Coding, Classification, and Reimbursement
Coding, Classification, and Reimbursement
Table of Contents
Table of Contents
About the Book
About the Book
Revenue Cycle Management Best Practices , Second Edition, helps health information professionals and students better understand and participate in the revenue cycle man- agement (RCM) process by providing examples of how facilities can move from managing the revenue cycle by department to managing with an interdisciplinary approach to gain sig- nificant improvements on the timely flow of revenue. This book educates the reader in understanding the interdepartmental dependencies and overall contributors to RCM with a fo- cus on acute-care hospitals from the perspective of the HIM department.
1 Revenue Cycle Basics 2 Financial Basics 3 Payer Reimbursement 4 Patient Access 5 Documentation and Charge Capture 6 Record Completion and Coding 7 Claims Management Appendix A: Glossary Appendix B: Answers to Check Your Understanding Questions Index
The eighth edition of Principles of Healthcare Reimbursement and Revenue Cycle Management is a comprehensive tool for educators, students, and healthcare profession- als to master understanding of the US healthcare reimbursement systems and their impact on the US healthcare delivery system and economy. This authoritative text offers detailed discussions of healthcare reimburse- ment methodologies and systems, the impact of health insurance, coding and billing compliance, value-based purchasing initiatives, and the rev- enue cycle and its management. It supports knowledge application and data analytics skill-building through real-life scenarios and case studies.
Part I: Foundations of Healthcare Reimbursement 1 Healthcare Reimbursement and Revenue Cycle Management 2 Health Insurance 3 Government-Sponsored Healthcare Programs Part II: Reimbursement Methodologies and Payment Systems 4 Healthcare Reimbursement Methodologies 5 Medicare Hospital Acute Inpatient Payment System 6 Medicare Skilled Nursing Facility Services Payment System 7 Medicare Outpatient Hospital Payment System 8 Medicare Physician and Other Health Professional Payment System Part III: Revenue Cycle Processes 9 Revenue Cycle Front End Processes—Patient Engagement 10 Revenue Cycle Middle Processes— Resource Tracking 11 Revenue Cycle Back-End Processes— Claims Production and Revenue Collection Part IV: Revenue Cycle Management 12 Coding and Clinical Documentation Integrity Management 13 Revenue Compliance Part V: Revenue Cycle Analysis 14 Healthcare Data in Action: Real-World Analysis Appendix A: Abbreviation List Appendix B: Glossary Appendix C: Answer Key for Check Your Understanding Questions Appendix D: CMS 1500 Claim Form Appendix E: CMS 1450 (UB-04) Claim Form Appendix F: Medicare Summary Notice Index On the Website: Chapter 15: Payment Systems for Specialty Settings Appendix G: Review of Mathematics and Statistics Methods
Revenue Cycle Management Best Practices, Second Edition Nadinia A. Davis , MBA, RHIA, CHDA, CCS, FAHIMA Belinda M. Doyle , MSJ
Principles of Healthcare Reimbursement and Revenue Cycle Management, Eighth Edition Anne B. Casto , RHIA, CCS Susan White , PhD, RHIA, CHDA
Key Features
• Chapter content illustrates best practices in RCM with a focus on acute-care hospitals from an HIM department perspective • Online resources include sample forms, logs, questionnaires, policies, and tracking tools as well as supplementary AHIMA toolkits, white papers, and practice briefs About the Authors Nadinia A. Davis , MBA, RHIA, CHDA, CCS, FAHIMA, is the program coordinator of the HIM program at Delaware Technical Community College. Belinda M. Doyle , MSJ, is the director of payer services for Children’s Specialized Hospital’s 14 locations throughout New Jersey
Key Features
• New online chapter 15 dedicated to payment systems for specialty settings • Patient Connection section in each chapter guides the reader through applying chapter concepts to real-life scenarios • New online appendix covering basic statistics • Student workbook included in online ancillaries About the Authors Anne B. Casto , RHIA, CCS, is president of Casto Consulting, LLC, and a lecturer in the HIMS division at The Ohio State University School of Allied Medical Professions. Susan White , PhD, RHIA, CHDA, is the chief analytics officer at The Ohio State University Wexner Medical Center.
Product#: AB106114
©2016
ISBN: 978-1-58426-526-9 Softcover 228 pages Premier Member: $71.95 Member: $75.95 List: $94.95
NEW
Product#: AB202022
©2024
ISBN: 978-1-58426-915-1 Softcover 392 pages Premier Member: $75.95 Member: $79.95 List: $99.95
ebook Available e-ISBN: 978-1-58426-534-4
ebook Available e-ISBN: 978-1-58426-916-8
Instructor Resources include the following: • Test bank and full answer key • Answer key for critical thinking questions • Presentation slides • Sample syllabus for baccalaureate programs The test bank is also available in Respondus.
Instructor Resources include the following: • Instructor manual • Test bank and supplementary mini quizzes • Presentation slides and supplementary mini slide decks • A map to the AHIMA HIM curricula competencies • Transition guide The test bank is also available in Respondus.
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AHIMA I ADVANCE
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