Principles of Healthcare Reimbursement


Book Description

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.










Principles of Healthcare Reimbursement


Book Description

Principles of Healthcare Reimbursement provides a comprehensive overview of the complex world of healthcare reimbursement. In today's healthcare landscape, understanding the intricacies of reimbursement systems is essential for healthcare providers, administrators, and professionals working in the healthcare industry. This book delves into the principles, policies, and practices involved in healthcare reimbursement, equipping readers with the knowledge they need to navigate this critical aspect of healthcare delivery. With a focus on the United States healthcare system, this book explores the various types of reimbursement systems, including public programs such as Medicare and Medicaid, as well as private insurance systems. It covers the role of insurance in reimbursement, the coding and billing process, and the impact of managed care on reimbursement models. Additionally, it discusses emerging trends in reimbursement, such as value-based models and the reimbursement challenges faced in rural healthcare settings.




Principles of Healthcare Reimbursement


Book Description

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.




Health Care Finance and the Mechanics of Insurance and Reimbursement


Book Description

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.




Gapenski's Healthcare Finance


Book Description

Gapenski's Healthcare Finance: An Introduction to Accounting and Financial Management explores how healthcare organizations manage financial operations to optimally provide patient care. This significantly revised edition of one of Health Administration Press's best-selling books introduces the key foundational elements of healthcare finance, including both accounting and financial management. Numerous examples throughout showcase how healthcare finance is practiced in a variety of organizations, including hospitals, medical practices, clinics, home health agencies, nursing homes, and managed care organizations. Authors Kristin L. Reiter and Paula H. Song present the financial management and accounting concepts that are most critical to managerial decision-making. They emphasize not only financial theory and principles but also practical tools healthcare managers can use to make the crucial decisions that promote the financial well-being of their organization. Gapenski's Healthcare Finance examines the current financial environment in which providers operate, with an emphasis on health system design, healthcare insurance, and reimbursement methodologies. Dates, exhibits, references, and resources have been updated throughout. All examples and financial statements reflect current accounting and reporting standards. Extensive updates and content new to this seventh edition include: A discussion of health reform that reflects the current status of the Affordable Care Act; Information on the field's increasing focus on social determinants of health; Tax rates and examples that reflect the effects of the Tax Cuts and Jobs Act; A discussion of Medicaid expansion and health insurance exchanges; Coverage of the implications of value-based payment for the revenue cycle; Significant reorganization of the financial accounting chapters to orient students to financial accounting before the book's coverage of the income statement, statement of changes in equity, the balance sheet, and the statement of cash flows; A new chapter supplement provides expanded analysis of the double-entry accounting system; Amendments to the financial accounting conceptual framework by the Financial Accounting Standards Board; Better differentiation of risk measures of realized vs. expected return distributions In a dynamic environment, healthcare leaders need to practice good financial decision-making for the health of their patients and the financial stability of their organization. From this book, current and future managers will understand the finance problems provider organizations face and how best to solve them.




Management Principles for Health Professionals


Book Description

Management Principles for Health Professionals is a practical guide for new or future practicing healthcare managers. The customary activities of the manager—planning, organizing, decision making, staffing, motivating, and budgeting—are succinctly defined, explained, and presented with detailed examples drawn from a variety of health care settings. Students will learn proven management concepts, techniques, models, and tools for managing individuals or teams with skill and ease. The Sixth Edition is loaded with all-new examples from real-world healthcare settings and covers many current topics such as: ? Emerging implications of the Patient Protection and Affordable Care Act of 2010. ? A template to track the areas of impact of this major law is presented; this enables a manager to identify the topics to monitor and to prepare responses to changes as they unfold. ? Developments concerning electronic health record initiatives ? Adapting and revitalizing one’s career; ? Information concerning various staffing alternatives such as outsourcing and telecommuting, and updates the material concerning job descriptions and their application. New material has been added in the section on consultant's contracts and reports. ? Patient privacy and the detection and prevention of medical identity theft, and much more.