Denials Management & Appeals Reference Guide - First Edition

Denials Management & Appeals Reference Guide - First Edition PDF 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!

Denials Management & Appeals Reference Guide - First Edition

Denials Management & Appeals Reference Guide - First Edition PDF Author: AAPC
Publisher: AAPC
ISBN: 1626889821
Category : Medical
Languages : en
Pages : 16

Get Book Here

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!

The Affordable Care Act

The Affordable Care Act PDF Author: Tamara Thompson
Publisher: Greenhaven Publishing LLC
ISBN: 0737771496
Category : Young Adult Nonfiction
Languages : en
Pages : 130

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Book Description
The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

Patient Appeals in Health Care

Patient Appeals in Health Care PDF Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher:
ISBN:
Category : Law
Languages : en
Pages : 104

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Book Description


Medicare Essentials

Medicare Essentials PDF Author: Tanya Feke
Publisher:
ISBN: 9780692418161
Category :
Languages : en
Pages : 184

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Book Description
The best-selling Medicare guide is now available with 2015 updates! Written by Tanya Feke MD, a board-certified family physician, Medicare Essentials tells you everything you really need to know about this government program. With experience both caring for patients and working with administrators, she has learned tricks that can save you money and improve your healthcare experience. This book shares the most up-to-date Medicare information with 2015 cost analyses, a review of Medicare's latest preventive screening offerings, and a discussion of Medicare's controversial 2-Midnight Rule. Simple worksheets guide you through the Medicare maze to help you on your way. Let Dr. Feke be your advocate and explain the fine print.

How to Win Medicare Appeals

How to Win Medicare Appeals PDF Author: David D. Mullens
Publisher:
ISBN: 9781641055987
Category : Administrative procedure
Languages : en
Pages : 280

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Book Description
"This book is about how to successfully fight for the payment of medically reasonable and necessary services when Medicare erroneously denies payment, or when Medicare erroneously demands a repayment of overpayment"--

Ethics, Conflict and Medical Treatment for Children E-Book

Ethics, Conflict and Medical Treatment for Children E-Book PDF Author: Dominic Wilkinson
Publisher: Elsevier Health Sciences
ISBN: 0702077828
Category : Medical
Languages : en
Pages : 190

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Book Description
What should happen when doctors and parents disagree about what would be best for a child? When should courts become involved? Should life support be stopped against parents' wishes? The case of Charlie Gard, reached global attention in 2017. It led to widespread debate about the ethics of disagreements between doctors and parents, about the place of the law in such disputes, and about the variation in approach between different parts of the world. In this book, medical ethicists Dominic Wilkinson and Julian Savulescu critically examine the ethical questions at the heart of disputes about medical treatment for children. They use the Gard case as a springboard to a wider discussion about the rights of parents, the harms of treatment, and the vital issue of limited resources. They discuss other prominent UK and international cases of disagreement and conflict. From opposite sides of the debate Wilkinson and Savulescu provocatively outline the strongest arguments in favour of and against treatment. They analyse some of the distinctive and challenging features of treatment disputes in the 21st century and argue that disagreement about controversial ethical questions is both inevitable and desirable. They outline a series of lessons from the Gard case and propose a radical new 'dissensus' framework for future cases of disagreement. - This new book critically examines the core ethical questions at the heart of disputes about medical treatment for children. - The contents review prominent cases of disagreement from the UK and internationally and analyse some of the distinctive and challenging features around treatment disputes in the 21st century. - The book proposes a radical new framework for future cases of disagreement around the care of gravely ill people.

For-Profit Enterprise in Health Care

For-Profit Enterprise in Health Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309036437
Category : Medical
Languages : en
Pages : 580

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Book Description
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

Medical and Dental Expenses

Medical and Dental Expenses PDF Author:
Publisher:
ISBN:
Category : Income tax deductions for medical expenses
Languages : en
Pages : 20

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Book Description


The Social Security Definition of Disability

The Social Security Definition of Disability PDF Author:
Publisher:
ISBN:
Category : Disability insurance
Languages : en
Pages : 52

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Book Description


Definition of Serious and Complex Medical Conditions

Definition of Serious and Complex Medical Conditions PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309172608
Category : Medical
Languages : en
Pages : 127

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Book Description
In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients.