Principles Of Healthcare Reimbursement

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.

Due to the countless variables that affect revenue and cost, the hospital reimbursement process is by far the most complex of any industry. Requiring only a basic financial background and a working knowledge of accounting, Hospital Reimbursement: Concepts and Principles supplies a clear understanding of the concepts and principles that drive the re

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.

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.