Compliance for Coding, Billing & Reimbursement

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A01=Duane C. Abbey
A01=James H. Handwerk
A01=Mark J. Kaiser
Apex Medical Center
Author_Duane C. Abbey
Author_James H. Handwerk
Author_Mark J. Kaiser
Billing Privileges
Category=KJW
Chief Compliance Officer
clinical documentation standards
CMS-855 Forms
Compliance Concerns
Corporate Compliance Program
Cpt Code
Cpt Manual
Diagnosis Codes
EPHI
eq_bestseller
eq_business-finance-law
eq_isMigrated=1
eq_isMigrated=2
eq_nobargain
eq_non-fiction
HCPCS Code
healthcare compliance program implementation
healthcare fraud prevention
Healthcare Providers
HIPAA Privacy
HIPAA Privacy Rule
HIPAA regulatory guidance
HIPAA Security
HIPAA Security Rule
HIPAA Transaction Standard
Hyperbaric Oxygen Therapy
Id
Key Learning Area
Medi Care Program
medical audit procedures
Observation Services
Observation Stay
Prospective Payment System
provider payment integrity
reimbursement compliance strategies
Urgent Care Clinic

Product details

  • ISBN 9781563273681
  • Weight: 578g
  • Dimensions: 210 x 280mm
  • Publication Date: 02 Apr 2008
  • Publisher: Taylor & Francis Inc
  • Publication City/Country: US
  • Product Form: Paperback
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While the vast majority of providers never intend to commit fraud or file false claims, complex procedures, changing regulations, and evolving technology make it nearly impossible to avoid billing errors. For example, if you play by HIPAA’s rules, a physician is a provider; however, Medicare requires that the same physician must be referred to as a supplier. Even more troubling is the need to alter claims to meet specific requirements that may conflict with national standards. Far from being a benign issue, differing guidelines can lead to false claims with financial and even criminal implications.

Compliance for Coding, Billing & Reimbursement, Second Edition: A Systematic Approach to Developing a Comprehensive Program provides an organized way to deal with the complex coding, billing, and reimbursement (CBR) processes that seem to force providers to choose between being paid and being compliant. Fully revised to account for recent changes and evolving terminology, this unique and accessible resource covers statutorily based programs and contract-based relationships, as well as ways to efficiently handle those situations that do not involve formal relationships.

Based on 25 years of direct client consultation and drawing on teaching techniques developed in highly successful workshops, Duane Abbey offers a logical approach to CBR compliance. Designed to facilitate efficient reimbursements that don’t run afoul of laws and regulations, this resource –

  • Addresses the seven key elements promulgated by the OIG for any compliance program
  • Discusses numerous types of compliance issues for all type of healthcare providers
  • Offers access to online resources that provide continually updated information
  • Cuts through the morass of terminology and acronyms with a comprehensive glossary
  • Includes downloadable resources packed with regulations and information

In addition to offering salient information illustrated by case studies, Dr, Abbey provides healthcare providers and administrators, as well as consultants and attorneys, with the mindset and attitude required to meet this very real challenge with savvy, humor, and perseverance.

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