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Health Care Finance and the Mechanics of Insurance and Reimbursement

Health Care Finance and the Mechanics of Insurance and Reimbursement
Author: Michael K. Harrington
Publisher: Jones & Bartlett Learning
Total Pages: 344
Release: 2019-10-01
Genre: Medical
ISBN: 1284169030

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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.


Health Insurance and Managed Care

Health Insurance and Managed Care
Author: Peter R. Kongstvedt
Publisher: Jones & Bartlett Learning
Total Pages: 355
Release: 2019-02-14
Genre: Medical
ISBN: 128415209X

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Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry. The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.


Hospital Reimbursement

Hospital Reimbursement
Author: Kyle Herbert
Publisher: CRC Press
Total Pages: 272
Release: 2012-06-05
Genre: Business & Economics
ISBN: 1439898952

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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


Consumer-Driven Health Care

Consumer-Driven Health Care
Author: Regina E. Herzlinger
Publisher: John Wiley & Sons
Total Pages: 930
Release: 2004-03-22
Genre: Medical
ISBN: 9780787972165

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Professor Herzlinger documents how the consumer-driven health caremovement is being implemented and its impact on insurers,providers, new intermediaries, and governments. With additionalcontributions by health care's leading strategists,innovators, regulators and scholars, Consumer-Driven HealthCare presents a compelling vision of a health care system builtto satisfy the people it serves. This comprehensive resource includes the most important thinkingon the topic and compelling case studies of consumer-driven healthcare (CDHC) in action, here and abroad, including newconsumer-driven intermediaries for information and support; typesof insurance plans; focused factories for delivering health care;personalized drugs and devices; and government roles.


Essentials of Health Care Finance

Essentials of Health Care Finance
Author: William Cleverley
Publisher: Jones & Bartlett Learning
Total Pages: 590
Release: 2011
Genre: Education
ISBN: 0763789291

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Essentials of Health Care Finance stands firmly in its place as the leading textbook on healthcare finance. No other text so completely blends the best of current finance theory with the tools needed in day-to-day practice. Useful for all course levels as well as a professional reference, this text offers a comprehensive introduction to the field. The Seventh Edition has been thoroughly revised to reflect the current economic environment in the healthcare industry, with thoughtful descriptions and ‘real-world’ examples. As the not-for-profit health care sector has increasingly come under attack by legislators seeking new sources of tax revenue, this edition also features a new chapter on assessing community benefits including an examination of the new Schedule H of the IRS 990 form. Ancillary instructor materials for the Seventh Edition have been significantly expanded and updated. PowerPoint lecture slides now include selected examples from the chapters. Electronic versions of many of the charts and tables in the chapters are provided to enable the instructor to re-create and modify existing examples. An expanded set of test questions with detailed answers will be provided for each chapter. New excel spreadsheets for selected chapters will be created to help both the students and the instructors perform a variety of financial analysis tasks with spreadsheet templates. The instructor’s manual has been revised to include key learning points, chapter overviews, and guidelines for class discussion.


The Future of Health-care Delivery

The Future of Health-care Delivery
Author: Stephen C. Schimpff
Publisher: Potomac Books, Inc.
Total Pages: 400
Release: 2012
Genre: Health & Fitness
ISBN: 1612341578

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Approximately 100,000 deaths per year in the United States result from preventable medical errors. This figure is about twice the number of people who die in car accidents and five times the number of murder victims annually, and twenty times the number of servicemen and women killed in Iraq and Afghanistan since the start of hostilities in 2001. If you think Americans have the best health-care system in the world, think again. In this deeply researched and controversial book, Dr. Stephen Schimpff explains why our health-care delivery system serves us so poorly, why it costs so much, and why government policy over many decades has not only failed to improve care delivery but has actually made it worse. In the process, he dispels common misconceptions about medicine and health care. The Future of Health-Care Delivery provides timely information and a road map to achieve world-class care delivery, putting health care where it belongs--in the hands of the patient and medical professionals instead of the insurance companies and government.


Making Them Pay

Making Them Pay
Author: Rhonda Orin
Publisher: St. Martin's Griffin
Total Pages: 256
Release: 2011-04-01
Genre: Business & Economics
ISBN: 9781429979108

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Most people don't understand health insurance, and insurance companies know it. Unfair denials, late payments, and hopeless confusion are the norm. At last there is a solution. In eight easy steps, Making Them Pay gives practical advice about the things that drive people crazy. Like: -Figuring out what health plans really say -Understanding what benefits they provide -Finding, and understanding, the exclusions -Determining what health plans really cost -How to talk to customer service, and other painful details -Easy ways to keep good records -Laws that can change your life-like the mandatory benefits laws in all fifty states -How to prepare successful appeals Along with this useful advice, Making Them Pay offers a much-needed sense of humor. It's filled with cartoons, sidebars, and vignettes that will make you laugh as you learn. Based on Rhonda D. Orin's extensive experience as a litigator, a journalist, and a mother fighting her own family's insurance battles, Making Them Pay is the book your health insurer doesn't want you to read. "A compact reference [that] simplifies a convoluted subject. -


Healthcare Finance

Healthcare Finance
Author: Louis C. Gapenski
Publisher:
Total Pages: 739
Release: 2016
Genre: Health facilities
ISBN: 9781567937411

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The essential concepts of both accounting and financial management are covered in this best-selling healthcare finance book. Through clear explanations, numerous examples, and realistic practice problems, it arms future managers with the grounding they need to make financially sound decisions for their healthcare organizations. This thoroughly updated edition provides more emphasis on the unique marketplace for healthcare services and additional examples from nonhospital settings, including medical practices, clinics, home health agencies, nursing homes, and managed care organizations.


Essentials of Health Care Finance

Essentials of Health Care Finance
Author: William O. Cleverley
Publisher: Jones & Bartlett Learning
Total Pages: 586
Release: 2023-12-11
Genre: Medical
ISBN: 1284260844

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Blending the topics of both accounting and finance, Essentials of Health Care Finance is a relevant, readable, and easily applied resource for health care management students and executives that explores finance theory and its practical application in health care across a full range of facilities, from hospitals, home health agencies, and skilled nursing facilities to surgical centers, physician practices, and integrated health systems. Carefully revised, the Ninth Edition of Essentials of Health Care Finance has been updated with additional reflection, examples, and application so that individuals with no healthcare experience can benefit from additional elaboration on key concepts such as physician practice management, flex budgeting, and strategic financial planning. The Ninth Edition also explores trends in national health expenditures and physician organizations and alignment; changes in health services financing and utilization since the enactment of the Affordable Care Act (ACA)