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Maximizing Billing and Collections in the Medical Practice

Maximizing Billing and Collections in the Medical Practice
Author: Kay Stanley
Publisher: American Medical Association Press
Total Pages: 0
Release: 2007
Genre: Accounts receivable
ISBN: 9781579478674

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"Provide analytical tools and systematic review processes for the practice administrator to strengthen the practice's business operations"--Provided by publisher.


The Physician Billing Process

The Physician Billing Process
Author: Deborah L. Walker
Publisher: Medical Group Management Assn
Total Pages: 274
Release: 2004
Genre: Business & Economics
ISBN: 9781568292304

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Collect money owed to your practice. Improve your revenue cycle by maximizing key processes for professional fee billing. Written by industry experts, this book is a step-by-step guide to billing and collection processes, performance outcomes and advanced billing practices. It includes case studies, tools, checklists, resources, policies and procedures to help you diagnose problems and develop plans to attain optimal financial performance.


The Physician Billing Process

The Physician Billing Process
Author: Deborah Walker Keegan
Publisher: Mgma
Total Pages: 428
Release: 2009-02
Genre: Accounts receivable
ISBN: 9781568293394

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Full of new, innovative tools, techniques, policies and procedures, and advanced practices that allow you to diagnose and treat your revenue cycle and ensure a financially healthy bottom line. The depth and magnitude of change in health care reimbursement means that your medical practice cannot rely on the same old billing methods. Anything less than optimal performance from your billing office reduces cash flow and costs you money. The authors present cutting edge strategies to meet today s reimbursement challenges and improve the profitability of your medical practice. The authors lay out real life business practices that can be adopted tomorrow in your medical practice, including how to: Decipher consumer-directed health plans; Conduct patient financial clearance; Segment patients in terms of financial risk; Staff to effectively conduct front-end and back-end billing; Capture increased revenue at the point of care; Understand real-time claims adjudication; Shrink your collections cycle; Position your practice for pay-for-performance; Work and prevent costly claim denials and rework; Code appropriately to ensure your fair share of differential payer reimbursement; Leverage multiple technologies; and Perform a cost/benefit analysis of your revenue cycle.


Medical Revenue Cycle Management - The Comprehensive Guide

Medical Revenue Cycle Management - The Comprehensive Guide
Author: VIRUTI SATYAN SHIVAN
Publisher: Viruti Satyan Shivan
Total Pages: 236
Release:
Genre: Medical
ISBN:

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This essential guide dives deep into the intricacies of Medical Revenue Cycle Management (MRCM), offering healthcare professionals, administrators, and students a clear roadmap to mastering the financial backbone of healthcare services. In a landscape where financial health is as critical as patient health, this book stands out by providing a meticulously researched, expertly written exploration of every phase of the revenue cycle—from patient registration to the final payment of balances. Without relying on images or illustrations, we navigate through complex regulations, coding challenges, and billing practices with clarity and precision, making this complex subject accessible and actionable. Our unique approach combines theoretical frameworks with practical, real-world applications, setting this book apart as a must-buy. We delve into innovative strategies for optimizing revenue, reducing denials, and enhancing patient satisfaction, all while maintaining compliance with evolving healthcare laws and regulations. By focusing on efficiency and effectiveness, we equip readers with the tools and insights needed to transform their revenue cycle processes. Whether you're looking to refine your current practices or build a foundation of knowledge from the ground up, this guide offers invaluable insights into achieving financial stability and success in the ever-changing world of healthcare.


VA Health Care: Ineffective Medical Center Controls Results in Inappropriate Billing and Collection Practices

VA Health Care: Ineffective Medical Center Controls Results in Inappropriate Billing and Collection Practices
Author: Kay L. Daly
Publisher: DIANE Publishing
Total Pages: 13
Release: 2010-02
Genre: Technology & Engineering
ISBN: 1437924328

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Daly was asked to testify on billing practices of the Department of Veterans Affairs (VA). She had previously reported that continuing problems in billing and collection processes at VA impaired its ability to maximize revenue from private insurance companies (third-party insurers). In June 2008, she reported on its follow-up review that: (1) evaluated VA billing controls; (2) assessed VA-wide controls for collections; and (3) determined the effectiveness of VA oversight over third-party billings and collections. To perform the review, Daly conducted case-study analyses of the third-party billing function at 18 medical centers, statistically tested controls over collections VA-wide, and reviewed current oversight policies and procedures. Illustrations.


Improve Billing and Collections

Improve Billing and Collections
Author: HCPro (Firm)
Publisher: HC Pro, Inc.
Total Pages: 149
Release: 2006
Genre: Accounts receivable
ISBN: 1578397782

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Handling the Medical Claim

Handling the Medical Claim
Author: Catherine Cochran
Publisher: CRC Press
Total Pages: 243
Release: 2012-09-25
Genre: Business & Economics
ISBN: 1439856249

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When a doctor sees a patient, how does the doctor’s office get paid? If a claim for a service or procedure provided is denied, how does the doctor’s office get the patient’s insurance company to pay? Handling the Medical Claim: An 8-Step Guide on "How To" Correct and Resolve Claim Issues explains—from beginning to end—how to bill and collect on claims for services provided in a physician’s office. Focusing on the CMS-1500 claim form, the book explains how to prepare and file the form to submit charges to patients’ insurance companies. Written by a medical billing specialist experienced in handling medical claims and denials on both the provider and insurer sides of the business, this step-by-step guide begins by covering some basic good practice management skills. Next, it outlines each department’s specific duties based on the each department’s responsibilities for specific parts of the claim. In addition to learning how to submit and resolve claims that cannot be processed or are denied, readers will learn how to: Enter data in the doctor’s schedule, including appointment types Gather patient data from medical records Register patients, including patient information, guarantor, and policyholder and insurance information Input information about the appointment and diagnosis Use the different types of coding systems used for billing charges Understand the claim cycle, determine reimbursement, and apply payment Obtain patient and insurance information Appeal a denied claim and handle patient balances The book includes case examples and step-by-step guidance for resolving claim issues that could arise—including how to determine what part of the chapter you can find your answer and how to link your findings to the box number on the claim form to which the problem pertains. Highlighting opportunities for increasing revenue, it includes an overview of the revenue cycle and the importance of keeping cash flow moving. Packed with forms, charts, and illustrative examples, the text supplies the tools and understanding you’ll need to manage billing and collection in any physician’s office or clinical department.


Practice Management Reference Guide - First Edition

Practice Management Reference Guide - First Edition
Author: AAPC
Publisher: AAPC
Total Pages: 14
Release: 2020-03-16
Genre: Medical
ISBN: 1626889856

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Effectively manage the business side of medicine. Profit margin, collections, cash flow, compliance, human resources, health information, efficient business processes—the broad responsibilities and complex requirements of practice management are endless. Drop one ball in the daily juggle and the fallout can be costly. There’s never enough time, which makes it tough to stay on top of regulations and best practices. That’s where AAPC’s Practice Management Reference Guide becomes vital to your organization, providing you with one-stop access to the latest and best in practice management. From office operations to financial oversight, the Practice Management Reference Guide lays out essential guidance to help you optimize efficiency, security, and profitability. Benefit from actionable steps to streamline accounts receivable. Discover how to bring in new patients and keep the ones you have happy. Leverage real-world strategies to command payer relations, recruitment, training, employee evaluations, HIPAA, MACRA, Medicare, CDI, EHR … everything you need to ensure bountiful operations in 2020 and beyond. With the Practice Management Reference Guide, you’ll gain working knowledge covering the spectrum of practice management issues, including: Negotiating favorable payer contracts Preventing an appeals backlog Remaining audit-ready Correctly applying incident-to billing rules to maximize reimbursement Using assessment tools to evaluate your risk Preparing a risk plan and know what questions to ask Knowing how and why you should implement policies and protocols Complying with state and federal patient privacy rules


Crossing the Quality Chasm

Crossing the Quality Chasm
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 360
Release: 2001-08-19
Genre: Medical
ISBN: 0309072808

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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.


VA Health Care

VA Health Care
Author: United States. General Accounting Office
Publisher:
Total Pages: 76
Release: 1990
Genre: Health insurance
ISBN:

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