Principles of Healthcare Reimbursement

Don't spend time searching through hundreds of different books and sources! Principles of Healthcare Reimbursement integrates information about all US healthcare payment systems into one authoritative source. You will examine the complex financial systems within today's healthcare environment, and understand the basics of health insurance, public fudning programs, managed care contracting, and how services are paid. The step-by-step detail in Casto and Laymans' book illustrates how each payment system functions, the history behind the systems, how complex reimbursement systems are used, and how profoundly they have made an impact on providers and payers, consumers, public policy makers, and the development of classification and information technology systems over the years. Need to understand the basics of revenue cycle management, and the bottom-line, nitty-gritty of the healthcare payment systems? Then Principles of Healthcare Reimbursement is the educational product for you. Savvy healthcare professionals who can help their employers, patients, or clients through the healthcare reimbursement maze will do them a great service. Includes exercises, glossary, bibliography and references, an in-book answer key, and index.

Anne B. Casto, RHIA, CCS, is the program manager for the Health Information Management and Systems Division at Ohio State University in Columbus, Ohio. She teaches courses in ICD-9-CM and CPT coding, as well as healthcare reimbursement systems. After earning her baccalaureate degree from Ohio State University in 1995, Anne was employed at Mount Sinai Medical Center and Beth Israel Medical Center in New York City managing several units including coding and abstracting, discharge processing, and DRG auditing. In 1998, Anne moved into the healthcare financial arena and worked for the Center for Healthcare Performance Industry Studies as product manager of clinical information. She then served as vice president of clinical products for Cleverley and Associates. Anne earned her CCS credential in 1998. Elizabeth Layman, PhD, RHIA, CCS, FAHIMA, is professor and chair in the Department of Health Services and Information Management at East Carolina University, Greenville, North Carolina. She previously worked at Hennepin County Medical Center and the University of Minnesota Hospitals, both in Minneapolis, Minnesota, from 1974 through 1990. She worked in several departments, such as third-party reimbursement, credit and collections, account auditing, outpatient registration, inpatient admissions, research studies, and quality management. Elizabeth has her baccalaureate degree from the University of Minnesota. While working, she returned to school to earn her associate's degree in medical record technology. She completed St. Scholastica's progression program to earn her post-baccalaureate certificate in health information administration. After earning her master's degree in organizational leadership from the College of St. Catherine's, Elizabeth joined the faculty of the Medical College of Georgia in Augusta, Georgia. She also consulted for the Physicians' Practice Group. Elizabeth successfully sat for the first CCS examination in 1992. In 1995, she earned her doctorate in higher education from Georgia State University. In 2001, she was awarded the designation of Fellow of the American Health Information Management Association, one of the first two individuals in the country to receive this award.