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This publication provides the patient financial services manager with a comprehensive practical guide to both the operational and analytical aspects of patient accounts management. It is appropriate for graduate and undergraduate programs as well as practitioners. Review questions are included for each chapter and forms are provided on diskette.
A basic guide to hospital billing and reimbursement, Understanding Hospital Billing and Coding, 3rd Edition helps you understand, complete, and submit the UB-04 claim form that is used for all Medicare and privately insured patients. It describes how hospitals are reimbursed for patient care and services, showing how the UB-04 claim form reflects the flow of patient data from the time of admission to the time of discharge. Written by coding expert Debra P. Ferenc, this book also ensures that you understand the essentials of ICD-10-CM and develop skills in both inpatient coding and outpatient/ambulatory surgery coding. UB-04 Claim Simulation on the companion Evolve website lets you practice entering information from source documents into the claim form. Over 300 illustrations and graphics bring important concepts to life. Detailed chapter objectives highlight what you are expected to learn. Key terms, acronyms, and abbreviations with definitions are included in each chapter. Concept Review boxes reinforce key concepts. Test Your Knowledge exercises reinforce lessons as you progress through the material. Chapter summaries review key concepts. Practice hospital cases let you apply concepts to real-life scenarios. Updated Claim Forms chapter covers the UB-04 claim form. Updated information covers diagnosis and procedural coding, with guidelines and applications. Updated claim forms and names are used throughout.
New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today. Understanding Value-Based Healthcare is divided into three sections: Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives. The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis. .
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
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Uncover the latest information you need to know when entering the growing health information management job market with Health Information: Management of a Strategic Resource, 5th Edition. Following the AHIMA standards for education for both two-year HIT programs and four-year HIA programs, this new edition boasts dynamic, state-of-the-art coverage of health information management, the deployment of information technology, and the role of the HIM professional in the development of the electronic health record. An easy-to-understand approach and expanded content on data analytics, meaningful use, and public health informatics content, plus a handy companion website, make it even easier for you to learn to manage and use healthcare data. - Did You Know? boxes highlight interesting facts to enhance learning. - Self-assessment quizzes test your learning and retention, with answers available on the companion Evolve website. - Learning features include a chapter outline, key words, common abbreviations, and learning objectives at the beginning of each chapter, and references at the end. - Diverse examples of healthcare deliveries, like long-term care, public health, home health care, and ambulatory care, prepare you to work in a variety of settings. - Interactive student exercises on Evolve, including a study guide and flash cards that can be used on smart phones. - Coverage of health information infrastructure and systems provides the foundational knowledge needed to effectively manage healthcare information. - Applied approach to Health Information Management and Health Informatics gives you problem-solving opportunities to develop proficiency. - EXPANDED! Data analytics, meaningful use, and public health informatics content prepares HIM professionals for new job responsibilities in order to meet today's, and tomorrow's, workforce needs. - EXPANDED! Emphasis on the electronic health care record educates you in methods of data collection, governance, and use. - NEW! Chapter on data access and retention provides examples of the paper health record and its transition to the EHR. - NEW! Focus on future trends, including specialty certifications offered by the AHIMA, the American Medical Informatics Associations (AMIA), and the Health Information Management Systems Society (HIMSS), explains the vast number of job opportunities and expanded career path awaiting you.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
This book provides the very lastest in position statements, and new, forward-thinking in administrative strategies. Addresses fiscal management of outpatient cancer centers, including financial systems models, use of CPT codes, cost effectivness and clinical applications of evidence-based practice guidelines.