Health Care Finance and the Mechanics of Insurance and Reimbursement: A Comprehensive Guide

By Michael K. Harrington, this book is a valuable resource for health administration and health information management students, as well as healthcare professionals seeking to navigate the complex world of health care finance and reimbursement.

Comprehensive Coverage of Health Care Finance and Reimbursement

This book expertly combines financial principles unique to the health care setting with the methods and processes for reimbursement, including:

• Coding and reimbursement strategies
• Compliance and financial reporting
• Case mix index and external auditing

The revenue cycle is thoroughly explained, correlating it with regular management functions, and reimbursement is covered from the initial point of care through claim submission and reconciliation.

Updated and Expanded Material

The Third Edition offers expanded material on financial statements, new and expanded Skilled Nursing Facility examples, and enhanced sections on:

• PDPM (Patient-Driven Payment Model)
• Practice Management for Primary Care and other Specialties
• Clearinghouse Processes
• Predictive Modeling (data mining)

In addition, the book addresses the new characteristics of the accounting authorities that healthcare administrators will have to deal with after the COVID-19 Pandemic, and includes a full chapter on the ACA (Affordable Care Act) that addresses recent and anticipated future changes.

Product Details

Publisher: Jones & Bartlett Learning

Edition: 3rd edition (November 20, 2023)

Language: English

Format: Paperback

Pages: 375

ISBN-10: 1284259293

ISBN-13: 978-1284259292

This comprehensive guide is an essential resource for healthcare professionals seeking to navigate the complex world of health care finance and reimbursement. With its thorough coverage of financial principles, reimbursement methods, and updated material, it provides the necessary tools for healthcare administrators to successfully transition from the classroom to the healthcare facility.