The RAC Toolkit for Physician Practices is your practice's answer to turning plans into proactive action for RAC success. Authors Elizabeth Lamkin, MHA, and Amanda Berglund, MS, MBA, describe how to establish and sustain an effective RAC-preparedness structure that can be adapted to fit any organization's system. They provide best practices for successful processes and outline each staff member's role in your RAC audit program. You will use their tested, proven, and practical tools to build a more effective billing compliance program. You'll learn how to bring finance, business office and clinical groups together for operational improvements that drop right to the bottom line.
This second edition goes beyond the fundamentals of E/M coding and delves into the gray, problematic compliance areas. Author Joe Rivet delivers step-by-step guidance from beginning to end of the E/M audit process. You'll learn how to select an E/M code, conduct an entire audit of your E/M services, and report your E/M audit findings. With this foundation, you'll be well prepared to enhance compliance and identify undercoding, underreporting, overcoding, revenue opportunities, and avenues for documentation improvement.
The American Medical Association and the American Health Lawyers Association have collaborated to publish Avoiding Fraud and Abuse in the Medical Office. Written by health law attorneys for physicians, this practical resource provides. Avoiding Fraud and Abuse in the Medical Office provides you with the tools and knowledge you need to confidently conduct business, leaving you with more time to focus on the most important aspect of your practice-your patients. Book jacket.
The text begins with a detailed review of the structure and design of the ICD-10-PCS system including a description of the code format and official ICD-10-PCS Coding Guidelines. A thorough description of coding concepts that are unique to ICD-10-PCS is included, as well as a systematic review of the root operations.
CMS Publication 100-4 Chapter 10: CMS Home Health Billing Manual This handy manual—updated to reflect 2010 changes—is a great resource for finding answers quickly and easily when you're stumped with a home health billing question. Spend less time looking for answers while receiving the most appropriate payment allowed. It's the perfect supplementary guide to your billing and payment procedures. Packed with examples, definitions, and calculations from CMS, this helpful guide also provides a quick billing reference for services and supplies, as well as tips when billing for non-routine supplies.
This book is designed for everyone involved in documenting, billing, data archiving and paying medical claims. It explains the interplay coding has to reimbursement, compliance, contract negotiations, adjudication, and risk. It can also be used as an introductory text in coding classes. Each chapter will have examples of medical documentation, bills, and remittance advices to emphasize the content of the chapter.
CPT coding education straight from the source: The AMA, the expert in CPT coding, offers this new publication on the Introduction to CPTr Coding: Basic principles to learning, understanding and applying the CPT code set. This entry-level coding education resource can be used alone or in a classroom setting. Students and self-learners entering the coding and billing field will learn how to appropriately select the correct codes for the services and procedures performed. It is crucial to understand and correctly apply the CPT coding guidelines for each section and subsection of the CPT codebook.
. This book will help you: Increase your skilled census and improve your facility's reputation with the support of your entire staff. Avoid under- and over payments from Medicare with easy-to-understand explanations of complex rules and regulations. Provide necessary skilled services to each resident through a complete understanding of eligibility requirements. Accurately document skilled services using proven, time-saving solutions. Properly assess skilled services under the MDS 3.0. Improve communication to increase resident and family satisfaction. Reduce audit risk and prove medical necessity through accurate documentation.
The Medicare Billing Manual for Long-Term Care will help you: * Understand and comply with the billing changes under RUG-IV * Correctly file monthly, no-pay, and benefits exhaust claims * Complete the UB-04 accurately * Apply expert insight and insider tips to your SNF consolidated billing * Understand which ancillary services are covered under Part B * Increase cash flow and financial viability with Part B billing * Avoid auditor scrutiny by correctly submitting claims to Medicare on the first try
The third edition of Principles of ICD-10-CM Coding Workbook helps health care professionals learn from real-life ICD-10-CM chart notes and case studies rather than simple diagnosis statements. A flexible design allows this ICD-10-CM training workbook to be equally effective in an independent study or classroom environment.
Procedural Coding and Reimbursement for Physician Services: Applying Current Procedural Terminology and HCPCS introduces the basic principles and conventions of CPT® and HCPCS coding while delivering the experience-based knowledge needed to code confidently and efficiently.