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Medical Revenue Cycle Management: One Book To Make You Genius by VIRUTI SHIVAN Are you a student aspiring to excel in the complex world of medical revenue cycle management? Look no further! This comprehensive guide is tailor-made to equip you with the knowledge and skills necessary to navigate the intricacies of this vital healthcare discipline. Medical Revenue Cycle Management: One Book To Make You Genius is a must-have resource that covers every aspect of the revenue cycle process, from patient registration to claim reimbursement. Written with students in mind, this book offers a comprehensive overview of the subject, providing a solid foundation for your future career. Inside this guide, you will find: 1. Introduction to Medical Revenue Cycle Management: Gain a clear understanding of the revenue cycle and its significance in healthcare organizations. Explore the various roles and responsibilities involved in revenue cycle management. 2. Patient Access and Registration: Learn the fundamentals of patient registration, insurance verification, and the importance of accurate patient data collection. Understand the impact of accurate information on revenue optimization. 3. Health Insurance and Payer Systems: Explore the intricacies of health insurance, different types of payers, and their impact on revenue cycle management. Gain insights into payer contracts, claim submission, and electronic data interchange (EDI). 4. Coding and Documentation: Discover the importance of accurate medical coding and its impact on reimbursement. Master the principles of coding, documentation guidelines, and coding systems such as ICD-10-CM and CPT. 5. Claims Management and Denial Resolution: Delve into the world of claims management, including claim submission, tracking, and denial resolution. Learn effective strategies to minimize claim denials and maximize revenue recovery. 6. Billing and Reimbursement: Understand the intricacies of billing processes, including charge capture, pricing, and electronic billing systems. Explore reimbursement methodologies, such as fee-for-service and value-based reimbursement. 7. Compliance and Regulatory Considerations: Stay up to date with the ever-evolving healthcare regulations and compliance requirements. Learn about HIPAA, fraud and abuse laws, and the importance of ethical billing practices. 8. Key Performance Indicators and Revenue Cycle Analytics: Gain insights into tracking and measuring revenue cycle performance through key performance indicators (KPIs) and analytics. Learn to identify areas for improvement and optimize revenue generation. With its student-friendly approach, practical examples, and case studies, this guide ensures that you not only grasp the theoretical concepts but also develop the critical thinking and problem-solving skills necessary for success in this field. Whether you are a healthcare administration student, aspiring medical coder, or revenue cycle professional, this comprehensive guide will serve as your go-to reference, providing you with a solid foundation in medical revenue cycle management. Unlock your potential and embark on a successful career in this crucial area of healthcare administration with confidence! Don't miss out on this essential resource. Get your copy of Medical Revenue Cycle Management: One Book To Make You Genius today and take your first step towards mastering this dynamic field!
Unlock the complexities of healthcare revenue management with "The Art and Science of Medical Billing and Coding" Whether you're a seasoned professional or just starting out in the field, this book offers a complete roadmap to understanding and excelling in medical billing and coding. In an era where accurate coding and billing are paramount to a healthcare institution's financial health, this book serves as your ultimate companion. Delve into the world of medical terminology, procedural coding, and claim submission, all while gaining a deep understanding of the revenue cycle management process. Inside these pages, you'll find: Foundational Knowledge: Begin your journey with an exploration of the fundamental principles of medical billing and coding. Grasp the significance of accurate documentation, learn to decipher complex medical terminology, and uncover the secrets of coding systems like CPT, ICD-10, and HCPCS Level II. Step-by-Step Guidance: Navigate the intricate web of coding guidelines and regulations with confidence. Follow step-by-step instructions for assigning codes to diagnoses, procedures, and supplies, ensuring compliance with industry standards and government regulations. Real-world Case Studies: Put theory into practice with real-world case studies that mimic the challenges and decisions faced in actual healthcare settings. Learn to analyze patient records, apply the appropriate codes, and prepare error-free claims for submission. Navigating the Revenue Cycle: Gain insights into the broader revenue cycle management process. From patient registration and insurance verification to claims submission and reimbursement, understand how each stage contributes to the financial success of healthcare organizations. Coding Ethics and Compliance: Explore the ethical considerations and compliance requirements that underpin medical coding and billing. Learn to maintain patient privacy, uphold coding integrity, and adhere to industry standards to ensure accurate reimbursement. Advanced Strategies: Elevate your skills with advanced coding techniques and strategies. Discover how to handle complex scenarios, navigate insurance denials and appeals, and optimize the revenue cycle for enhanced financial outcomes. "The Art and Science of Medical Billing and Coding" is not just a book; it's your indispensable resource for achieving excellence in the crucial domains of medical billing and coding. Whether you're a student, a professional looking to upskill, or a healthcare administrator aiming to streamline revenue management, this guide will empower you to succeed in a dynamic and rewarding field.
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
Are you a student aspiring to excel in the complex world of medical revenue cycle management? Look no further! This comprehensive guide is tailor-made to equip you with the knowledge and skills necessary to navigate the intricacies of this vital healthcare discipline. Medical Revenue Cycle Management: The Comprehensive Guide is a must-have resource that covers every aspect of the revenue cycle process, from patient registration to claim reimbursement. Written with students in mind, this book offers a comprehensive overview of the subject, providing a solid foundation for your future career. Inside this guide, you will find: 1. Introduction to Medical Revenue Cycle Management: Gain a clear understanding of the revenue cycle and its significance in healthcare organizations. Explore the various roles and responsibilities involved in revenue cycle management. 2. Patient Access and Registration: Learn the fundamentals of patient registration, insurance verification, and the importance of accurate patient data collection. Understand the impact of accurate information on revenue optimization. 3. Health Insurance and Payer Systems: Explore the intricacies of health insurance, different types of payers, and their impact on revenue cycle management. Gain insights into payer contracts, claim submission, and electronic data interchange (EDI). 4. Coding and Documentation: Discover the importance of accurate medical coding and its impact on reimbursement. Master the principles of coding, documentation guidelines, and coding systems such as ICD-10-CM and CPT. 5. Claims Management and Denial Resolution: Delve into the world of claims management, including claim submission, tracking, and denial resolution. Learn effective strategies to minimize claim denials and maximize revenue recovery. 6. Billing and Reimbursement: Understand the intricacies of billing processes, including charge capture, pricing, and electronic billing systems. Explore reimbursement methodologies, such as fee-for-service and value-based reimbursement. 7. Compliance and Regulatory Considerations: Stay up to date with the ever-evolving healthcare regulations and compliance requirements. Learn about HIPAA, fraud and abuse laws, and the importance of ethical billing practices. 8. Key Performance Indicators and Revenue Cycle Analytics: Gain insights into tracking and measuring revenue cycle performance through key performance indicators (KPIs) and analytics. Learn to identify areas for improvement and optimize revenue generation. With its student-friendly approach, practical examples, and case studies, this guide ensures that you not only grasp the theoretical concepts but also develop the critical thinking and problem-solving skills necessary for success in this field. Whether you are a healthcare administration student, aspiring medical coder, or revenue cycle professional, this comprehensive guide will serve as your go-to reference, providing you with a solid foundation in medical revenue cycle management. Unlock your potential and embark on a successful career in this crucial area of healthcare administration with confidence! Don't miss out on this essential resource. Get your copy of Medical Revenue Cycle Management: A Comprehensive Guide today and take your first step towards mastering this dynamic field!
The inspirational bestseller that ignited a movement and asked us to find our WHY Discover the book that is captivating millions on TikTok and that served as the basis for one of the most popular TED Talks of all time—with more than 56 million views and counting. Over a decade ago, Simon Sinek started a movement that inspired millions to demand purpose at work, to ask what was the WHY of their organization. Since then, millions have been touched by the power of his ideas, and these ideas remain as relevant and timely as ever. START WITH WHY asks (and answers) the questions: why are some people and organizations more innovative, more influential, and more profitable than others? Why do some command greater loyalty from customers and employees alike? Even among the successful, why are so few able to repeat their success over and over? People like Martin Luther King Jr., Steve Jobs, and the Wright Brothers had little in common, but they all started with WHY. They realized that people won't truly buy into a product, service, movement, or idea until they understand the WHY behind it. START WITH WHY shows that the leaders who have had the greatest influence in the world all think, act and communicate the same way—and it's the opposite of what everyone else does. Sinek calls this powerful idea The Golden Circle, and it provides a framework upon which organizations can be built, movements can be led, and people can be inspired. And it all starts with WHY.
A renowned authority from Harvard Business School confronts America's health care crisis-and how consumer control can fix it PRAISE FOR WHO KILLED HEALTHCARE? “A brilliant analysis... A must-read.” – Bill George, Professor, Harvard Business School and Former CEO of Medtronic “As it becomes more and more obvious to everyone that our current health care system is unsustainable, this is the book that had to be written.” – Daniel H. Johnson, Jr. MD, former president of the American Medical Association “Regina Herzlinger’s ideas to tackle the crisis of the U.S. health care system are based on keen knowledge of the system’s existing difficulties along with insights that introduce the reader to new streamlined choices that have the potential of getting both quantity and cost under control.” – Joseph Kennedy, founder, chairman, and president, Citizens Energy Corporation, CEO, Citizens Health Care, former representative (D-Mass) “Regina Herzlinger... offers a vision of the way things can be, should be, and will be sooner or later. The only question is: how long do we have to wait?” – Greg Scandlen, founder, Consumers for Health Choices“Regi Herzlinger has brilliantly articulated a better way – embracing the principles of competition and innovation that cause every other sector of our economy to thrive. Discharging American health care from the ICU can only happen by putting individual Americans – not politicians and bureaucrats – back in charge of their health care decisioins.” – U.S. Senator Tom Coburn (R-Okla), M.D. “Following on the heels of her landmark Market-Driven Health Care, Herzlinger lays it on the line with her expose of what many who work in the health care industry have felt in their gut. Now it is articulated in an entertaining and must-read portrayal, with you and me as the only way out.” – Dennis White, executive vice president for strategic development, National Business Coalition on Health“A wonderful Orwellian romp through issues which carry a deadly irony. The killers of health care are, of course, the third parties, each of which has an itchy palm and a commitment to profit or power which exceeds the commitment to service, with each engaging the others within a politically shaped box. Rarely has the case for the public been made with so much force, foresight, and wit, and a better way forward shown so clearly.” – James F. Fries, MD, Professor of Medicine, Stanford University School of Medicine “You can practically hear the war chants as Professor Herzlinger sets out her view of what’s wrong with the health care system and how to fix it. You’d best read it so you can decide which side you will be on when the battle is joined.” – Paul Levy, CEO, Beth Israel Hospital, Boston, MA “Regina Herzlinger, the nation’s leading expert on consumer-driven health care, has given us a brilliant analysis of the flaws in our health care system and what it will take to get it back on track. Her latest book is a must-read.” – Bill George, Professor of Management Practice, Harvard Business School, Former CEO, Medtronic, and author of Authentic Leadership“You don’t have to agree with her diagnosis and prescription for the U.S. health care system, but you do have to read her book. Once again, Professor Herzlinger has put together a well researched, well written, and very provocative blueprint for the future of health care.” Peter L. Slavin, MD, President, Massachusetts General Hospital
Stay up on the latest in insurance billing and coding with Marilyn Fordney’s Insurance Handbook for the Medical Office, 14th Edition. Trusted for more than 30 years, this market-leading handbook equips you to succeed as medical insurance specialist in any of today’s outpatient settings. Coverage emphasizes the role of the medical insurance specialist in areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. As with previous editions, all the plans that are most commonly encountered in clinics and physicians’ offices are incorporated into the text, as well as icons for different types of payers, lists of key abbreviations, and numerous practice exercises that assist you in accurately filling out claim forms. This new edition also features expanded coverage of ICD-10, electronic medical records, electronic claims submission, and the HIPAA 5010 — keeping you one step ahead of the latest practices and protocols of the profession. Key terms are defined and emphasized throughout the text to reinforce understanding of new concepts and terminology. Separate chapter on HIPAA Compliance in Insurance Billing, as well as Compliance Alerts throughout the text highlights important HIPAA compliance issues to ensure readers are compliant with the latest regulations. Emphasis on the business of running a medical office and the importance of the medical insurance specialist details the importance of the medical insurance specialist in the business of the medical office. Increased focus on electronic filing/claims submission prepares readers for the industry-wide transition to electronic claims submission. Separate chapter on documentation in the medical office covers the principles of medical documentation and the rationales for it. Service to Patient features in most chapters offer examples of good customer service. User resources on the Evolve companion website feature performance checklists, self-assessment quizzes, the Student Software Challenge (with cases on different payer types and an interactive CMS-1500 (02-12) form to fill in). NEW! Expanded coverage of ICD-10 prepares users to code ICD-10 with the planned effective date of October 2015. NEW! Added information on the electronic medical record and electronic claims submission — including information on the HIPAA 5010 — equips users for the transition between paper and electronic methods of medical records and links the CMS-1500 (02-12) form to the electronic submissions process. NEW! SimChart for the Medical Office (SCMO) application activities on the companion Evolve website adds additional functionality to the insurance module on the SCMO roadmap.
- NEW! Insights From The Field includes short interviews with insurance billing specialists who have experience in the field, providing a snapshot of their career paths and offering advice to the new student. - NEW! Scenario boxes help you apply concepts to real-world situations. - NEW! Quick Review sections summarize chapter content and also include review questions. - NEW! Discussion Points provide the opportunity for students and instructors to participate in interesting and open dialogues related to the chapter's content. - NEW! Expanded Health Care Facility Billing chapters are revised to provide the latest information impacting the insurance billing specialist working in a variety of healthcare facility settings.