Section 1557 of the Affordable Care Act PDF Download
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Author: American Dental Association
Publisher: American Dental Association
ISBN: 1941807712
Category : Medical
Languages : en
Pages : 60
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Book Description
Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.
Author: Patricia A. Davis
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.
Author: AAPC
Publisher: AAPC
ISBN: 1626889821
Category : Medical
Languages : en
Pages : 16
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Book Description
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 Dental Association
Publisher: American Dental Association
ISBN: 1941807712
Category : Medical
Languages : en
Pages : 60
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Book Description
Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.
Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 44
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Book Description
Author: Department Of Health And Human Services
Publisher: Lulu.com
ISBN: 9781716599989
Category : Medical
Languages : en
Pages : 128
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Book Description
These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. The instructions and conventions of the classification take precedence over guidelines. These guidelines are based on the coding and sequencing instructions in the Tabular List and Alphabetic Index of ICD-10-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. These guidelines have been developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The importance of consistent, complete documentation in the medical record cannot be overemphasized. Without such documentation accurate coding cannot be achieved. The entire record should be reviewed to determine the specific reason for the encounter and the conditions treated.
Author: Robin L. Linker
Publisher: American Medical Association Press
ISBN: 9781640160378
Category : Medical
Languages : en
Pages : 0
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Book Description
"Coding with Modifiers, 6th Ed, is the ultimate resource for modifier guidelines. This revised edition provides guidance on how and when to use modifiers in order to avoid costly payment delays and denials. Coding with Modifiers uses real-life modifier scenarios and medical records to guide correct CPT® and HCPCS modifier usage. Modifiers create clear, concise communications between the provider and payer, and are essential to the coding process. Clinical documentation improvement and other pertinent considerations highlight important clinical documentation improvements for each modifier and related best practices to ensure correct modifier usage. Provides guidelines from CPT, CMS, third-party payers, and NCCI to explain how and when to use modifiers to avoid payment delays and denials"--
Author:
Publisher:
ISBN:
Category : Classification
Languages : en
Pages : 76
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Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309104726
Category : Medical
Languages : en
Pages : 619
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Book Description
The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.
Author: Aspen Health Law Center
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 156
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Book Description
Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.
Author: U.s. Government Accountability Office
Publisher:
ISBN: 9781974244263
Category :
Languages : en
Pages : 38
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Book Description
"Why GAO Did This StudyAccording to the Centers for Medicare & Medicaid Services (CMS)-the agency within the Department of Health and Human Services (HHS) that administers the Medicare program-more than 1.5 million health providers and suppliers of medical equipment were enrolled in the Medicare program in 2011, and 30,000 more enroll each month. CMS has established Medicare enrollment standards and procedures intended to ensure that only qualified providers and suppliers can enroll. While most providers and suppliers pose a limited risk to the Medicare program, our previous work found persistent weaknesses in CMS's Medicare enrollment standards and procedures that increased the risk of enrolling entities intent on defrauding the program. In 2010, the Patient Protection and Affordable Care Act (PPACA) authorized CMS to implement procedures to strengthen the Medicare enrollment process.GAO was asked to review CMS's Medicare provider enrollment procedures. In this report, GAO describes (1) how CMS and its contractors use provider and supplier enrollment information to prevent improper payments and factors that may affect the usefulness of this information, and (2) the extent to which CMS has implemented new provider and supplier enrollment screening procedures since the enactment of PPACA. To do so, GAO reviewed relevant regulations and documents, and interviewed officials from CMS"
