The seventh edition of Principles of Healthcare Reimbursement and Revenue Cycle Management is a comprehensive tool for educators, students, and healthcare professionals to master understanding of the US healthcare reimbursement systems and their impact on the US healthcare delivery system and economy. This authoritative text offers detailed discussions of healthcare reimbursement methodologies and systems, the impact of health insurance, coding and billing compliance, value-based purchasing initiatives, and the revenue cycle and its management. It supports knowledge application and data analytics skill-building through real-life scenarios and case studies." --from back cover

"Downloadable resources"--Cover.

Healthcare reimbursement and revenue cycle management -- Health insurance -- Government-sponsored healthcare programs -- Healthcare reimbursement methodologies -- Medicare hospital acute inpatient payment system -- Medicare skilled nursing facility services payment system -- Medicare hospital outpatient payment system -- Medicare physician and other health professional payment system -- Revenue cycle front-end processes-patient engagement -- Revenue cycle middle processes-resource tracking -- Revenue cycle back-end processes-claims production and revenue collection -- Coding and clinical documentation integrity management -- Revenue compliance -- Healthcare data in action: real-world analysis Appendix A: Glossary -- Appendix B: Answer Key for Check your Understanding Questions -- Appendix C: CMS 1500 Claim Form -- Appendix D: CMS 1450 (UB-04) Claim Form -- Appendix E: Medicare Summary Notice