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

✍ Scribed by Duane C. Abbey (Author); James H. Handwerk (Author); Mark J. Kaiser (Author)

• Publisher: Productivity Press
• Year: 2008
• Leaves: 220
• Edition: 2
• Category: Library

✦ Synopsis

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

✦ Table of Contents

Introduction. Case study listing. Structuring CBR compliance programs. Coding, billing, and reimbursement: Problem/opportunity areas. Investigation and problem solving. Development of CBR policies and procedures. Developing effective training. Monitoring and corrective action. Conducting CBR baseline audits. Integrating CBR compliance into corporate compliance. HIPAA compliance. Compliance considerations for hospitals. Compliance considerations for physicians and clinics. Special compliance audits and reviews. References and bibliography. Appendices.

✦ Subjects

Economics, Finance, Business & Industry;Business, Management and Marketing;Public & Nonprofit Management;Healthcare Management