Reimbursement Compliance For Hospital Laboratories PDF Download

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Lab Billing and Coding

Lab Billing and Coding
Author: Dawn Runge
Publisher: HC Pro, Inc.
Total Pages: 242
Release: 2005
Genre: Health insurance claims
ISBN: 9781578396764

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Medicare Laboratory Payment Policy

Medicare Laboratory Payment Policy
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 261
Release: 2000-12-04
Genre: Medical
ISBN: 0309183618

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Clinical laboratory tests play an integral role in helping physicians diagnose and treat patients. New developments in laboratory technology offer the prospect of improvements in diagnosis and care, but will place an increased burden on the payment system. Medicare, the federal program providing coverage of health-care services for the elderly and disabled, is the largest payer of clinical laboratory services. Originally designed in the early 1980s, Medicare's payment policy methodology for outpatient laboratory services has not evolved to take into account technology, market, and regulatory changes, and is now outdated. This report examines the current Medicare payment methodology for outpatient clinical laboratory services in the context of environmental and technological trends, evaluates payment policy alternatives, and makes recommendations to improve the system.


Clinical Laboratory Management

Clinical Laboratory Management
Author: Donna L. Nigon
Publisher: McGraw-Hill Professional Publishing
Total Pages: 360
Release: 2000
Genre: Medical
ISBN:

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Over the past twenty years, laboratories have evolved from isolated, purely technical departments into integral segments of broader provider systems. Excelling in this new environment requires business knowledge, management skills, and marketing savvy in addition to the age-old prerequisites of clinical competence and technical expertise. This new book imparts these skills and much more. Addressing both emerging needs in the curriculum and the new demands upon practitioners, the text concentrates on critical issues of lab management including strategic thinking and planning, maximizing reimbursement, practical financial issues, compliance with governmental regulations, optimizing productivity and much more.


Chargemasters

Chargemasters
Author: Duane C. Abbey
Publisher: HC Pro, Inc.
Total Pages: 282
Release: 2005
Genre: Information storage and retrieval systems
ISBN: 9781578396306

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Clinical Laboratory Management

Clinical Laboratory Management
Author: Lynne Shore Garcia
Publisher: John Wiley & Sons
Total Pages: 821
Release: 2024-04-30
Genre: Medical
ISBN: 1683673913

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Apply the principles of management in a clinical setting with this vital guide Managerial expertise is increasingly essential to the practice of medicine. It's no longer possible for laboratory directors or heads of clinical practice to grasp only the principles of medicine and pathology; it's now more necessary than ever that they be versed in fiscal management, patient care testing, quality assurance, and many other potential areas of expertise. Recent changes to the practice of medicine driven by the COVID-19 pandemic have only rendered this need more urgent. Clinical Laboratory Management provides a practical, comprehensive introduction to this body of expertise for practitioners who find themselves in supervisory positions. Beginning with an overview of management principles and their clinical applications, it assesses in detail the challenges facing clinical laboratories and the best practices for meeting them. Now fully updated to reflect the latest contributions from both business and medicine, it's an indispensable tool in a changing clinical world. Readers of the third edition of Clinical Laboratory Management will also find: Updates reflecting the lessons and transformations brought about by COVID-19 Detailed discussion of topics including point-of-care testing, information systems, reimbursement compliance, and more Practical examples and summary tables throughout Clinical Laboratory Management is ideal for laboratory directors, chief technologists, healthcare administrators, and trainees for leadership positions.


Hospital Billing from A to Z

Hospital Billing from A to Z
Author: Charlotte L. Kohler
Publisher:
Total Pages: 0
Release: 2014-08-21
Genre:
ISBN: 9781556451584

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Hospital Billing from A to Z Charlotte L. Kohler, RN, CPA, CVA, CRCE-I, CPC, ACS, CHBC With Kohler HealthCare Consulting, Inc., associates Catherine Clark, CPC, CRCE-I Darrin Cornwell, CRCS-I Janet Ellis, RN, BSN, MS Dawn Doll Homer, CPC, CRCS-I, CDC Daria Malan, RN, LNHA, MBA, RAC-CT(R) John Ninos, MS, MT(ASCP), CCS Robin Stover, RN, BSBA, CPC, CPC-H, CMAS Deanna Turner, MBA, CPOC, CPC, CPC-I, CSSGB Susan Walberg, JD, MPA, CHC Hospital billing departments are known by various names, but their staff all experience the same problems understanding and complying with Medicare's many billing requirements. Hospital Billing From A to Z is a comprehensive, user-friendly guide to hospital billing requirements, with particular emphasis on Medicare. This valuable resource will help hospital billers understand how compliance, external audits, and cost-cutting initiatives affect the billing process. Beginning with Advance Beneficiary Notice and ending with Zone Program Integrity Contractors, this book addresses 88 topics in alphabetical order, including the following: 2-Midnight Rule and Inpatient Admission Criteria Correct Coding Initiative CPT(R), HCPCS, Condition Codes, Occurrence Codes, Occurrence Span Codes, Revenue Codes, and Value Codes Critical Access Hospitals Deductibles, Copayments, and Coinsurance Denials, Appeals, and Reconsideration Requirements Dialysis and DME Billing in Hospitals Hospital-Issued Notice of Noncoverage Laboratory Billing and Fee Schedule Local and National Coverage Determinations Medically Unlikely Edits and Outpatient Code Editor Medicare Advantage Plans Medicare Beneficiary Numbers and National Provider Identifier Medicare Part A and Part B No-Pay Claims Observation Services Outlier Payments Present on Admission Rejected and Returned Claims UB-04 Form Definitions Who should read this book? Finance and reimbursement staff Chargemaster staff Billers and coders HIM staff Clinical department staff Revenue managers Compliance officers and auditors Registration staff Fiscal intermediary staff Healthcare attorneys, consultants, and CPAs Legal department staff