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| Author | : AAPC |
| Publisher | : AAPC |
| Total Pages | : 16 |
| Release | : 2020-03-17 |
| Genre | : Medical |
| ISBN | : 1626889821 |
Recoup lost time and revenue with denials management and appeals know-how. Claim denials can sink a profit margin. And given the cost of appeals, roughly $118 per claim, not all denials can be reworked. A practice submitting 50 claims a day at an average reimbursement rate of $200 per claim should bring in $10,000 in daily revenue. But if 10% of those claims are denied, and the practice can only appeal one, they lose $800 per day—upwards of $200K annually. Your medical claims are the lifeblood of operations. Don’t compromise your financial health. Learn how to preempt denials with the Denials Management & Appeals Reference Guide. This vital resource will equip you to get ahead of payers by simplifying the leading causes of denials and showing you how to address insufficient documentation, failing to establish medical necessity, coding and billing errors, coverage stipulations, and untimely filing. Rely on AAPC to walk you through the appeal process. We’ll help you establish protocols to avoid an appeals backlog and teach you how to identify and prioritize denials likely to win an appeal. What’s more, you’ll learn when a claim can be “reopened” to fix a problem. Collect the revenue your practice deserves with effective denials and appeals solutions: Know how to analyze your denials Defeat documentation and compliance issues for successful claims success Utilize payer policy for coverage clues Lock in revenue with face-to-face reimbursement guidance Refine efforts to avoid E/M claim denials Ace ICD-10 coding for optimum reimbursement Put an end to modifier confusion Stave off denials with CCI edits advice Navigate the appeals process like a pro And much more!
| Author | : American Medical Association |
| Publisher | : |
| Total Pages | : 1200 |
| Release | : 2021-09-17 |
| Genre | : |
| ISBN | : 9781640160873 |
CPT(R) 2022 Professional Edition is the definitive AMA-authored resource to help healthcare professionals correctly report and bill medical procedures and services.
| Author | : AAPC |
| Publisher | : AAPC |
| Total Pages | : 14 |
| Release | : 2020-06-30 |
| Genre | : Medical |
| ISBN | : 162688983X |
Defeat the challenges that threaten your E/M claims and compliance success. Evaluation and management (E/M) services are the lifeblood of your revenue stream, and yet they’re the most problematic to report. Claim denials remain high. E/M coding errors, in fact, rose from 11.9% in 2018 to account for 12.8% of CMS’s overall 2019 improper payment rate. How much E/M revenue are you losing? Safeguard your organization from claim denials and audit scrutiny with the Evaluation & Management Coding Reference Guide. Our experts break down E/M coding rules and requirements into simple, manageable steps written in everyday language to boost your E/M reporting skills. Learn how to capture the key components of medical history, physical exam, and medical decision-making—and capitalize on real-world clinical scenarios to prevent over- or under-coding. The Evaluation & Management Coding Reference Guide will help you prep for 2021 E/M guideline changes overhauling new and established office and outpatient services, and walk you through online digital E/M services, remote physiologic monitoring, and more. Master the ins and outs of E/M coding—CPT® guidelines, level of service, modifiers, regulations, and documentation guidelines. Put an end to avoidable denials and optimize your E/M claims for full and prompt reimbursement. Benefit from expert tutorials covering the spectrum of E/M reporting concepts and challenges: Prep for 2021 guideline changes and their impact on your organization Master the ins and outs of E/M guidelines in CPT® Capture the seven components of E/M services Sort out medical decision-making coding Avoid the pitfalls of time-based coding Nail down specifics for critical care E/M services Clear up modifier confusion Understand NPPs rules for same-day E/M services Take the guesswork out of complexity determinations Get the details on coding surgery and E/M together Learn the principles of E/M documentation
| Author | : Aapc |
| Publisher | : |
| Total Pages | : 1392 |
| Release | : 2020-09 |
| Genre | : |
| ISBN | : 9781635277371 |
| Author | : AAPC |
| Publisher | : AAPC |
| Total Pages | : 14 |
| Release | : 2020-03-16 |
| Genre | : Medical |
| ISBN | : 1626889856 |
Effectively manage the business side of medicine. Profit margin, collections, cash flow, compliance, human resources, health information, efficient business processes—the broad responsibilities and complex requirements of practice management are endless. Drop one ball in the daily juggle and the fallout can be costly. There’s never enough time, which makes it tough to stay on top of regulations and best practices. That’s where AAPC’s Practice Management Reference Guide becomes vital to your organization, providing you with one-stop access to the latest and best in practice management. From office operations to financial oversight, the Practice Management Reference Guide lays out essential guidance to help you optimize efficiency, security, and profitability. Benefit from actionable steps to streamline accounts receivable. Discover how to bring in new patients and keep the ones you have happy. Leverage real-world strategies to command payer relations, recruitment, training, employee evaluations, HIPAA, MACRA, Medicare, CDI, EHR … everything you need to ensure bountiful operations in 2020 and beyond. With the Practice Management Reference Guide, you’ll gain working knowledge covering the spectrum of practice management issues, including: Negotiating favorable payer contracts Preventing an appeals backlog Remaining audit-ready Correctly applying incident-to billing rules to maximize reimbursement Using assessment tools to evaluate your risk Preparing a risk plan and know what questions to ask Knowing how and why you should implement policies and protocols Complying with state and federal patient privacy rules
| Author | : The Coders Choice LLC |
| Publisher | : |
| Total Pages | : 89 |
| Release | : 2018-02-27 |
| Genre | : |
| ISBN | : 9781980412595 |
The CPC exam is comprised of 150 multiple-choice questions. The test takes five hours and 40 minutes to complete, making it fairly rigorous. There are two breaks in the middle of the test. The CPC exam costs $300 to take, but only $260 if the test-taker is a member of the AAPC (annual dues are $125 for individuals and $70 for students).The CPC exam thoroughly tests a coder's grasp of the entire coding process, from medical terminology to code sets and beyond. Per the AAPC's website, the CPC exam covers 24 subject areas, including anesthesia, radiology, and medicine.You should recognize a number of these (like Evaluation and Management, or Radiology) as sections of the CPT code manual. Others, like Anatomy and Physiology, are parts of the coder's everyday skill set.You should note that the questions on the exam are not divided or identified by the topic they are related to. That is, questions on the CPC exam will test you on all of the above 24 fields of medical coding, but they won't outright say, "This is an anesthesia question." Instead they'll just ask you about anesthesia, or surgery, or human anatomy.During the test, you'll be presented with a number of tests cases pertaining to the practice of coding. These test case questions will present you with a condensed medical report and ask you to select the correct set of codes from the answers below.For instance, a test case question might read:"Sarah, a 45-year-old patient, visits the doctor and presents symptoms including a sore throat, swollen lymph nodes, and a fever. After performing a rapid strep test, the doctor confirms a diagnosis of streptococcal sore throat. The doctor prescribes an Amoxicillin as an antibiotic. Which of the following are the correct codes for this diagnosis, procedure and prescription?"There are also general knowledge questions, like "Which types of joints are synovial?" that don't have an attached test case. That question's related to the musculoskeletal system, but the test won't come right out and say so. You'll have to rely on your knowledge of code sets, medical terminology, best practices, and the coding process in general to pass.Individuals who earn a score of 70 percent or better (105 correct questions) will pass the CPC exam. If you fail your first test, you are allowed one free retake.GETTING CERTIFIEDOnce you pass the CPC exam, you are not officially certified by the AAPC until you fulfill a few other criteria. In order to complete a CPC certification, you must become a member of the AAPC. Certification is also limited to coders with two years of professional experience or those willing to complete an apprentice program.As such, the CPC exam is recommended for individuals who have already started their coding career. That won't prevent us from going over the basics of this important exam.
| Author | : Carol J. Buck |
| Publisher | : Elsevier Health Sciences |
| Total Pages | : 1003 |
| Release | : 2015-12-01 |
| Genre | : Medical |
| ISBN | : 032338918X |
Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! From bestselling author Carol J. Buck, Step-by-Step Medical Coding, 2016 Edition is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. Practice exercises follow each 'step' of information to reinforce your understanding of important concepts. In-depth coverage includes reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, with an Evolve website that includes 30-day access to TruCode® Encoder Essentials. No other text so thoroughly covers all coding sets in one source! - 30-day access to TruCode® Encoder Essentials and practice exercises on the Evolve companion website provide additional practice and help you understand how to utilize an encoder product. - A step-by-step approach makes it easier to build skills and remember the material. - Over 475 illustrations include medical procedures and conditions to help you understand the services being coded. - Real-world coding reports (cleared of any confidential information) simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Dual coding includes answers for both ICD-10 and ICD-9 for every exercise, chapter review, and workbook question to help you ease into the full use of ICD-10. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - From the Trenches, Coding Shots, Stop!, Caution!, Check This Out!, and CMS Rules boxes offer valuable tips and helpful advice for working in today's medical coding field. - Four coding-question variations develop your coding ability and critical thinking skills, including one-code or multiple-code answers. - Official Guidelines for Coding and Reporting boxes allow you to read the official wording for inpatient and outpatient coding alongside in-text explanations. - Coders' Index makes it easy to quickly locate specific codes. - Appendix with sample Electronic Health Record screenshots provides examples similar to the EHRs you will encounter in the workplace. - Online practice activities on Evolve include questions such as multiple choice, matching, fill-in-the-blank, and coding reports. - A workbook corresponds to the textbook and offers review and practice with more than 1,200 theory, practical, and report exercises (odd-numbered answers provided in appendix) to reinforce your understanding of medical coding. Available separately. - NEW! Separate HCPCS chapter expands coverage of the HCPCS code set. - UPDATED content includes the latest coding information available, promoting accurate coding and success on the job.
| Author | : Karen Smiley |
| Publisher | : John Wiley & Sons |
| Total Pages | : 355 |
| Release | : 2019-12-05 |
| Genre | : Medical |
| ISBN | : 1119625440 |
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!
| Author | : Carol J. Buck |
| Publisher | : Elsevier Health Sciences |
| Total Pages | : 1011 |
| Release | : 2014-11-18 |
| Genre | : Medical |
| ISBN | : 0323292011 |
Take your first step toward a successful career in medical coding with in-depth coverage from the most trusted name in coding education! From Carol J. Buck, Step-by-Step Medical Coding, 2015 Edition is a practical, easy-to-use resource that shows you exactly how to code using all current coding systems. Explanations of coding concepts are followed by practice exercises to reinforce your understanding. In addition to coverage of reimbursement, ICD-9-CM, CPT, HCPCS, and inpatient coding, this edition fully covers ICD-10-CM in preparation for the transition to ICD-10. No other text on the market so thoroughly covers all coding sets in one source! - A step-by-step approach makes it easier to build skills and remember the material. - Dual coding addresses the transition to ICD-10 by providing coding answers for both ICD-10 and ICD-9. - Over 500 illustrations include medical procedures and conditions that help you understand the services being coded, and images from Carol J. Buck's professional ICD and HCPCS manuals that familiarize you with the format of professional coding manuals. - Real-life coding reports simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Complete coverage of ICD-10-CM prepares you for the transition to ICD-10. - A workbook corresponds to the textbook and offers review and practice with more than 1,500 questions, activities, and terminology exercises to reinforce your understanding of medical coding. Available separately. - Official Guidelines for Coding and Reporting boxes allow you to read the official wording for inpatient and outpatient coding alongside in-text explanations. - Four coding question variations develop your coding ability and critical thinking skills, including one-code or multiple-code answer blanks. - From the Trenches, Coding Shots, Stop!, Caution!, Check This Out!, and CMS Rules boxes offer valuable tips and helpful advice for working in today's medical coding field. - Coder's Index makes it easy to quickly locate specific codes. - Appendix with sample EHR (Electronic Health Record) screenshots provides examples similar to the EHRs you will encounter in the workplace. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts, and emphasize key information. - NEW! Encoder practice exercises on the companion Evolve website provide added practice and help you understand how to utilize an encoder product. - UPDATED content includes the latest coding information available, promoting accurate coding and success on the job.
| Author | : United States. Congress. House. Committee on Appropriations. Subcommittee on Foreign Operations and Related Agencies (1968?-1978) |
| Publisher | : |
| Total Pages | : 1900 |
| Release | : 1969 |
| Genre | : Economic assistance, American |
| ISBN | : |
