Medical Revenue Cycle Management - The Comprehensive Guide


Book Description

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.




Medical Insurance: A Revenue Cycle Process Approach


Book Description

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







Billing & Coding Clear & Simple


Book Description

Today’s fast-paced and constantly changing health-care environment demands that you find the answers you need quickly and easily. This brand-new approach to billing and coding teaches you the who, what, why, when, and how of proper diagnostic and procedural coding, claim form completion, and medical recordkeeping.




Medical Billing & Coding For Dummies


Book Description

The definitive guide to starting a successful career in medical billing and coding With the healthcare sector growing at breakneck speed—it’s currently the largest employment sector in the U.S. and expanding fast—medical billing and coding specialists are more essential than ever. These critical experts, also known as medical records and health information technicians, keep systems working smoothly by ensuring patient billing and insurance data are accurately and efficiently administered. This updated edition provides everything you need to begin—and then excel in—your chosen career. From finding the right study course and the latest certification requirements to industry standard practices and insider tips for dealing with government agencies and insurance companies, Medical Billing & Coding For Dummies has you completely covered. Find out about the flexible employment options available and how to qualify Understand the latest updates to the ICD-10 Get familiar with ethical and legal issues Discover ways to stay competitive and get ahead The prognosis is good—get this book today and set yourself up with the perfect prescription for a bright, secure, and financially healthy future!




The Hospital Guide to Contemporary Utilization Review


Book Description

The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives




Medical Office Billing


Book Description

"This workbook explains the fundamentals of how to work effectively as a medical office insurance staff member. It introduces individuals to the various steps of filing a claim and the role that insurance staff members play in claims processing and thus in the organization's financial health"--Provided by publisher.




Medical Coding and Billing - The Comprehensive Guide


Book Description

Dive into the world of medical coding and billing with "Medical Coding and Billing - The Comprehensive Guide." This essential resource provides a thorough understanding of the crucial role these fields play in healthcare administration. Whether you're a student, a healthcare professional, or simply interested in the administrative side of healthcare, this guide offers comprehensive coverage of the latest coding systems, billing procedures, and regulatory requirements. Written by experts in the field, the book navigates through complex coding systems, including ICD-10, CPT, and HCPCS, ensuring you're up-to-date with current practices. Beyond the codes, it delves into the practical aspects of billing, claims processing, and the nuances of insurance. Essential topics like compliance, ethics, and the impact of coding on revenue cycle management are covered in depth. This guide also addresses the ever-evolving landscape of healthcare legislation, providing insights into how these changes affect medical coding and billing. Furthermore, to ensure a clear focus on content, this book does not include images or illustrations for copyright purposes. Whether you're aiming for certification or looking to enhance your professional skills, "Medical Coding and Billing - The Comprehensive Guide" is your indispensable resource in mastering the intricacies of this vital healthcare industry role.