Catalogue


Hospital reimbursement : concepts and principles /
Kyle Herbert.
imprint
Boca Raton : CRC Press, c2012.
description
xv, 256 p. : ill. ; 26 cm.
ISBN
1439898944 (hardcover: alk. paper), 9781439898949 (hardcover: alk. paper)
format(s)
Book
Holdings
More Details
imprint
Boca Raton : CRC Press, c2012.
isbn
1439898944 (hardcover: alk. paper)
9781439898949 (hardcover: alk. paper)
contents note
Fundamentals of accounting -- Types of hospitals/conceptual framework -- Hospital revenue cycle -- Hospital services -- Medicare -- Medicaid -- Other insurance providers -- Governmental cost reporting -- Statement of operations (income statement) -- Statement of financial position (balance sheet) -- Coding -- Managing the month end close process -- Calculating the financial impact of hospital length of stay -- Future of health care accounting -- Incorporating faith in to the workplace.
catalogue key
8679212
 
Includes bibliographical references and index.
A Look Inside
Reviews
This item was reviewed in:
Reference & Research Book News, October 2012
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Summaries
Bowker Data Service Summary
Hospital reimbursement is a complex field that is driven by numerous factors and variables. This easy-to-read text provides a clear understanding of the concepts and principles that drive the revenue cycle within a hospital setting.
Main Description
Hospital reimbursement is a complex field driven by government regulations. This easy-to-read manual provides a clear understanding of the concepts and principles of financial reimbursement within a hospital setting. It discusses Medicare and Medicaid financial models, hospital revenue cycles, income statements, balance sheets, and accounting fundamentals as they apply to healthcare. Providing a foundation in coding principles, the text discusses the complexity of the Medicare Cost Report. It highlights critical issues and uses diagrams and flowcharts to illustrate processes.
Main Description
Hospital reimbursement is a complex field that is driven by numerous factors and variables. This easy-to-read text provides a clear understanding of the concepts and principles that drive the revenue cycle within a hospital setting. The formulation of the Medicare blend rate is explained as well as the computation of both DSH and IME. The DRG and APC reimbursement models are also discussed and the computation of an outlier payment is detailed. The process of Medicaid reimbursement is addressed along with other third party payer models. Financial statements pertaining to both for-profit and not-for-profit hospitals are reviewed and an extensive background of coding is given. In addition, the text walks through step-by-step the creation of a mock Medicare cost report for a sample hospital.
Main Description
Due to the countless variables that affect revenue and cost, the hospital reimbursement process is by far the most complex of any industry. Requiring only a basic financial background and a working knowledge of accounting, Hospital Reimbursement: Concepts and Principles supplies a clear understanding of the concepts and principles that drive the revenue cycle within a hospital setting. The book explains the technical aspects of reimbursement in language that is easy to comprehend. It illustrates the complexities of the hospital revenue cycle and explains the Medicare and Medicaid financial models in detail. The text also addresses the Medicaid reimbursement methodology, the formulation of the Medicare blend rate, the computation of both DSH and IME, as well as other third-party payers. It also: Covers the full range of services and procedures for which a hospital can receive reimbursement Explains the difference between a for-profit and not-for-profit hospital Contains chapters devoted to Statements of Operations (Income Statement) and Statements of Financial Position (Balance Sheet) Examines governmental cost reporting-including Worksheets A, A-6, A-8, A-8-2, B-1, B Part 1, C Part 1, D-3, D-5, and E Part A Supplying readers with a foundation in coding principles, the text also includes a model for calculating the financial impact of variations in patient length of stay. It discusses the DRG and APC reimbursement models and details the computation of an outlier payment. In addition, it walks the reader step-by-step through the creation of a mock Medicare cost report for a sample hospital.

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