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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.
List of contents
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
About the author
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.
Summary
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.
