Physician Practice Billing From A to Z

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Physician Practice Billing From A to Z

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Physician Practice Billing From A to Z

Charlotte L. Kohler, RN, CPA, CVA, CRCE-I, CPC, ACS, CHBC
And:
Kohler Healthcare Consulting, Inc., associates
Darrin Cornwell, CRCS-I
Dawn Doll Homer, CPC, CRCS-I, CDC
Daria Malan, RN, LNHA, MBA, RAC-CT®
John Ninos, MS, MT(ASCP), CCS
Timothy Sheridan
Deanna Turner, MBA, CPOC, CPC, CPC-I, CSSGB
Susan Walberg, JD, MPA, CHC


Physician Practice Billing From A to Z
is a comprehensive, user-friendly guide to billing requirements, with particular emphasis on Medicare. This resource will help physician practice billers understand the relevant regulations, code sets, compliance issues, and myriad other factors that affect the billing process.

From ABNs to ZPICs, this valuable reference book addresses, defines, and explains more than 100 topics in alphabetical order, including the following:

  • Billing Compliance 
  • Codes—CPT and HCPCS 
  • Deductibles, Copayments, and Coinsurance 
  • Denial of Related Part B Services When Inpatient Service Denied by Medicare 
  • Evaluation and Management and Procedure—Same Day 
  • HCPCS vs. CPT: G (Temporary) Code Assignment 
  • Laboratory Billing and Modifiers -91 and -59 
  • Local Coverage Determinations and National Coverage Determinations 
  • Locum Tenens 
  • Medically Unlikely Edits and Their Adjudication Indicators 
  • Medicare Beneficiary Numbers—Health Insurance Claim Number Prefixes and Suffixes 
  • Medicare Coverage Overview 
  • Modifier Overview 
  • National Provider Identifier 
  • Observation—Billing Codes and Requirements 
  • Rejected and Denied Claims 
  • Split/SharedVisits


Who should read this book?

  • Physician practice manager
  • Physician office manager
  • Physician practice administrator
  • Practice manager
  • Office manager
  • Practice administrator
  • Business manager
  • Coding supervisor
  • Billing supervisor
  • Compliance officer
  • Biller

 

About the Author

Charlotte L. Kohler, RN, CPA, CVA, CRCE-I, CPC, ACS, CHBC, president of Kohler Healthcare Consulting, Inc., has more than 30 years of healthcare experience, including reimbursement compliance and fraud and abuse litigation support. She is also the author of HCPro's Hospital Billing From A to Z.

Her work in billing and reimbursement has included:

  • Analysis of billing methods and concepts to recommend appropriate coding and billing techniques for Forms 1500 and UB-04
  • Hospital process improvements, including forms design and training
  • Analysis of computer system capabilities for required statistical and financial data
  • Reimbursement and billing analysis to assist with operational changes, service development, litigation support, and third-party investigations
  • Statistical analysis of billing errors and problems for testimony


Published: June 2015

Page count: 248
Dimensions: 8.5x11
ISBN: 978-1-55645-329-8