You just stepped into a new role as an office manager in a medical practice. Due to a lack of consistency throughout the office, you have been asked to update the billing policies and procedures to include the following elements:
• Step by step instructions for the entire revenue cycle from pre-verification
of insurance to accounts receivable management.
• Methodology your office will use to determine a pricing structure.
• Considerations for negotiating insurance contracts, Considerations for private pay and charity care.
Material Needed:
Essentials of Health Care Finance
Seventh Edition
William O. Cleverley, PhD
President Cleverley & Associates Professor Emeritus The Ohio State University Columbus, Ohio
Paula H. Song, PhD
Assistant Professor Division of Health Services Management and Policy The Ohio State University Columbus, Ohio
James O. Cleverley, MHA
Principal Cleverley & Associates Columbus, Ohio
9781449621988
Use Chapters 5, 6, 7
Read Chapter 5, “Measuring Community Benefit,” pages 113–134.
Read Chapter 6, “Revenue Determination,” pages 135–156.
Read Chapter 7, “Health Insurance and Managed Care,” page 157–180.