Principles of Healthcare Reimbursement

This fourth edition of Principles of Healthcare Reimbursement provides health information management educators and students an up-to-date textbook to understand how reimbursement systems affect providers and payers, consumers, policy makers, and the development of classification and information technology systems.

This publication makes a complex topic understandable for students and practitioners and helps to clarify the US healthcare reimbursement maze.

New to this Edition

• Affordable Care Act overview and implementation timeline
• Expanded requirement for electronic claim submissions
• Accountable care organizations and value-based purchasing
• Most recent PPS rules
• Dual eligibility and special needs plans
• Safety-net providers and hospice

Key Features

• Covers accessing and using fee schedules, payment classification groups, exclusion lists, market baskets, and wage indexes required for accurate reimbursement
• Explanations of the various methods, plans, and programs that typify government-sponsored payment systems, commercial insurance, and managed care
• Online student workbook
• Instructor's material includes downloadable instructor manual with answer key and PowerPoint slides for presentations