The Physician Billing Process

The Physician Billing Process - 12 Potholes to Avoid in the Road to Getting Paid, 2nd Edition

Meet today’s reimbursement challenges and improve the profitability of your medical practice.
Item # 8079

ISBN: 9781568293394

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Nonmember Price: $128.00

Member price: $82.00

The depth and magnitude of change in health care reimbursement means that your medical practice cannot rely on the same old billing methods. Anything less than optimal performance from your billing office reduces cash flow and costs you money. Get cutting-edge strategies to meet today’s reimbursement challenges and improve the profitability of your medical practice.

As follow-up to the best-selling first edition, this book shares more strategies to optimize your revenue cycle and ensure a financially healthy bottom line.

Gain real-life business practices that you can adopt tomorrow in your medical practice:

  • Decipher consumer-directed health plans
  • Conduct patient financial clearance
  • Segment patients in terms of financial risk
  • Staff to effectively conduct front-end and back-end billing
  • Capture increased revenue at the point of care
  • Understand real-time claims adjudication
  • Shrink your collections cycle
  • Position your practice for pay-for-performance
  • Work – and prevent – costly claim denials and rework
  • Code appropriately to ensure your fair share of differential payer reimbursement
  • Leverage multiple technologies
  • Perform a cost/benefit analysis of your revenue cycle

Physician Billing Process: 12 Potholes to Avoid in the Road to Getting Paid

  • Chapter 1 — The Changing Reimbursement Environment
  • Chapter 2 — The Revenue Cycle: An Overview
  • Chapter 3 — POTHOLE 1: The Patient Financial Clearance Process
  • Chapter 4 — POTHOLE 2: The Patient Check-in and Check-out Processes
  • Chapter 5 — POTHOLE 3: The Charge Capture Process
  • Chapter 6 — POTHOLE 4: The Coding Process
  • Chapter 7 — POTHOLE 5: The Charge Entry Process
  • Chapter 8 — POTHOLE 6: The Claims Management Process
  • Chapter 9 — POTHOLE 7: The Patient Statement Process
  • Chapter 10 — POTHOLE 8: The Payment and Denial Posting Process
  • Chapter 11 — POTHOLE 9: The Insurance Follow-up Process
  • Chapter 12 — POTHOLE 10: The Denial Management Process
  • Chapter 13 — POTHOLE 11: The Patient Collections Process
  • Chapter 14 — POTHOLE 12: The Contract and Reimbursement Management Process
  • Chapter 15 — Staffing the Revenue Cycle
  • Chapter 16 — Internal Controls for the Revenue Cycle
  • Chapter 17 — The Debate: Centralize, Decentralize, or Outsource Billing?
  • Chapter 18 — Leveraging Technology to Enhance the Revenue Cycle
  • Chapter 19 — Measuring and Analyzing the Revenue Cycle
  • Chapter 20 — Regulations Impacting the Revenue Cycle

Deborah Walker Keegan, PhD, FACMPE

Deborah Walker Keegan is a nationally recognized consultant, keynote speaker, and author.  She is president of Medical Practice Dimensions, Inc. and a principal with Woodcock & Walker Consulting. With more than 25 years of experience, she helps healthcare organizations improve medical practice operations, enhance physician and staff productivity, and align physician compensation systems. She has developed special expertise in ensuring sustainable improvement in academic, hospital-owned, and private medical practices.

She has co-authored four best-selling books: Rightsizing: Appropriate Staffing for Your Medical Practice, The Physician Billing Process: Avoiding Potholes in the Road to Getting Paid"and its second edition, The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting Paid, and Physician Compensation Plans: State-of-the-Art Strategies. She is in high demand as a keynote speaker and has collaborated with Elizabeth Woodcock to offer a series of educational DVDs on hot topics in medical practice management.

Keegan earned her PhD at the Peter F. Drucker Graduate School of Management, her MBA from UCLA, and she is a Fellow of the American College of Medical Practice Executives. In 2008, she received the Edward B. Stevens Article of the Year Award for "Are you ready for the perfect storm?"  published in the January 2008 MGMA Connexion.

Elizabeth W. Woodcock, MBA, FACMPE, CPC

Elizabeth W. Woodcock is a professional speaker, author and trainer specializing in medical practice management. 

Woodcock has focused on medical practice operations and revenue cycle management for more than 15 years. Combining innovation and analysis to teach practice operations, she has delivered presentations at regional and national conferences to more than 150,000 physicians and managers. In addition to her popular e-mail newsletters, she has authored several best-selling practice management manuals and textbooks, and published dozens of articles in national healthcare management journals.

Woodcock is a Fellow in the American College of Medical Practice Executives and a Certified Professional Coder. In addition to a bachelor of arts degree from Duke University, she completed a MBA in healthcare management from The Wharton School of Business of the University of Pennsylvania.

Sara M. Larch, MSHA, FACMPE

Larch is the vice president of Physician Services at the Inova Health System, a not-for-profit healthcare system of five hospitals, 16,000 employees and nearly 3,000 physicians. She is the former COO of University Physicians, Inc. in Baltimore. Larch has more than 25 years of medical group experience in single- and multispecialty practices both small and large. She focuses on revenue cycle performance, ambulatory operations, key physician strategies and leading organizational change. She has a master’s degree in health sciences administration from Virginia Commonwealth University ad is a fellow of the American College of Medical Practice Executives (ACMPE).

Larch serves on the advisory board for the Women Business Leaders of the United States Health Care Industry Foundation. She is past board chair of the Medical Group Management Association (MGMA) and is past president of both the Academic Practice Assembly (APA) and the Association of Managers of Obstetrics and Gynecology (AMGO). Larch is a frequently invited professional speaker on topics such as billing and reimbursement, practice operations and women leadership.


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