Download or read book Medicare Primer written by Patricia A. Davis and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.

Download or read book Section 1557 of the Affordable Care Act written by American Dental Association and published by American Dental Association. This book was released on 2017-05-24 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.

Download or read book Buck s Step by Step Medical Coding 2019 Edition E Book written by Elsevier and published by Elsevier Health Sciences. This book was released on 2018-11-05 with total page 805 pages. Available in PDF, EPUB and Kindle. Book excerpt: Take your first step toward a successful career in medical coding with guidance from the most trusted name in coding education! The bestselling Buck's Step-by-Step Medical Coding is a practical, easy-to-use resource that shows you exactly how to code using all current coding sets. Explanations of coding concepts are followed by practice exercises to reinforce understanding of the material. In addition to coverage of reimbursement, ICD-10-CM, CPT, HCPCS, and inpatient coding, an Evolve website includes 30-day access to TruCode® Encoder Essentials. No other text so thoroughly covers all coding sets in one source! - A step-by-step approach makes it easier to build your skills and remember the material. - 30-day trial access to TruCode® Encoder Essentials gives you experience with using an encoder (in addition to separate encoder practice exercises on the Evolve website). - Learning Objective and glossary review questions are included at the end of each chapter. - UNIQUE! Concrete "real-life" coding reports (cleared of any confidential information) simulate the reports you will encounter as a coder and help you apply coding principles to actual cases. - Instructor-led assessments on the companion Evolve website provide additional assessment options in classroom settings (answers and rationales provided at the discretion of your instructor). - UNIQUE! Four coding-question variations — covering both single-code questions and multiple-code questions and scenarios — develop your coding ability and critical thinking skills. - Over 450 total illustrations help you understand the types of medical conditions and procedures being coded, along with examples taken directly from Elsevier's professional ICD-10 and HCPCS manuals. - Official Guidelines for Coding and Reporting boxes show the official guidelines wording for inpatient and outpatient coding alongside in-text explanations. - UNIQUE! Coders' Index in the back of the book makes it easy to quickly locate specific codes. - Exercises, Quick Checks, and Toolbox features reinforce coding rules and concepts and emphasize key information. - Valuable tips and advice are offered in features such as From the Trenches, Coding Shots, Stop!, Caution!, Check This Out, and CMS Rules. - Sample electronic health record screenshots (located in Appendix D) show examples similar to the EHRs you will encounter in the workplace. - NEW! Updated content includes the latest coding information available, promoting accurate coding and success on the job. - NEW! Additional exercise questions covering the Official Guidelines for Coding and Reporting.

Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.

Download or read book Conditions of Participation for Hospitals written by United States. Social Security Administration and published by . This book was released on 1966 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Birth Settings in America written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-05-01 with total page 369 pages. Available in PDF, EPUB and Kindle. Book excerpt: The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

Download or read book The Future of Nursing 2020 2030 written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2021-09-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.

Download or read book Report to the Congress Medicare Payment Policy written by Medicare Payment Advisory Commission (U.S.) and published by . This book was released on 1998 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Health Care Fraud and Abuse written by Aspen Health Law Center and published by . This book was released on 1998 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.

Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Download or read book Annual Report on Medicare written by United States. Health Care Financing Administration and published by . This book was released on 1980 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Accounting for Social Risk Factors in Medicare Payment written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-10-14 with total page 83 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver. Accounting For Social Risk Factors in Medicare Payment: Data is the fourth in a series of five brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report provides guidance on data sources for and strategies to collect data on indicators of social risk factors that could be accounted for Medicare quality measurement and payment programs.

Download or read book Medicaid Eligibility Quality Control written by United States. Social and Rehabilitation Service and published by . This book was released on 1975 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Improving Medicare written by Adam K. Brooks and published by . This book was released on 2011 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medicare program enables millions of beneficiaries to obtain health care services; however, lacks many of the essential elements of a high-quality, high-value and efficient health system. Program spending and utilisation have increased substantially, without corresponding improvements in beneficiaries' health. This new and important book describes the need for Medicare to move away from payment policies that encourage service volume and are indifferent to quality and toward policies that promote better value for Medicare and its beneficiaries.

Download or read book Medication Therapy Management Second Edition written by Karen Lynn Whalen and published by McGraw Hill Professional. This book was released on 2018-04-05 with total page 654 pages. Available in PDF, EPUB and Kindle. Book excerpt: Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product. Discover the medication therapy management solution—with this definitive, up-to-date sourcebook The need to improve the use of medications has major implications for the nation’s healthcare system. Burdened by high costs and an ineffective process of providing medication therapy, the current prescription drug environment poses considerable risks to patient safety. Medication therapy management (MTM) is designed to address these deficiencies—and this essential text gives pharmacists all the right MTM tools to identify and eliminate drug-related problems that can cause potentially severe adverse events. Medication Therapy Management delivers the most relevant insights into MTM—a vital service that is gaining momentum due to the rapid growth of patient-centered care, healthcare information technology, new practice models (e.g., Patient Centered Medical Home), and new payment methods. Cohesively organized, this expert-authored guide begins with an introduction to data sets for MTM, covering essential topics such as establishing quality and performance improvement, the payer perspective, conducting the comprehensive medication review, and reimbursement. The second part of Medication Therapy Management reviews MTM data sets for a wide spectrum of disorders, from asthma and atrial fibrillation to HIV and heart disease. Enhanced by the latest perspectives on therapeutics, including completely up-to-date tables throughout, Medication Therapy Management is a practical, skill-building roadmap for optimizing drug therapy and enhancing patient outcomes. Features • Everything you need to provide successful MTM services and empower patients to take an active role in their medication and overall healthcare • Turnkey disease-based data sets help you apply proven MTM principles to common disorders • Helpful appendices cover therapy management characteristics and answers to key questions; the MTM practice model and training survey; and the Medicare Part D MTM program standardized format

Download or read book Implementing the Medicare Prescription Drug Benefit and Medicare Advantage Program written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2005 with total page 532 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Code of Federal Regulations Title 42 Public Health PT 414 429 Revised as of October 1 2014 written by Centers for Medicare and Medicaid Services (U S and published by Office of the Federal Register. This book was released on 2015-01-30 with total page 868 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Code of Federal Regulations is a codification of the general and permanent rules published in the Federal Register by the Executive departments and agencies of the United States Federal Government. This print ISBN is the official U.S. Federal Government edition. 42 CFR Parts 414-429 covers the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. This volume covers rules, procedures and regulations pertaining to payment for Part B Medical and other health services, services by physicians, ambulatory surgical services, health maintenance organizations, hospice care, competitive medical plans, healthcare prepayment plans, medicare contracting, medicare advantage program, and more. Other products pertaining to this topic include the following: Federal Register, V. 76, No. 228, Monday, November 28, 2011, Medicare Program: Payment Policies Under the Physician Fee Schedule and Other Revisions To Part B for CY 2012 can be found at this link: https://bookstore.gpo.gov/products/sku/069-001-00196-0 Health United States 2013 With Special Feature on Prescription Drugs can be found at this link: https://bookstore.gpo.gov/products/sku/017-022-01621-4 Keywords: Medicare conditions for payment; medicare shared savings program; national coverage determinations and local medicare , coverage determiniations; health insurance; voluntary medicare prescription drug benefit; Medicare Advantage Program, Prospective Payment System for Hospital Outpatient Services; outpatient services; prescription drugs; medicare savings; medicare payments; Medicare; MEDICARE; Medicare hospice covera≥ Medicare prescription drug covera≥ Medicare Part B Health covera≥ Medicare Part B Heatlh Covera≥ HMO; HMOs; medical plans; Medical plans; competitive medical plans; ambulance surgery; ambulance surgical services; Medicare program integrity; Medicare prescription drug benefit; Medicare Shared Savings Program; Medicare Program; MEDICARE Program; MEDICARE program; Medicare physician care covera≥ Medicare physician office visit covera≥ Medicare outpatient service covera≥ 42 CFR Parts 414 to 429; 42 CFR Parts 414-429; 42 CFR Parts 414-429; cfr 42 parts 414 to 429; cfr 42 parts 414-429; Medicare Benefits; Medicare benefits; medicare benefits; medicare health benefits; Medicare entitlement health benefits; senior health care; health care for older Americans; Federal Medicare program;