Gain an understanding of advanced topics in healthcare revenue cycle management and explore current issues impacting healthcare organization reimbursements with Parks' REVENUE CYCLE FOR HEALTHCARE. This book introduces you to the various roles of HIM professionals beyond the traditional HIM department. You study measures of hospital performance, such as case mix and risk adjustment programs. You also examine important topics, such as clinical documentation integrity, physician queries, predictive analytics use in the revenue cycle, claims audits, denials and appeals and pay-for-performance. All content corresponds to the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) competencies. Enrichment activities and case studies give you a first-hand view of real-world experiences as you prepare for employment. MindTap digital resources are also available to reinforce your grasp of healthcare revenue cycle management.
Chapter 1: Overview of Revenue Cycle Management
Chapter 2: Reimbursement Processes and Tools
Chapter 3: Healthcare Financial Information, a strategic resource
Chapter 4: Inpatient Prospective Payment System
Chapter 5: Outpatient Prospective Payment System
Chapter 6: Measures of Hospital Performance
Chapter 7: Pay-for-Performance and Value-Based Purchasing
Chapter 8: Charge Description Master
Chapter 9: Clinical Documentation Integrity
Chapter 10: Physician Queries
Chapter 11: Claims Denials and Appeals
Chapter 12: Compliant Billing and Audits
Appendices
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Linda Parks
Linda J. Parks is associate professor emeritus at Dakota State University. She holds a master's degree in HIIM from St. Scholastica and has RHIT and CCS credentials. Before teaching at Dakota State University, she was HIT program director at Darton College and a faculty member at the College of St. Mary and Macon State College. Professor Parks has previous experience with inpatient settings as RHIT in the patient care unit. She also has experience in utilization review and quality audits in teaching hospitals and has served as a coding supervisor and coder in a community hospital. In outpatient setting, she has also served as an office manager for an internal medicine practice. Professor Parks briefly held the credentials of CTR, working part-time in Cancer Registry. She has been an active member of AHIMA, SDHIMA, GHIMA, HIMSS and SDHIMSS. She also serves as a Cengage Faculty Partner.
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UNIQUE MINDTAP DIGITAL RESOURCES PROVIDE INSTRUCTOR SUPPORT FOR YOU AND RESOURCES FOR YOUR STUDENTS. This award-winning online platform, not offered by other revenue cycle management texts, delivers time-saving resources at your fingertips. You customize content to your course, unique teaching style and student needs as you determine which MindTap activities to use. You can even add your own notes, other material and lectures. Videos, hands-on activities, self-check options and review exams increase your students' retention of key concepts.
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ALL CONTENT AND CRITICAL-THINKING ACTIVITIES CORRESPOND TO CAHIIM DOMAINS FOR A BACHELOR'S DEGREE. Students learn to evaluate and assign diagnostic and procedural codes and groupings according to official guidelines. They learn to manage the revenue cycle in compliance with regulatory requirements and reimbursement methodologies. Students also master organizational management and leadership skills as they learn to verify financial management processes and assess ethical standards of practice.
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EXPLANATIONS DISCUSS THE "WHAT, WHY AND HOW" BEHIND THE REVENUE CYCLE IN HEALTHCARE. Students study clean claims and compliance with government regulations and insurers’ health plans. They learn to monitor and report case mix index, review for documentation integrity and HCC risk adjustments to be compliant and receive correct reimbursement for services rendered on a timely basis. Your students also learn how to use of artificial intelligence and predictive analytics, ethical coding practices, up-to-date charge description masters, physician queries, internal audits and appeals.
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CASE STUDIES AND PROFESSIONAL REFERENCES REINFORCE KEY POINTS. Each of this edition's twelve chapters includes authentic case studies and helpful references to current, professional articles to clearly illustrate important points.
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ALL ACTIVITIES CORRESPOND TO BLOOM’S TAXONOMY IN COMPLIANCE WITH CAHIIM STANDARDS. The author has created meaningful, interactive activities throughout the text and within the instructor's manual that correspond to the 5 and 6 level of Bloom’s taxonomy and meet CAHIIM standards. The instructor's manual includes additional activities, review questions and quizzes for your optional use. MindTap also offers digital matching and multiple-choice questions that you can use for review or assignments.
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