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Compliance for Coding, Billing & Reimbursement - A Systematic Approach to Developing a Comprehensive Program (Paperback, 2nd edition)
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Compliance for Coding, Billing & Reimbursement - A Systematic Approach to Developing a Comprehensive Program (Paperback, 2nd edition)
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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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