- 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.
The 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
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.
Basics of the U.S. Health Care System, Third Edition provides students with a broad, fundamental introduction to the workings of the healthcare industry. Engaging and activities-oriented, the text offers an especially accessible overview of the major concepts of healthcare operations, the role of government, public and private financing, as well as ethical and legal issues. Each chapter features review exercises and Web resources that make studying this complex industry both enjoyable and easy. Students of various disciplines—including healthcare administration, business, nursing, public health, and others—will discover a practical guide that prepares them for professional opportunities in this rapidly growing sector.
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.
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.
Social Security disability is an enormous program, with hundreds of thousands of people participating each year. Consequently, it's easy for both participants and first-time applicants to get lost in the system's bureaucracy.Nolo's Guide to Social Security Disability is an essential book for anyone dealing with a long-term or permanent disability. Written both for first-time applicants and those who already receive Social Security disability, Dr. David Morton's book demystifies the program in plain English, thoroughly explaining:* what Social Security disability is* what benefits are available to disabled children* how to prove a disability* how age, education and work experience affect benefits* whether or not one can work while receiving benefits* how to appeal a denial of benefits* how to respond to a Continuing Disability Review* and much more