Hospital Billing from A to Z

Hospital billing departments are known by various names, but their staff all experience the same problems understanding and complying with Medicare's many billing requirements.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 DefinitionsWho 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