Compliance for Coding, Billing & Reimbursement, 2nd Edition

Compliance for Coding, Billing & Reimbursement, 2nd Edition

Author: Duane C. Abbey

Publisher: CRC Press

Published: 2008-04-02

Total Pages: 232

ISBN-13: 1563273683

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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.


Book Synopsis Compliance for Coding, Billing & Reimbursement, 2nd Edition by : Duane C. Abbey

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.


Correct Coding for Medicare, Compliance, and Reimbursement

Correct Coding for Medicare, Compliance, and Reimbursement

Author: Belinda S. Frisch

Publisher: Delmar Thomson Learning

Published: 2007

Total Pages: 0

ISBN-13: 9781418015619

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Two CD-ROM discs in pocket.


Book Synopsis Correct Coding for Medicare, Compliance, and Reimbursement by : Belinda S. Frisch

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


Compliance for Coding, Billing & Reimbursement

Compliance for Coding, Billing & Reimbursement

Author: Duane C. Abbey

Publisher: McGraw-Hill Companies

Published: 1999

Total Pages: 261

ISBN-13: 9780071353489

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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


Book Synopsis Compliance for Coding, Billing & Reimbursement by : Duane C. Abbey

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


Correct Coding for Medicare, Compliance, and Reimbursement

Correct Coding for Medicare, Compliance, and Reimbursement

Author: Belinda S. Frisch

Publisher:

Published: 2007

Total Pages: 0

ISBN-13:

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Book Synopsis Correct Coding for Medicare, Compliance, and Reimbursement by : Belinda S. Frisch

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:


Health Care Finance and the Mechanics of Insurance and Reimbursement

Health Care Finance and the Mechanics of Insurance and Reimbursement

Author: Michael K. Harrington

Publisher: Jones & Bartlett Learning

Published: 2019-10-01

Total Pages: 344

ISBN-13: 1284169030

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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.


Book Synopsis Health Care Finance and the Mechanics of Insurance and Reimbursement by : Michael K. Harrington

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.


CodeBusters

CodeBusters

Author: Patricia T. Aalseth

Publisher: Jones & Bartlett Learning

Published: 1998-12

Total Pages: 60

ISBN-13: 9780834213173

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Medicine


Book Synopsis CodeBusters by : Patricia T. Aalseth

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


Chargemasters

Chargemasters

Author: Duane C. Abbey

Publisher: HC Pro, Inc.

Published: 2005

Total Pages: 282

ISBN-13: 9781578396306

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Book Synopsis Chargemasters by : Duane C. Abbey

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:


Comprehensive Health Insurance + MyHealthProfessionsLab Access Code

Comprehensive Health Insurance + MyHealthProfessionsLab Access Code

Author: Deborah Vines Allen

Publisher: Prentice Hall

Published: 2012-08-15

Total Pages: 984

ISBN-13: 9780133141320

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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


Book Synopsis Comprehensive Health Insurance + MyHealthProfessionsLab Access Code by : Deborah Vines Allen

Download or read book Comprehensive Health Insurance + MyHealthProfessionsLab Access Code written by Deborah Vines Allen and published by Prentice Hall. This book was released on 2012-08-15 with total page 984 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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


Medical Billing & Coding Demystified, 2nd Edition

Medical Billing & Coding Demystified, 2nd Edition

Author: Marilyn Burgos

Publisher: McGraw Hill Professional

Published: 2015-11-22

Total Pages: 305

ISBN-13: 0071849335

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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


Book Synopsis Medical Billing & Coding Demystified, 2nd Edition by : Marilyn Burgos

Download or read book Medical Billing & Coding Demystified, 2nd Edition written by Marilyn Burgos and published by McGraw Hill Professional. This book was released on 2015-11-22 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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


Lab Billing and Coding

Lab Billing and Coding

Author: Dawn Runge

Publisher: HC Pro, Inc.

Published: 2005

Total Pages: 242

ISBN-13: 9781578396764

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Book Synopsis Lab Billing and Coding by : Dawn Runge

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: