The Medicare Handbook


Book Description




Section 1557 of the Affordable Care Act


Book Description

Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.







Medicare Primer


Book Description

This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.




Making Medicines Affordable


Book Description

Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.




Health-Care Utilization as a Proxy in Disability Determination


Book Description

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.




Health Care Facilities Code Handbook


Book Description




Closing the Quality Gap


Book Description




Step-by-Step Medical Coding, 2018 Edition - E-Book


Book Description

Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! From Carol J. Buck, the bestselling Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. Explanations of coding concepts are followed by practice exercises to reinforce understanding of the material. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other text so thoroughly covers all coding sets in one source! - A step-by-step approach makes it easier to build your skills and remember the material. - 30-day trial access to TruCode® Encoder Essentials gives you experience with using an encoder (in addition to separate encoder practice exercises on the Evolve website). - Learning Objective Review questions are included at the end of each chapter. - UNIQUE! Concrete "real-life" coding reports (cleared of any confidential information) simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Instructor-led assessments on the companion Evolve website provide additional assessment options in classroom settings (answers and rationales provided at the discretion of your instructor). - UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop your coding ability and critical thinking skills. - Over 450 total illustrations help you understand the types of medical conditions and procedures being coded, along with examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. - Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - UNIQUE! Coders' Index in the back of the book makes it easy to quickly locate specific codes. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - Sample electronic health record screenshots (located in Appendix D) show examples similar to the EHRs you will encounter in the workplace. - NEW! Updated content includes the latest coding information available, promoting accurate coding and success on the job. - NEW! Glossary review questions are included at the end of each chapter.




Physician Coding Exam Review 2018 - E-Book


Book Description

Prepare to succeed on your physician coding certification exam with Physician Coding Exam Review 2018: The Certification Step! From leading coding author and educator Carol J. Buck, this exam review provides complete coverage of all topics included on the physician coding certification exam — including anatomy, terminology, and pathophysiology for each body system; reimbursement issues; CPT, HCPCS, and ICD-10-CM coding; and more. Four full practice exams (answers and rationales included) simulate the testing experience and provide enough practice to reassure even the most insecure exam-taker. It's the only physician coding exam review you need! - UNIQUE! Four full practice exams on Evolve simulate the experience of taking the actual physician coding exam, allowing you to assess your strengths and weaknesses in order to develop a plan for focused study. - Answers and rationales to the practice exams are available on Evolve to help you check your work. - Concise outline format helps you access key information quickly and study more efficiently. - Concrete "real-life" coding reports (cleared of any confidential information) simulate the reports that you will encounter on the job and challenge you to apply key coding principles to actual cases. - Mobile-optimized quick quizzes offer on-the-go practice with over 350 medical terminology, pathophysiology, CPT, HCPCS, and ICD-10-CM questions. - Success Strategies section guides you step-by-step through the entire exam process. - NEW! Updated content features the latest coding information available, promoting accurate coding and success on the job.