- Features completely updated information that reflects the many changes in the insurance industry. - Contains a new chapter on UB-92 insurance billing for hospitals and outpatient facilities. - Includes a new appendix, Quick Guide to HIPAA for the Physician's Office, to provide a basic overview of the important HIPAA-related information necessary on the job.
Prepare for a successful career in medical billing and insurance processing or revenue management with the help of Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2020 Edition. This comprehensive, inviting book presents the latest medical code sets and coding guidelines as you learn to complete health plan claims and master revenue management concepts. This edition focuses on today’s most important topics, including managed care, legal and regulatory issues, coding systems and compliance, reimbursement methods, clinical documentation improvement, coding for medical necessity, and common health insurance plans. Updates introduce new legislation that impacts health care. You also examine the impact on ICD-10-CM, CPT, and HCPCS level II coding; revenue cycle management; and individual health plans. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.
Understanding Health Insurance: A Guide to Professional Billing, 7th edition,utilizes a step-by-step approach to provide instruction about the completion of health insurance claims. the objectives of this edition are to 1) introduce information about major third party payer programs and federal health care regulations, 2) clarify coding guidelines and provide application exercises for each national diagnosis and procedure coding system, and 3) simplify the process of completing claims. Case studies and review exercises provide users with numerous opportunities to apply knowledge and to build s
How does a medical practice thrive in a business environment where the margin of management error has all but disappeared? Profit margins are being squeezed by declining reimbursement rates, capitation plans, gamesmanship on the part of the payors, and increasing operating costs. Addressing the specific needs of today’s medical practice, Medical Practice Business Plan Workbook, Third Edition supplies a detailed and ordered work plan to tackle some of the most pressing issues facing the field. Peter D. Lucash delves into decades of experience helping physician groups develop business plans to guide you along the process of building the profitable practice you want and deserve. This updated edition of a bestseller begins with a review of the fundamentals, including the questions your plan should answer, how to get started, how to organize and develop your plan, and the staff support and resources you will need. Complete with a wealth of helpful sample plans and worksheets, this workbook: Reflects recent changes in the healthcare industry, including federal healthcare reform Offers a one-of-a-kind design and approach tailored to the medical practice Covers conceptualization, organization, and implementation of your business plan This updated edition reflects current and forecasted challenges for practices, including the Affordable Care Act, data security, and quality and outcome measures. It supplies detailed coverage of the different types of organizations, governance and management, personnel needs, key business relationships and contacts, demographics and economic factors, patients as customers, competitor analysis, marketing, information technology, disaster and business continuity planning, and financial strategies. The final section outlines a process for implementing your plan. Sticking to this process will help ensure your plan covers what is needed to succeed in today’s complex medical environment. Visit www.Lucash.com for videos and other resources to help you develop and implement your practice business plan.
The definitive guide to starting a successful career in medical billing and coding With the healthcare sector growing at breakneck speed—it’s currently the largest employment sector in the U.S. and expanding fast—medical billing and coding specialists are more essential than ever. These critical experts, also known as medical records and health information technicians, keep systems working smoothly by ensuring patient billing and insurance data are accurately and efficiently administered. This updated edition provides everything you need to begin—and then excel in—your chosen career. From finding the right study course and the latest certification requirements to industry standard practices and insider tips for dealing with government agencies and insurance companies, Medical Billing & Coding For Dummies has you completely covered. Find out about the flexible employment options available and how to qualify Understand the latest updates to the ICD-10 Get familiar with ethical and legal issues Discover ways to stay competitive and get ahead The prognosis is good—get this book today and set yourself up with the perfect prescription for a bright, secure, and financially healthy future!
Many countries that subscribe to the Millennium Development Goals (MDGs) have committed to ensuring access to basic health services for their citizens. Health insurance has been considered and promoted as the major financing mechanism to improve access to health services, as well to provide financial risk protection.
Strengthen your skills and develop a solid foundation in medical insurance processing and revenue management with Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2022 Edition. This reader-friendly, comprehensive resource explains the latest developments and medical code sets and coding guidelines as you learn how to assign ICD-10-CM, CPT 2022 codes and HCPCS level II codes, complete health care claims and master revenue management concepts. You focus on important topics such as the latest managed care, legal and regulatory issues, coding systems and compliance, reimbursement methods, clinical documentation improvement, coding for medical necessity and common health insurance plans. New material introduces electronic claims, performance measurement and processing clinical quality language. A helpful workbook provides hands-on assignments and case studies, while MindTap online resources offer practice in CMS-1500 claims completion and assigning codes.
The demand for health information continues to increase, but the ability of health professionals to provide it clearly remains variable. The aim of this book is (1) to summarize and synthesize research on the selection and presentation of data pertinent to public health, and (2) to provide practical suggestions, based on this research summary and synthesis, on how scientists and other public health practitioners can better communicate data to the public, policy makers, and the press in typical real-world situations. Because communication is complex and no one approach works for all audiences, the authors emphasize how to communicate data "better" (and in some instances, contrast this with how to communicate data "worse"), rather than attempting a cookbook approach. The book contains a wealth of case studies and other examples to illustrate major points, and actual situations whenever possible. Key principles and recommendations are summarized at the end of each chapter. This book will stimulate interest among public health practitioners, scholars, and students to more seriously consider ways they can understand and improve communication about data and other types of scientific information with the public, policy makers, and the press. Improved data communication will increase the chances that evidence-based scientific findings can play a greater role in improving the public's health.
The most trusted and comprehensive guide to the healthcare system—fully updated with the latest changes and trends A Doody's Core Title for 2022! Understanding Health Policy: A Clinical Approach provides everything you need to master the healthcare system’s nuances and complexities, work more effectively with other members of healthcare teams, and identify areas in need of change. Written by practicing primary care physicians who are experts in healthcare policy, this peerless guide covers the entire scope of the U.S. healthcare system and draws on lessons from systems in other nations. The authors carefully weave key principles, descriptions, and concrete examples into chapters that make vital health policy issues interesting and understandable. Whether you’re a student, medical practitioner, or public policy professional, you will come away with a clearer, more systematic way of thinking about our healthcare system, its biggest challenges, and the most effective ways of making it better for everyone. Features • Covers every aspect of healthcare, including finance, organization, and reimbursement • Delivers updated information on the Affordable Care Act, Accountable Care Organizations, and system consolidation • Provides new insights into the role of social determinants in patient health • Clinical vignettes highlight key policy issues and clarify difficult concepts
