Author : Pam Waymack
Publisher : HC Pro, Inc.
Page : 170 pages
File Size : 55,9 Mb
Release : 2005
Category : Business & Economics
ISBN : 1578397111
Denial Management
Pam Waymack
Denial Management
Denial Management Book in PDF, ePub and Kindle version is available to download in english. Read online anytime anywhere directly from your device. Click on the download button below to get a free pdf file of Denial Management book. This book definitely worth reading, it is an incredibly well-written.
Denials Management & Appeals Reference Guide - First Edition
AAPC
Author : AAPC
Publisher : AAPC
Page : 16 pages
File Size : 43,8 Mb
Release : 2020-03-17
Category : Medical
ISBN : 9781626889828
Denials Management & Appeals Reference Guide - First Edition by AAPC Pdf
Recoup lost time and revenue with denials management and appeals know-how. Claim denials can sink a profit margin. And given the cost of appeals, roughly $118 per claim, not all denials can be reworked. A practice submitting 50 claims a day at an average reimbursement rate of $200 per claim should bring in $10,000 in daily revenue. But if 10% of those claims are denied, and the practice can only appeal one, they lose $800 per day—upwards of $200K annually. Your medical claims are the lifeblood of operations. Don’t compromise your financial health. Learn how to preempt denials with the Denials Management & Appeals Reference Guide. This vital resource will equip you to get ahead of payers by simplifying the leading causes of denials and showing you how to address insufficient documentation, failing to establish medical necessity, coding and billing errors, coverage stipulations, and untimely filing. Rely on AAPC to walk you through the appeal process. We’ll help you establish protocols to avoid an appeals backlog and teach you how to identify and prioritize denials likely to win an appeal. What’s more, you’ll learn when a claim can be “reopened” to fix a problem. Collect the revenue your practice deserves with effective denials and appeals solutions: Know how to analyze your denials Defeat documentation and compliance issues for successful claims success Utilize payer policy for coverage clues Lock in revenue with face-to-face reimbursement guidance Refine efforts to avoid E/M claim denials Ace ICD-10 coding for optimum reimbursement Put an end to modifier confusion Stave off denials with CCI edits advice Navigate the appeals process like a pro And much more!
The Case Manager's Training Manual
David W. Plocher,Patricia L. Metzger
Author : David W. Plocher,Patricia L. Metzger
Publisher : Jones & Bartlett Learning
Page : 332 pages
File Size : 50,5 Mb
Release : 2001
Category : Hospitals
ISBN : 0834219301
The Case Manager's Training Manual by David W. Plocher,Patricia L. Metzger Pdf
Stem Cell and Bone Marrow Transplantation
Denial Management Tool Kit
Ingenix (Firm)
Author : Ingenix (Firm)
Publisher : Unknown
Page : 128 pages
File Size : 40,9 Mb
Release : 2007-06-30
Category : Medical
ISBN : 156337952X
Denial Management Tool Kit by Ingenix (Firm) Pdf
The denial management tool kit helps physicians manage the complete claims process, from data collection and claims submission to responding to payer inquiries and managing denials.
Denial Management Tool Kit
Ingenix, Incorporated
Author : Ingenix, Incorporated
Publisher : Elsevier Health Sciences
Page : 0 pages
File Size : 51,5 Mb
Release : 2005
Category : Health insurance claims
ISBN : 1563377314
Denial Management Tool Kit by Ingenix, Incorporated Pdf
The denial management tool kit helps physicians manage the complete claims process, from data collection and claims submission to responding to payer inquiries and managing denials.
The Leader's Guide to Hospital Case Management
Stefani Daniels,Marianne Ramey
Author : Stefani Daniels,Marianne Ramey
Publisher : Jones & Bartlett Learning
Page : 356 pages
File Size : 53,9 Mb
Release : 2005
Category : Hospitals
ISBN : 0763733547
The Leader's Guide to Hospital Case Management by Stefani Daniels,Marianne Ramey Pdf
This text will address the role of the hospital case manager from a busniess perspective rather than a nursing perspective. Will engage all areas that are involved with the health care system, in pursuit of global objectives on behalf of every stakeholder.
The Denials Management Training Handbook
Tanja Twist
Author : Tanja Twist
Publisher : Unknown
Page : 56 pages
File Size : 55,6 Mb
Release : 2017-01-17
Category : Electronic
ISBN : 1683081471
The Denials Management Training Handbook by Tanja Twist Pdf
The Denials Management Training Handbook (Pack of 5) Tanja Twist, MBA/HCM Many hospitals struggle with denials management thanks to the complex regulations and various types of denials. Payers often send denials to the wrong person, and hospitals may lose valuable research and appeals time as a result. In addition, drafting effective appeals letters that follow Medicare's regulations can be time-consuming and difficult even for experienced staff. Worst of all, the hard work of managing denials and submitting appeals on the back end can all be wasted if there is no system to use denials data to address root causes on the front end. The Denials Management Training Handbook provides clear, concise explanations of the complex appeal guidelines for Medicare and other payers. This information is presented in an easy-to-understand handbook for distribution to staff members involved in preventing and handling appeals. This handbook will help you manage the denials management process by: Providing an overview of common denial types and appeal timelines Giving you sample forms and templates Exploring best practices for improving the denials management process throughout the revenue cycle Gliding in the use of denials data to track recurrent denials and address their causes
Core Skills for Hospital Case Managers
Tony Cesta,Beverly Cunningham
Author : Tony Cesta,Beverly Cunningham
Publisher : HC Pro, Inc.
Page : 319 pages
File Size : 53,9 Mb
Release : 2009-06
Category : Medical
ISBN : 9781601463531
Core Skills for Hospital Case Managers by Tony Cesta,Beverly Cunningham Pdf
Core Skills for Hospital Case Managers: A Training Toolkit for Effective Outcomes Toni Cesta, PhD, RN, FAAN; Beverly Cunningham, MS, RN As of June 20, 2014, contact hours for nurses are no longer available with this product. Finally--an affordable, effective, and consistent training program for your hospital case managers. This one-of-a-kind guide to fundamental case management responsibilities is a necessary reference tool for every hospital case management department. This resource is designed to give case management directors and hospital leaders the tools they need to build and strengthen the basic and advanced skills their case management staff needs to succeed. Core Skills for Hospital Case Managers is an orientation and training manual for nurses transitioning into case management, an easy-to-read reference guide for new case managers, and a source of inspiration, tools, and resources for seasoned professionals. With a flexible format, this book and CD-ROM offer practical information and customizable tools to develop and maintain a wide variety of care management skills. Table of contents Chapter 1: Hospital Case Management 101 Chapter 2: Case Manager Role Chapter 3: Roles, Functions, and Caseloads Chapter 4: The Case Management Process Chapter 5: The Case Manager's Role in Transitional and Discharge Planning Chapter 6: Utilization Management Chapter 7: Managing Long Length of Stay Patients Chapter 8: Denials: Prevention and Appeals Strategies Chapter 9: Reimbursement Chapter 10: The Role of the Case Manager in Patient Flow Chapter 11: Measuring Success: Strategic Outcome Measures Chapter 12: Dealing with the Uninsured and Underinsured Chapter 13: Working with Multidisciplinary Teams Chapter 14: Crucial Communication and Conflict Resolution Learning objectives: Discuss the evolution of hospital case management Explain the different models of hospital case management Determine the various goals of hospital case management Examine the various roles of case management Discuss the variety of functions performed by case managers Discuss the scope of the case manager position Examine staffing ratios in various models List the steps in the case management process Determine the role of case managers in documentation Examine case managers' role in discharge planning List the factors that influence the discharge planning process Determine strategies for improving discharge planning Discuss how hospital reimbursement affects utilization management (UM) List the stages of UM coordination Determine the affect of outside influences on UM Evaluate different payers' regulations regarding UM Examine case management's role in length of stay (LOS) Evaluate strategies for managing patients with long LOS Identify data used to track and trend LOS Evaluate the reasons behind denials Discuss case management's role in preventing denials Examine case management's roles in reversing denials Examine case management's role in reimbursement Determine strategies for effective case management related to reimbursement Evaluate case management's role in patient flow Discuss demand and capacity management Identify strategies for managing patient flow Identify measurable case management outcomes Explain how case managers can track quality outcome metrics Discuss other metrics case management departments can track and trend Examine ways to create a case management report card Discuss the unfunded or underfunded patient populations Describe the role of the ED case manager with unfunded or underfunded patient populations Evaluate strategies for dealing with unfunded or underfunded patient populations Examine strategies for successfully working with multidisciplinary teams Describe sources of conflict with which case managers frequently come in contact Discuss strategies for reducing conflict Intended audience Staff nurses, charge nurses, staff educators, staff development specialists, directors of education, nurse managers, and nurse leaders
Revenue Cycle Management
HCPro (Firm)
Author : HCPro (Firm)
Publisher : HC Pro, Inc.
Page : 155 pages
File Size : 50,7 Mb
Release : 2006
Category : Health facilities
ISBN : 9781578397631
Revenue Cycle Management by HCPro (Firm) Pdf
The Coding Manager's Handbook
Rose T. Dunn
Author : Rose T. Dunn
Publisher : HC Pro, Inc.
Page : 177 pages
File Size : 50,9 Mb
Release : 2010-03-12
Category : Medical
ISBN : 9781601463289
The Coding Manager's Handbook by Rose T. Dunn Pdf
Provides a comprehensive and detailed look at coding managers' and supervisors' responsibilities and explains how to: allocate resources and structure the coding function to maximize productivity; select, develop, retain, and motivate staff; and establish a coding quality review program to ensure accuracy and compliance.
The Physician Billing Process
Deborah L. Walker,Sara M. Larch,Elizabeth W. Woodcock
Author : Deborah L. Walker,Sara M. Larch,Elizabeth W. Woodcock
Publisher : Medical Group Management Assn
Page : 274 pages
File Size : 42,5 Mb
Release : 2004
Category : Business & Economics
ISBN : 1568292309
The Physician Billing Process by Deborah L. Walker,Sara M. Larch,Elizabeth W. Woodcock Pdf
Collect money owed to your practice. Improve your revenue cycle by maximizing key processes for professional fee billing. Written by industry experts, this book is a step-by-step guide to billing and collection processes, performance outcomes and advanced billing practices. It includes case studies, tools, checklists, resources, policies and procedures to help you diagnose problems and develop plans to attain optimal financial performance.
Denial Management Counseling Professional Guide
Terence T. Gorski
Author : Terence T. Gorski
Publisher : Unknown
Page : 0 pages
File Size : 53,8 Mb
Release : 2000
Category : Addicts
ISBN : 0830909656
Denial Management Counseling Professional Guide by Terence T. Gorski Pdf
Leveraging Data in Healthcare
Rebecca Mendoza Saltiel Busch
Author : Rebecca Mendoza Saltiel Busch
Publisher : CRC Press
Page : 215 pages
File Size : 50,8 Mb
Release : 2016-01-05
Category : Business & Economics
ISBN : 9781498757737
Leveraging Data in Healthcare by Rebecca Mendoza Saltiel Busch Pdf
The healthcare industry is in a state of accelerated transition. The proliferation of data and its assimilation, access, use, and security are ever-increasing challenges. Finding ways to operationalize business and clinical data management in the face of government and market mandates is enough to keep most chief officers up at night! Leveraging Data in Healthcare: Best Practices for Controlling, Analyzing, and Using Data argues that the key to survival for any healthcare organization in today’s data-saturated market is to fundamentally redefine the roles of chief information executives—CIOs, CFOs, CMIOs, CTOs, CNIOs, CTOs and CDOs—from suppliers of data to drivers of data intelligence. This book presents best practices for controlling, analyzing, and using data. The elements of preparing an actionable data strategy are exemplified on subjects such as revenue integrity, revenue management, and patient engagement. Further, the book illustrates how to operationalize the electronic integration of health and financial data within patient financial services, information management services, and patient engagement activities. An integrated environment will activate a data-driven intelligent decision support infrastructure. The increasing impact of consumer engagement will continue to affect the organization’s bottom line. Success in this new world will need collaboration among the chiefs, users, and data creators.
Medical Revenue Cycle Management - The Comprehensive Guide
VIRUTI SATYAN SHIVAN
Author : VIRUTI SATYAN SHIVAN
Publisher : Viruti Satyan Shivan
Page : 236 pages
File Size : 44,8 Mb
Release : 2024-06-28
Category : Medical
ISBN : 8210379456XXX
Medical Revenue Cycle Management - The Comprehensive Guide by VIRUTI SATYAN SHIVAN Pdf
This essential guide dives deep into the intricacies of Medical Revenue Cycle Management (MRCM), offering healthcare professionals, administrators, and students a clear roadmap to mastering the financial backbone of healthcare services. In a landscape where financial health is as critical as patient health, this book stands out by providing a meticulously researched, expertly written exploration of every phase of the revenue cycle—from patient registration to the final payment of balances. Without relying on images or illustrations, we navigate through complex regulations, coding challenges, and billing practices with clarity and precision, making this complex subject accessible and actionable. Our unique approach combines theoretical frameworks with practical, real-world applications, setting this book apart as a must-buy. We delve into innovative strategies for optimizing revenue, reducing denials, and enhancing patient satisfaction, all while maintaining compliance with evolving healthcare laws and regulations. By focusing on efficiency and effectiveness, we equip readers with the tools and insights needed to transform their revenue cycle processes. Whether you're looking to refine your current practices or build a foundation of knowledge from the ground up, this guide offers invaluable insights into achieving financial stability and success in the ever-changing world of healthcare.
CMSA Core Curriculum for Case Management
Anonim
Author : Anonim
Publisher : Lippincott Williams & Wilkins
Page : 666 pages
File Size : 41,9 Mb
Release : 2008
Category : Medical
ISBN : 0781779170
CMSA Core Curriculum for Case Management by Anonim Pdf
This text contains the core body of knowledge for case management practice as delineated by the Case Management Society of America (CMSA), the largest professional organization of case managers. The core curriculum provides a "synthesis of case management evolution," and presents essential elements, concepts, and vision for current and future case management practice. This edition is significantly expanded to reflect the dynamic changes taking place in case management. Each chapter is organized in a consistent format that includes learning objectives; introduction; important terms and concepts; key definitions; and references.
