Compliance for Coding, Billing and Reimbursement
Duane C. Abbey
Softcover: 232 pages + bonus CD-ROM
Productivity Press / Taylor and Francis
(click below for the very best available price for this edition)
Compliance for Coding, Billing & Reimbursement 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.
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.
Based on 25 years of direct consultation, Duane Abbey explains how to deal with the complex coding, billing, and reimbursement processes that can force providers to choose between being paid and being compliant.
Fully revised and updated, this unique resource covers statutorily based programs and contracted relationships, as well as situations that do not involve formal relationships. 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 a CD-ROM packed with regulations and information
In addition to offering recent information illustrated by case studies, Dr, Abbey provides providers and administrators, as well as consultants and attorneys, with the mindset and attitude required to meet this challenge with savvy and perseverance.
Includes a CD packed with regulations and information!
Please remember: The government no longer allows a grace period for annual code sets. The new HIPAA Transaction and Code Set Rule requires providers to use national medical code sets that are valid at the time that a service is provided. ICD-9-CM code revisions become effective October 1st each year while CPT and HCPCS code revisions become effective January 1st. In order for you to meet this requirement, you must have the revised CPT, HCPCS, and ICD-9-CM codes in your possession before the implementation dates. The best way to do this is to order your code books early. Review current coding resources.
You may also be interested: Coding Resources
(information provided by the publisher)
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