Hospital Billing From A to Z is a comprehensive, user-friendly guide to hospital billing requirements, with particular emphasis on Medicare. This valuable resource will help hospital billers understand how compliance, external audits, and cost-cutting initiatives affect the billing process.
Beginning with 2-Midnight Rule and Inpatient Admission Criteria and ending with Zone Program Integrity Contractors, this book addresses 88 topics in alphabetical order, including the following:
- Correct Coding Initiative
- CPT®, HCPCS, Condition Codes, Occurrence Codes, Occurrence Span Codes, Revenue Codes, and Value Codes
- Critical Access Hospitals
- Deductibles, Copayments, and Coinsurance
- Denials, Appeals, and Reconsideration Requirements
- Dialysis and DME Billing in Hospitals
- Hospital-Issued Notice of Noncoverage
- Laboratory Billing and Fee Schedule
- Local and National Coverage Determinations
- Medically Unlikely Edits and Outpatient Code Editor
- Medicare Advantage Plans
- Medicare Beneficiary Numbers and National Provider Identifier
- Medicare Part A and Part B
- No-Pay Claims
- Observation Services
- Outlier Payments
- Present on Admission
- Rejected and Returned Claims
- UB-04 Form Definitions
Who should read this book?
- Finance and reimbursement staff
- Chargemaster staff
- Billers and coders
- HIM staff
- Clinical department staff
- Revenue managers
- Compliance officers and auditors
- Registration staff
- Fiscal intermediary staff
- Healthcare attorneys, consultants, and CPAs
- Legal department staff