Evaluation and Management Coding Reference Guide - First Edition


Book Description

Defeat the challenges that threaten your E/M claims and compliance success. Evaluation and management (E/M) services are the lifeblood of your revenue stream, and yet they’re the most problematic to report. Claim denials remain high. E/M coding errors, in fact, rose from 11.9% in 2018 to account for 12.8% of CMS’s overall 2019 improper payment rate. How much E/M revenue are you losing? Safeguard your organization from claim denials and audit scrutiny with the Evaluation & Management Coding Reference Guide. Our experts break down E/M coding rules and requirements into simple, manageable steps written in everyday language to boost your E/M reporting skills. Learn how to capture the key components of medical history, physical exam, and medical decision-making—and capitalize on real-world clinical scenarios to prevent over- or under-coding. The Evaluation & Management Coding Reference Guide will help you prep for 2021 E/M guideline changes overhauling new and established office and outpatient services, and walk you through online digital E/M services, remote physiologic monitoring, and more. Master the ins and outs of E/M coding—CPT® guidelines, level of service, modifiers, regulations, and documentation guidelines. Put an end to avoidable denials and optimize your E/M claims for full and prompt reimbursement. Benefit from expert tutorials covering the spectrum of E/M reporting concepts and challenges: Prep for 2021 guideline changes and their impact on your organization Master the ins and outs of E/M guidelines in CPT® Capture the seven components of E/M services Sort out medical decision-making coding Avoid the pitfalls of time-based coding Nail down specifics for critical care E/M services Clear up modifier confusion Understand NPPs rules for same-day E/M services Take the guesswork out of complexity determinations Get the details on coding surgery and E/M together Learn the principles of E/M documentation




Evaluation Management in South Africa and Africa


Book Description

This blind peer reviewed book systematically records, analyses and assesses for the first time in a single volume the implications of the global development and management of professional evaluation for the African continent.The book deals with the most strategic contemporary evaluation themes. Each of these themes contains discussions of theoretical issues illustrated with one or more short case studies, while selected longer case studies and other relevant documentation are also taken up in annexures at the end of the book. The book therefore comprises a guide to best M&E practices for purposes of systematic policy, programme and project evaluations. It is suitable for both professional M&E institutionalisation and capacity-building projects as well as for evaluation information dissemination and education at different levels in the public, private and voluntary sectors in society, especially in a developmental context.




Information Systems Evaluation Management


Book Description

Investments in IT are growing extensively and business managers worry about the fact that the benefits of IT investments might not be as high as expected. Information Systems Evaluation Management discusses this issue among others, through its presentation of the most current research in the field of IS evaluation.




Monitoring and Evaluation


Book Description

Most manuals currently available emphasize either M and E or Evaluation. Here is a primer with a significant difference. If you are already an expert or still a neophyte with a strong urge to improve your skills including those who have always wanted to know but feared asking, here is a manual for you that is unique, inclusive, and practical in several extraordinary ways.The primer covers a range of concepts, illustrations and real life cases studies. The vignette on the cover is a comprehensive example of what it is all about.The handbook leads the reader from a program management life cycle to strategic frameworks to a model designed by the author on performance indicators quality control including case studies. It has been implemented in Asia and Africa with an oral presentation made at a Canadian Evaluation Conference in Toronto, Canada. The real life cases include basic and advanced studies like randomized control trials using a quasi experimental design conducted during one of the author's evaluation assignments.The data management systems (DMS) section follows the same approach above with a framework that includes all the relevant DMS components including sections on basic statistics complemented with illustrations and more real life case studies. Concepts, illustrations, and cases cover statistical means, sampling protocols and student tests among others.







Compendium of HHS Evaluation Studies


Book Description




Software Maintenance Management


Book Description

This book explores the domain of software maintenance management and provides road maps for improving software maintenance organizations. It describes full maintenance maturity models organized by levels 1, 2, and 3, which allow for benchmarking and continuous improvement paths. Goals for each key practice area are also provided, and the model presented is fully aligned with the architecture and framework of software development maturity models of CMMI and ISO 15504. It is complete with case studies, figures, tables, and graphs.







Coding for Medical Necessity Reference Guide - First Edition


Book Description

Master coding concepts related to medical necessity and report compliant codes for your services. Revenue loss, rework, payback demands—how much are medical necessity errors costing your practice? And that’s to say nothing of potential civil penalties. Get medical necessity wrong and it’s considered a “knowingly false” act punishable under the FCA. Stay liability-free and get reimbursed for your services with reliable medical necessity know-how. AAPC’s Coding for Medical Necessity Reference Guide provides you with step-by-step tutorials to remedy the range of documentation and coding issues at the crux of medical necessity claim errors. Learn how to integrate best practices within your clinical processes—including spot-checks and self-audits to identify problems. Benefit from real-world reporting examples, Q&A, and expert guidance across specialties to master coding for medical necessity. Learn how to lock in medical necessity and keep your practice safe and profitable: Avoid Medical Necessity Errors with CERT Smarts Rules to Improve Provider Documentation Denials? Pay Attention to Procedure/Diagnosis Linkage Nail Down the Ins and Outs of Time-based Coding Expert Guidance to Fend Off RAC Audits and Denials Beat E/M Coding Confusion with Payer Advice Improve Your ABN Know How with This FAQ




Health Program Management


Book Description

Learn how to effectively plan, implement, and evaluate health programs Health Program Management: From Development Through Evaluation, Second Edition is a practical and useful introduction to the management of health programs. While providing an overview of the current best practices in management, the textbook goes beyond simple management techniques, teaching students how to develop, lead, and evaluate their programs to ensure quality outcomes. The focus is on the three core management concepts of strategy, design, and leadership, but time is also devoted to describing facilitative management activities integral to successful programs. Students will learn techniques for communication, decision-making, quality assurance, marketing, and program evaluation within the structure of the book's program management model. Logically organized with a separate chapter for each activity, this resource provides a thorough, systematic overview of the effective development, implementation, and evaluation of health programs. Health Program Management: From Development Through Evaluation, Second Edition provides a comprehensive approach to management throughout all stages of a health program. Learn to develop a strategy that steers the program toward specific goals Discover how to design, market, and lead an effective health program Become familiar with the manager's role in a quality health program Evaluate potential and existing programs for performance and capability Students and aspiring managers and leaders preparing themselves for the challenges of managing health programs will find the information and techniques to develop the skills they need in Health Program Management: From Development Through Evaluation, Second Edition.