Compliance for Coding Billing Reimbursement or Financial and Managerial Accounting for School Administrators

Compliance for Coding, Billing & Reimbursement: A Systematic Approach to Developing a Comprehensive Program

Author: Duane Abbey

Health care providers have to cut through more red tape than ever to get paid for their services. What's more, a mountain of federal and state mandates are pressuring providers to become more savvy about laws and regulations regarding taxes, health and safety, labor, patient confidentiality, and financial compliance.

Compliance for Coding, Billing & Reimbursement, 2nd Edition provides guidance concerning the development of a specialized health care compliance program to cover coding, billing, documentation, and reimbursement. The required steps and systematic process are addressed along with various peripheral concerns. The primary emphasis is on hospital coding, billing, and reimbursement, with physician and clinic concerns also being addressed. The seven key elements promulgated by the OIG for any compliance program are addressed with specific application to the coding, billing and reimbursement area.

This book also defines the confusing terminology used in the complex web of policies and procedures. By referring to the comprehensive glossary and acronym listing, readers have instant explanations at their fingertips.

Table of Contents:

Case study listing

1 Overview of healthcare compliance 1

2 Structuring CBR compliance programs 11

3 Coding, billing, and reimbursement: Problem/opportunity areas 19

4 Investigation and problem solving 43

5 Development of CBR policies and procedures 57

6 Implementing changes 67

7 Developing effective training 75

8 Monitoring and corrective action 83

9 Conducting CBR baseline audits 95

10 Integrating CBR compliance into corporate compliance 105

11 HIPAA compliance 117

12 Special regulatory areas 127

13 Compliance considerations for hospitals 139

14 Compliance considerations for physicians and clinics 151

15 Special compliance audits and reviews 163

References and bibliography 179

Acronyms 185

Appendix 189

Index 199

Book review: Connective Leadership or The Medical Malpractice Myth

Financial and Managerial Accounting for School Administrators: Tools for Schools

Author: Ronald E Edmond Everett

An update to Financial and Managerial Accounting for School Administrators Superintendents, School Business Administrators and Principals, this edition includes current best practices, GASB pronouncements, and Internet (web-based) applications. This book will be useful to superintendents, school business managers, and principals.