Healthcare Payment Systems: An Introduction

The skill levels of financial workers can vary as much as those of medical personnel, and the impact that these workers have on the viability, let alone profitability and efficient running, of any hospital, medical practice or facility is quite profound. The common belief now is that the multitude of payment systems that every medical practitioner must access, with their diverse procedures and hundreds if not thousands of medical codes, are scarcely manageable. However, with the right knowledge and the right approach, you can turn a system that controls you into one that you control.

Healthcare Payment Systems: An Introduction provides a complete introduction to healthcare payment systems. Written by Duane Abbey, one of the nation’s leading experts and most sought out consultants in payment systems, this volume makes the monumental task of medical reimbursement approachable and manageable. Covering all the fundamentals and terminology needed to understand this discipline, and the insight and strategies needed to master it, Dr. Abbey —

• Provides a detailed understanding of the differences among healthcare payment systems
• Shows you the best ways to categorize specific third-party payer requirements
• Explains what you need to know about Medicare’s use of different payment systems
• Gives you the understanding needed to negotiate better contractual arrangements

This self-contained guide is more than a reference. It provides an overview and discussion of topics that one must understand to optimize usage of various systems. Ultimately, it will help you begin to develop the solid core of skills and knowledge needed to confidently approach payment systems as tools to use rather than hazards to avoid — tools that will lead to improved revenue cycles and higher levels of profitability.

This book is the first in Dr. Abbey’s Healthcare Payment System Series from Productivity Press. Look for future books in the series covering a variety of service-specific payment systems for physicians, hospitals, and specialized programs.