A basic guide to hospital billing and reimbursement, Understanding Hospital Billing and Coding, 3rd Edition helps you understand, complete, and submit the UB-04 claim form that is used for all Medicare and privately insured patients. It describes how hospitals are reimbursed for patient care and services, showing how the UB-04 claim form reflects the flow of patient data from the time of admission to the time of discharge. Written by coding expert Debra P. Ferenc, this book also ensures that you understand the essentials of ICD-10-CM and develop skills in both inpatient coding and outpatient/ambulatory surgery coding. UB-04 Claim Simulation on the companion Evolve website lets you practice entering information from source documents into the claim form. Over 300 illustrations and graphics bring important concepts to life. Detailed chapter objectives highlight what you are expected to learn. Key terms, acronyms, and abbreviations with definitions are included in each chapter. Concept Review boxes reinforce key concepts. Test Your Knowledge exercises reinforce lessons as you progress through the material. Chapter summaries review key concepts. Practice hospital cases let you apply concepts to real-life scenarios. UPDATED content reflects the most current industry changes in ICD-10, MR-DRGs, PPS Systems, and the Electronic Health Record. NEW Hospital Introduction chapter includes a department-by-department overview showing how today’s hospitals really work NEW Health Care Payers and Reimbursement section follows the workflow of the hospital claim by including successive chapters on payers, prospect payment systems, and accounts receivable management.

The definitive guide to starting a successful career in medical billing and coding With the healthcare sector growing at breakneck speed—it’s currently the largest employment sector in the U.S. and expanding fast—medical billing and coding specialists are more essential than ever. These critical experts, also known as medical records and health information technicians, keep systems working smoothly by ensuring patient billing and insurance data are accurately and efficiently administered. This updated edition provides everything you need to begin—and then excel in—your chosen career. From finding the right study course and the latest certification requirements to industry standard practices and insider tips for dealing with government agencies and insurance companies, Medical Billing & Coding For Dummies has you completely covered. Find out about the flexible employment options available and how to qualify Understand the latest updates to the ICD-10 Get familiar with ethical and legal issues Discover ways to stay competitive and get ahead The prognosis is good—get this book today and set yourself up with the perfect prescription for a bright, secure, and financially healthy future!

When a doctor sees a patient, how does the doctor‘s office get paid? If a claim for a service or procedure provided is denied, how does the doctor‘s office get the patient‘s insurance company to pay? Handling the Medical Claim: An 8-Step Guide on "How To" Correct and Resolve Claim Issues explains from beginning to end how to bill and collect on cla

New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.

The easy way to start a career in medical billing and coding With healthcare providers moving to electronic record systems, data accuracy and efficient data processing is more important than ever. Medical offices need professionally trained billers and coders, either in the office or via telecommute, to handle records for internal and external accessibility and efficiency. Medical Billing & Coding For Dummies gives you everything you need to know to get started in medical billing and coding. It gives you practical, easy-to-follow coverage and advice on how to find a course, educational topics you should review and pursue in order to stay competitive in the field, and the laws and other regulations you'll encounter in your work. Certification requirements and standard industry practices Tips for dealing with government agencies and insurance companies Ethical and legal issues If you're looking to start a career in the popular field of medical billing and coding, this hands-on, friendly guide has you covered!

"Claim Success! is written to provide entrepreneurs, business people, and anyone investigating medical billing as a potential career, with completely up-to-date, comprehensive information about literally everything you will need to know to decide if running a medical billing and practice management company is a good business for you to consider." --Publisher.

Collect money owed to your practice. Improve your revenue cycle by maximizing key processes for professional fee billing. Written by industry experts, this book is a step-by-step guide to billing and collection processes, performance outcomes and advanced billing practices. It includes case studies, tools, checklists, resources, policies and procedures to help you diagnose problems and develop plans to attain optimal financial performance.