Full Description
Intended to demystify the payment of insurance claims, Outcomes in Coding Practice: A Roadmap from Provider to Payer provides insight into coding from the payer perspective. By understanding the rules, laws and contracts HMO, PPOs or Medicare must consider when payment decision are made, you will be able to make the correct coding choices and improve the claim to payment ratio for your medical office. Coverage includes the Correct Coding Initiative, HMO and PPO contracts, Medicare and Medicaid, CPT Modifiers, how to improve compliance and manage provider disputes
Contents
Chapter 1Chapter 2: Health Maintenance Organization (HMO) Contracts.Chapter 3: Preferred Provider Organizations.Chapter 4: Fee Schedules.Chapter 5: Medicare.Chapter 6: Medicaid.Chapter 7: CPT Modifiers.Chapter 8: Usual, Customary, and Reasonable.Chapter 9: CPT Conventions to Be Considered.Chapter 10: Provider Disputes and Balance Billing.Chapter 11: Compliance and Audits.Chapter 12: Noncontracted Providers.
