Revised and updated with more than 200 pages of new information, this outstanding book guides users through the reimbursement process from start to finish. Perfect for trainers, students, and veteran reimbursement professionals alike, this Third Edition offers concise, informative, and easy-to-understand overviews of insurance basics, types of insurance and payers, coding systems, insurance processing, and review and appeals. The book also includes several extensive appendices of related information. The new information includes entirely new chapters on: Electronic claims processing Compliance plans for physicians Privacy and confidentiality issues, including HIPAA And, new appendices on OIG Compliance and Internet Resources
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Book Description
Editorial Reviews
From the Back Cover
Praise for Mastering the Reimbursement Process
"Mastering the Reimbursement Process is the single best source for the physician, medical office staff, or others to get a comprehensive understanding of health insurance, claims submission, and the follow-up necessary to get paid by third parties."
Michael T. Myers, Jr, MD, MBA Director, Health Care Regulatory Group PricewaterhouseCoopers LLP
"Physicians, practice managers and compliance professionals will find Mastering the Reimbursement Process and its Appendices to be an invaluable resource for achieving the proper reimbursement and reducing compliance risks."
J. William Tillett, Jr, CPA National Director Health Care Corporate Compliance Services Ernst & Young LLP
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Most Helpful Customer Reviews
6 of 6 people found the following review helpful:
5.0 out of 5 stars
Help with billing,
By
Amazon Verified Purchase(What's this?)
This review is from: Mastering the Reimbursement Process (Paperback)
I find that this book is written in an easily understandable style, and it goes into great detail about the process of obtaining financial reimbursement for health care from insurance companies and from medicare/medicaid. For example, the reader learns the proper forms and the name of the forms to be filled out for an insurance claim, and the method of filling them out. Great detail is covered for the proper coding and billing for medicare, and the time limits for the bills to be turned in, and software that may be helpful. According to the book, most claims are denied because claim forms are not filled out in the proper manner, so called "clean" copies.
Mastering the Reimbursement Process emphasizes, too, that the health care billing is constantly changing, and it points out the web sites, telephone numbers, and government agencies that keep a biller informed of constantly changing rules and regulations for billing. This book is a valuable resource for individuals in healthcare, billing or anyone who has the need to understand in detail healthcare billing and reimbursement. It is well worth the money spent because so much information is packed in; more than a casual reading is appropriate. Moreover, it contains a huge number of referrals for further information.
11 of 14 people found the following review helpful:
5.0 out of 5 stars
Great resource for any physician practice !,
By
This review is from: Mastering the Reimbursement Process (Paperback)
With Medicare compliance and false claim risks increasing, this is a wonderful guide for Physicians and those who bill for them.
8 of 11 people found the following review helpful:
5.0 out of 5 stars
Best Source of Reimbursement Information for Physicians,
By A Customer
This review is from: Mastering the Reimbursement Process (Billing and Compliance) (Paperback)
"Mastering the Reimbursement Process is the single best source for the physician, medical office staff, or others to get a comprehensive understanding of health insurance, claims submission, and the follow-up necessary to get paid by third parties." - Michael T. Myers, Jr, MD, MBA, Director, Health Care Regulatory Group, PriceWaterhouseCoopers LLP
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Inside This Book
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First Sentence:
Health insurance has traditionally been made available to help offset the expenses of the treatment of illness or injury. Read the first page Key Phrases - Statistically Improbable Phrases (SIPs): (learn more)
primary insurance plan, secondary insurance claims, health care program business, small group physician practices, outpatient deductible, additional risk areas, federal health care programs, nonparticipating physician, surgical package, billing training, compliance program guidance, designated health services, medical billing software, patient information form, surgery code, voluntary compliance program, insurance plan coverage, coding initiative, contractual adjustments, electronic claims, secondary payer, performing physician, primary payment, noncovered services, limiting charge Key Phrases - Capitalized Phrases (CAPs): (learn more)
Blue Shield, Blue Cross, Social Security, Veterans Affairs, Healthcare Management Advisors, United States, Health Care Financing Administration, American Medical Association, Hometown Clinic, Marketing Group, Public Law, Indian Health Service, Medicare Leave, National Uniform Claim Committee, Insurance Accounts Receivable Management, Understanding Insurance Basics, After Submission of Claims, Current Procedural Terminology, Discontinued Outpatient Hospital, District of Columbia, Employer's Address, Federal Claims Collections Act, American National Standards Institute, Amount of Deductible Remaining, Health Administration Center New!
Books on Related Topics | Concordance | Text Stats Browse Sample Pages:
Front Cover | Table of Contents | First Pages | Index | Back Cover | Surprise Me!
Health insurance has traditionally been made available to help offset the expenses of the treatment of illness or injury. Read the first page Key Phrases - Statistically Improbable Phrases (SIPs): (learn more)
primary insurance plan, secondary insurance claims, health care program business, small group physician practices, outpatient deductible, additional risk areas, federal health care programs, nonparticipating physician, surgical package, billing training, compliance program guidance, designated health services, medical billing software, patient information form, surgery code, voluntary compliance program, insurance plan coverage, coding initiative, contractual adjustments, electronic claims, secondary payer, performing physician, primary payment, noncovered services, limiting charge Key Phrases - Capitalized Phrases (CAPs): (learn more)
Blue Shield, Blue Cross, Social Security, Veterans Affairs, Healthcare Management Advisors, United States, Health Care Financing Administration, American Medical Association, Hometown Clinic, Marketing Group, Public Law, Indian Health Service, Medicare Leave, National Uniform Claim Committee, Insurance Accounts Receivable Management, Understanding Insurance Basics, After Submission of Claims, Current Procedural Terminology, Discontinued Outpatient Hospital, District of Columbia, Employer's Address, Federal Claims Collections Act, American National Standards Institute, Amount of Deductible Remaining, Health Administration Center New!
Books on Related Topics | Concordance | Text Stats Browse Sample Pages:
Front Cover | Table of Contents | First Pages | Index | Back Cover | Surprise Me!
Citations (learn more)
This book cites 2
books:
- Annual Report 2004 by Social Science Research Unit in Back Matter
- Risk Management by Dearborn Financial Services in Front Matter
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