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
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
Answer keys designated as "instructor material" are only provided to verified instructors employed at a school with an .edu address. No exceptions will be made
About the Authors
Anne B. Casto, RHIA, CCS, is president of Casto Consulting, LLC.
Elizabeth Forrestal, PhD, RHIA, CCS, FAHIMA, is professor in the Department of Health Services and Information Management at East Carolina University.