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4 results for "Medicare Payment"
Medicare Regulations & Payment Policy for Ambulatory Surgery Centers - 2013 Edition By John Goehle
Paperback: $149.99
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For five years running, the ASC Industry's most comprehensive one-volume summary of the Medicare Rules & Payment Policies applicable to ASC's including the Conditions for Coverage (CfC) & the... More > CMS interpretations & clarifications provided to state surveyors to evaluate compliance. The CfC are the rules & regulations that all ASC's must meet to maintain it's certification. The book also includes a summary of the current Medicare Payment system, the CMS ASC Claims Processing Manual, and a complete list of the allowable Medicare procedures, drugs & ancillaries (with 2013 Rates Compared to 2012 Rates and 2013 HOPD Rates). Also included is an extensive index to the regulations and a crosswalk to the CMS Interpretative Guidelines. This year's edition includes a comprehensive overview of the new Quality Reporting program. This guide will assist ASC Administrators, Managers, and Staff in quickly locating current Medicare regulations & payment policies using one convenient volume.< Less
Health Care Taxonomy & Medicare Fee Schedule with CPT codes Reference Resource By Vasu Brown
Paperback: $15.99
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The Healthcare Provider Taxonomy Codes (HPTC) are a HIPAA standard code set named in the implementation specifications for some of the ASC X12 standard HIPAA transactions. The “Healthcare... More > Provider Taxonomy Code” is a situational data element in the 4010 X12 Implementation Guides and the 5010 X12 TR3 Reports for the 837 Professional and Institutional. If the Taxonomy code is required in order to properly pay or process a claim/encounter information transaction, it is required to be reported. The Healthcare Provider Taxonomy code set divides health care providers into hierarchical groupings by type, classification, and specialization, and assigns a code to each grouping. The Taxonomy consists of two parts: individuals (e.g., physicians) and non-individuals (e.g., ambulatory health care facilities). All codes are alphanumeric and are 10 positions in length. The Healthcare Provider Taxonomy code set is maintained by the National Uniform Claim Committee (NUCC).< Less
Medicare Overpayment Demands: Seven Strategies to Help Your Client By Edward M. Roche
Paperback: $10.95
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Medicare fraud is an important problem. Qualified Independent Contractors (QICs) and Recovery Audit Contractors (RACs) perform audits to recover over-payments made to health care providers. The... More > extrapolated refund demand is the result of an analysis of a statistically random sample of your client's claims. Coding analysis is used to determine a general error rate for claims submitted. This error rate is then extrapolated against the total universe of paid claims to create the final overpayment demand. Forensic statistics can be used to expose errors made in the extrapolations leading to the overpayment demand. This document reviews 7 strategies to consider in order to get the best outcome possible for your client.< Less
Medicare Overpayment Demands: Seven Strategies to Help Your Client By Edward M. Roche
eBook (PDF): $5.00
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Medicare fraud is an important problem. Qualified Independent Contractors (QICs) and Recovery Audit Contractors (RACs) perform audits to recover over-payments made to health care providers. The... More > extrapolated refund demand is the result of an analysis of a statistically random sample of your client's claims. Coding analysis is used to determine a general error rate for claims submitted. This error rate is then extrapolated against the total universe of paid claims to create the final overpayment demand. Forensic statistics can be used to expose errors made in the extrapolations leading to the overpayment demand. This document reviews 7 strategies to consider in order to get the best outcome possible for your client.< Less