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Principles of Healthcare Reimbursement by Anne B. Casto Pdf
The sixth edition of Principles of Healthcare Reimbursement gives educators, students, and healthcare professionals comprehensive, up-to-date information on healthcare reimbursement systems, and the impact each system has on the entire US healthcare delivery system and economy, in one trusted source. In addition to describing healthcare reimbursement methodologies and systems, this text discusses the impact of health insurance, coding and billing compliance and value-based purchasing initiatives. New and future healthcare professionals desiring to work in healthcare finance, revenue cycle, compliance and coding will gain the knowledge and training they need to succeed. Key Features include: New 4-color interior design! -- Covers accessing and using fee schedules, payment classification groups, exclusion lists, market baskets, and wage indexes required for accurate reimbursement -- Explains the various methods, plans, and programs that typify government-sponsored payment systems, commercial insurance, and managed-care -- Describes various types of healthcare cost-sharing and their effects on providers and consumers -- Illustrates specialized data collection instruments and electronic submission software used in postacute care -- Provided by publisher.
Due 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 re
Health Care Finance and the Mechanics of Insurance and Reimbursement by Michael K. Harrington Pdf
Health 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.
Principles of Healthcare Reimbursement by Elsie Gordon Pdf
A healthcare reimbursement plan is an advantage where managers repay their workers for clinical costs. This contrasts from customary gathering wellbeing plan inclusion in light of the fact that the business offers an advantage leniency accessible as opposed to picking and overseeing a gathering health care coverage strategy from a transporter.
Project Management for Healthcare by David Shirley Pdf
As a growing number of healthcare organizations implement project management principles to improve cost and service efficiencies, they are in desperate need of resources that illustrate the project management needs of today’s healthcare professional. Project Management for Healthcare fills this need. Using easy-to-follow language, it explains how the time-tested principles of project management can help maximize limited resources and ensure the highest possible quality of care. Exploring the discipline of project management from the perspective of the healthcare environment, the book dissects the project process and provides the tools and techniques required to successfully plan, execute, and control any healthcare-based project. From identifying stakeholders to constructing a project plan, it covers the spectrum of project planning activities. Complete with chapter summaries, exercises, hints, review questions, and case studies, it illustrates applications across a range of healthcare settings. Explains how to utilize the project plan to execute projects within budget, schedule, and quality objectives Covers program management as it relates to healthcare Addresses the interaction between healthcare and information technology Presents best practices from the pharmaceutical and medical equipment industries—that can easily be adapted to any healthcare setting Because most healthcare personnel will inevitably have to work with program management and need to interact with pharmaceutical companies and medical device manufacturers, the book provides an inside look at the processes and best practices used to bring products to market in these industries. Explaining how to adapt these processes to drive down costs and improve the quality of care in any healthcare setting, the book includes a case study of a medical facility that illustrates the proper application of the tools and techniques needed to manage healthcare projects effectively and efficiently.
Revenue Cycle Management Toolkit: A Comprehensive Guide to Managing Cash Flow William L. Malm, ND, RN, Contributing Editor Maintain a complete, thorough revenue cycle process The scope of a healthcare organization's revenue cycle is broad, encompassing issues on the front end of operations, in the coding and chargemaster departments, and in back-end/ reimbursement duties. New elements are constantly being introduced, with concepts such as MS-DRGs, Recovery Audit Contractors, and the Present on Admission Indicator, which all require operational changes. "Revenue Cycle Management Toolkit: A Comprehensive Guide to Managing Cash Flow" caters to the complexities and demands that come with managing every facet of your organization's revenue cycle, from the moment a patient walks through the door to reconciling payment for services rendered. A follow-up to HCPro's successful 2006 edition, "Revenue Cycle Management Toolkit: A Comprehensive Guide to Managing Cash Flow" features forms, checklists, tips, and advice for all aspects of the revenue cycle including: Registration and scheduling Upfront collections Chargemaster maintenance Outpatient coding, including major OPPS changes, drug administration and incident-to Inpatient coding, including RACs Billing and collections Emergency department Taken from the pages of HCPro's popular newsletters Patient Access Advisor, Briefings on Coding Compliance Strategies, Briefings on APCs, and Managed Care Contracting and Reimbursement Advisor, "Revenue Cycle Management Toolkit" offers value-added management and training tools such as quizzes to reinforce learning and assess competency, and sample case studies to illustrate practical demonstrations of the material provided in the book. With a foreword written by William Malm, ND, RN, director of HCPro's Revenue Cycle Institute, "Revenue Cycle Management Toolkit" provides sensible guidance and tools you can use immediately to start strengthening all of the functions in your revenue cycle, from patient access, all the way through to managed care contracting. This book will help you: Reference specific details relevant to each step in the cycle with easy-to-navigate tabs and chapters Identify specific successful methods used by your peers, that you can implement in your own organization, including detailed case studies and applicable tools Customize important documents such as audit plans and model letters, with templates provided on the accompanying CD-ROM Discover time-sensitive analysis of important changes and programs in 2008, including MSDRGs, Recovery Audit Contractors, and the Present on Admission Indicator Take a look at the table of contents, which are chock full of ways to upgrade your revenue cycle process: Foreword Chapter 1: UNCHS Case Studies Chapter 2: Patient Access Chapter 3: Chargemaster and Outpatient Coding Chapter 4: Inpatient Coding Chapter 5: Patient Financial Services Chapter 6: Spotlight on the Emergency Department
Institute of Medicine,LeighAnne M. Olsen,Elizabeth G. Nabel,J. Michael McGinnis,Mark B. McClellan
Author : Institute of Medicine,LeighAnne M. Olsen,Elizabeth G. Nabel,J. Michael McGinnis,Mark B. McClellan Publisher : National Academies Press Page : 202 pages File Size : 43,6 Mb Release : 2008-09-06 Category : Medical ISBN : 9780309113694
Evidence-Based Medicine and the Changing Nature of Health Care by Institute of Medicine,LeighAnne M. Olsen,Elizabeth G. Nabel,J. Michael McGinnis,Mark B. McClellan Pdf
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
National Research Council,Division of Behavioral and Social Sciences and Education,Committee on Human-Systems Integration,Committee on the Role of Human Factors in Home Health Care
Author : National Research Council,Division of Behavioral and Social Sciences and Education,Committee on Human-Systems Integration,Committee on the Role of Human Factors in Home Health Care Publisher : National Academies Press Page : 322 pages File Size : 52,8 Mb Release : 2010-11-14 Category : Medical ISBN : 9780309156295
The Role of Human Factors in Home Health Care by National Research Council,Division of Behavioral and Social Sciences and Education,Committee on Human-Systems Integration,Committee on the Role of Human Factors in Home Health Care Pdf
The rapid growth of home health care has raised many unsolved issues and will have consequences that are far too broad for any one group to analyze in their entirety. Yet a major influence on the safety, quality, and effectiveness of home health care will be the set of issues encompassed by the field of human factors research-the discipline of applying what is known about human capabilities and limitations to the design of products, processes, systems, and work environments. To address these challenges, the National Research Council began a multidisciplinary study to examine a diverse range of behavioral and human factors issues resulting from the increasing migration of medical devices, technologies, and care practices into the home. Its goal is to lay the groundwork for a thorough integration of human factors research with the design and implementation of home health care devices, technologies, and practices. On October 1 and 2, 2009, a group of human factors and other experts met to consider a diverse range of behavioral and human factors issues associated with the increasing migration of medical devices, technologies, and care practices into the home. This book is a summary of that workshop, representing the culmination of the first phase of the study.
Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies by OECD,World Health Organization Pdf
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
The Future of Nursing 2020-2030 by National Academies of Sciences Engineering and Medicine,Committee on the Future of Nursing 2020-2030 Pdf
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
