Principles of Healthcare Reimbursement, Fifth Edition

Anne Casto RHIA, CCS, Elizabeth Forrestal PhD, RHIA, CCS, FAHIMA
AB202014
Books
9781584264347
AHIMA Press

e-book available

The fifth edition of Principles of Healthcare Reimbursement provides educators, students, and practitioners with up-to-date information on healthcare payment systems and their effects on the US healthcare delivery system and economy in one authoritative source. Not only does the textbook provide step-by-step detail about how each payment system functions, but the history behind each payment system is also provided. This publication makes a complex topic understandable for students and practitioners and helps to clarify the US healthcare reimbursement maze.



New to this Edition

• Alignment with the Affordable Care Act
• Graphics illustrating Medicare payment systems
• Content on prospective payment system for federally qualified health centers (FQHCs)
• Dimensions of performance that can be measured and evaluated
• Expanded content on the charge description master

 

Key Features

• Covers accessing and using fee schedules, payment classification groups, exclusion lists, market baskets, and wage indexes required for accurate reimbursement
• Explains the various methods, plans, and programs that typify government-sponsored payment systems, commercial insurance, and managed care
• Describes various types of healthcare cost-sharing and their effects on providers and consumers
• Illustrates specialized data collection instruments and electronic submission software used in postacute care

 

About the Authors

Anne B. Casto, RHIA, CCS, is president of Casto Consulting, LLC.

Elizabeth Forrestal
, PhD, RHIA, CCS, FAHIMA, is professor emerita in the Department of Health Services and Information Management at East Carolina University.

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