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Author: Kem Tolliver
Publisher: Medical Group Management Association/Center for Research in Ambulatory Health Care Administration
Published: 2020-04-16
Total Pages: 482
ISBN-13: 9781568296777
DOWNLOAD EBOOKIt is easy to get lost in all the phases of revenue management, so how does a practice keep it all straight? Proven solutions to optimize revenue cycle are the key, and this primer is a business-critical resource to deliver just that.
Author: April Wilson
Publisher:
Published: 2018-06-08
Total Pages: 72
ISBN-13: 9781982995706
DOWNLOAD EBOOKWhile the industry continues to undergo growing pains, transitioning to value-based care from fee-for-service, hospitals and providers are also fielding new challenges that have emerged on the regulatory, technology, and patient-consumer fronts. Hospitals and providers are in a race against one another to find new ways to attract and retain patients. Now that patients are assuming greater financial responsibility for their healthcare costs, whether voluntarily or involuntarily, their expectations are high about having a positive clinical and financial experience. Therefore, the engagement of patients should begin before the actual clinical encounter. The RCM departments of forward-thinking organizations recognize that an active patient engagement strategy is an effective way of influencing positive patient payment behaviors.Revenue cycle plays an intrinsic role in the overall patient experience, and there are multiple touchpoints by which to engage patients before billing them. Some examples include being transparent with patients at the outset about their financial obligations, removing barriers to payment by providing flexible options and payment tools, such as an online payment portal, and enhancing the design of billing statements. Patient engagement that prioritizes consumer satisfaction can lead to good financial outcomes for healthcare organizations.This book will help RCM professionals navigate the changing environment successfully.
Author: Kyle Herbert
Publisher: CRC Press
Published: 2012-06-05
Total Pages: 275
ISBN-13: 1439898944
DOWNLOAD EBOOKDue to the countless variables that affect revenue and cost, the hospital reimbursement process is by far the most complex of any industry. Requiring only a basic financial background and a working knowledge of accounting, Hospital Reimbursement: Concepts and Principles supplies a clear understanding of the concepts and principles that drive the revenue cycle within a hospital setting. The book explains the technical aspects of reimbursement in language that is easy to comprehend. It illustrates the complexities of the hospital revenue cycle and explains the Medicare and Medicaid financial models in detail. The text also addresses the Medicaid reimbursement methodology, the formulation of the Medicare blend rate, the computation of both DSH and IME, as well as other third-party payers. It also: Covers the full range of services and procedures for which a hospital can receive reimbursement Explains the difference between a for-profit and not-for-profit hospital Contains chapters devoted to Statements of Operations (Income Statement) and Statements of Financial Position (Balance Sheet) Examines governmental cost reporting—including Worksheets A, A-6, A-8, A-8-2, B-1, B Part 1, C Part 1, D-3, D-5, and E Part A Supplying readers with a foundation in coding principles, the text also includes a model for calculating the financial impact of variations in patient length of stay. It discusses the DRG and APC reimbursement models and details the computation of an outlier payment. In addition, it walks the reader step-by-step through the creation of a mock Medicare cost report for a sample hospital.
Author: Neil Baum
Publisher: Springer Nature
Published: 2019-11-20
Total Pages: 209
ISBN-13: 3030277763
DOWNLOAD EBOOKThis book is intended to be a roadmap towards a successful practice for medical students, residents, fellows, and doctors. This roadmap focuses on how to build and manage a medical practice, and can be applied regardless if the reader is employed, joins a small group, or if they are a doctor who decides to start their own practice. Part I covers the basic business concepts that every physician needs to know. Chapters emphasize the benefits that accrue to a physician who understands the basics of business. Part II provides a guide for doctors who are beginning a medical practice. The chapters define the various options for doctors’ employment such as solo practice, group practice, and academic medicine. The section also includes the process of negotiating contracts, identifying the advisers who help physicians become successful, and secure within their field and practice. The final part emphasizes strategies on how to build and grow a successful practice by covering topics such as hiring staff, employee motivation, creating a brand, gaining recognition, online reputation and presence, crisis management, integrating new technology, and work/life balance. The Business Basics of Building and Managing a Healthcare Practice serves as a valuable resource that helps doctors make a difference in the lives of their patients, as well as help them make good financial decisions.
Author: Khuntia, Jiban
Publisher: IGI Global
Published: 2019-12-27
Total Pages: 322
ISBN-13: 1799823113
DOWNLOAD EBOOKBusiness intelligence supports managers in enterprises to make informed business decisions in various levels and domains such as in healthcare. These technologies can handle large structured and unstructured data (big data) in the healthcare industry. Because of the complex nature of healthcare data and the significant impact of healthcare data analysis, it is important to understand both the theories and practices of business intelligence in healthcare. Theory and Practice of Business Intelligence in Healthcare is a collection of innovative research that introduces data mining, modeling, and analytic techniques to health and healthcare data; articulates the value of big volumes of data to health and healthcare; evaluates business intelligence tools; and explores business intelligence use and applications in healthcare. While highlighting topics including digital health, operations intelligence, and patient empowerment, this book is ideally designed for healthcare professionals, IT consultants, hospital directors, data management staff, data analysts, hospital administrators, executives, managers, academicians, students, and researchers seeking current research on the digitization of health records and health systems integration.
Author: Michael K. Harrington
Publisher: Jones & Bartlett Learning
Published: 2019-10-01
Total Pages: 344
ISBN-13: 1284169030
DOWNLOAD EBOOKHealth 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: James E. Szalados
Publisher: Springer Nature
Published: 2021-04-02
Total Pages: 694
ISBN-13: 3030685705
DOWNLOAD EBOOKThe Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a comprehensive resource intended to provide a state-of-the-art overview of complex ethical, regulatory, and legal issues of importance to clinical healthcare professionals in the area of acute care medicine; including, for example, physicians, advanced practice providers, nurses, pharmacists, social workers, and care managers. In addition, this book also covers key legal and regulatory issues relevant to non-clinicians, such as hospital and practice administrators; department heads, educators, and risk managers. This text reviews traditional and emerging areas of ethical and legal controversies in healthcare such as resuscitation; mass-casualty event response and triage; patient autonomy and shared decision-making; medical research and teaching; ethical and legal issues in the care of the mental health patient; and, medical record documentation and confidentiality. Furthermore, this volume includes chapters dedicated to critically important topics, such as team leadership, the team model of clinical care, drug and device regulation, professional negligence, clinical education, the law of corporations, tele-medicine and e-health, medical errors and the culture of safety, regulatory compliance, the regulation of clinical laboratories, the law of insurance, and a practical overview of claims management and billing. Authored by experts in the field, The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a valuable resource for all clinical and non-clinical healthcare professionals.
Author: Anne Casto
Publisher:
Published: 2023-10-02
Total Pages: 0
ISBN-13: 9781584269151
DOWNLOAD EBOOKAuthor: Nenna L. Bayes, BA, MEd
Publisher: McGraw-Hill Education
Published: 2019-01-24
Total Pages: 0
ISBN-13: 9781259608551
DOWNLOAD EBOOKThe Eighth edition of Medical Insurance: A Revenue Cycle Process Approach emphasizes the revenue cycle—ten steps that clearly identify all the components needed to successfully manage the medical insurance claims process . The cycle shows how administrative medical professionals “follow the money .” Medical insurance specialists must be familiar with the rules and guidelines of each health plan in order to submit proper documentation, which then ensures that offices receive maximum, appropriate reimbursement for services provided . Learn the skills you need for your health professions career using multiple digital resources . Read and study the content more effectively—spending more time on topics you don’t know and less time on the topics you do by using SmartBook®, McGraw-Hill Education’s revolutionary adaptive learning technology
Author: Rose T Dunn
Publisher:
Published: 2018-04
Total Pages: 140
ISBN-13: 9781683081494
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