read book Emergency Department Coding and Billing written by Duane C. Abbey and published by HC Pro, Inc.. This book was released on 2005 with total page 238 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : Dawn Runge
Publisher : HC Pro, Inc.
ISBN 13 : 9781578396764
Total Pages : 242 pages
Book Rating : 4.6X/5 ( download)

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Download or read book Lab Billing and Coding written by Dawn Runge and published by HC Pro, Inc.. This book was released on 2005 with total page 242 pages. Available in PDF, EPUB and Kindle. Book excerpt: