The Physician Billing Process: Navigating Potholes on the Road to Getting Paid, 3rd Edition


Billing & Collections


Provider Compensation

SKU: 8911


ISBN#: 978-1-56829-494-0

This professional fee billing primer is business critical whether you’re new to medical revenue cycle management or a seasoned medical billing professional.

As the medical reimbursement landscape changes, let industry experts Deborah Walker Keegan and Elizabeth Woodcock be your guides as you navigate the complex revenue cycle management journey of your medical practice.

What's new:

This third edition of the MGMA bestseller on physician billing process and revenue cycle management is a completely revised, comprehensive manual. Delivering proven solutions to optimize your revenue cycle, this professional fee billing primer is business critical whether you’re new to managing the revenue cycle or a seasoned professional. Uncover new possibilities for improving your medical billing and collection performance with this valuable resource.

Physicians are working harder than ever. You deserve a dependable revenue cycle that works relentlessly to ensure that every cent due the medical practice is collected — in a timely, efficient and accurate manner.

The Physician Billing Process is a one-stop power punch for a more profitable medical practice!

2015, 422 pp., ISBN 978-1-56829-494-0

Deborah Walker Keegan

Deborah Walker Keegan, PhD, FACMPE

Dr. 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 as a leading healthcare administrator and consultant, she brings knowledge, expertise and solutions to healthcare organizations. Co-author of the MGMA best-seller, The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting Paid and a national consultant on revenue cycle operations, Dr. Keegan's presentations are characterized by a dynamic, educational style and "real-life" case material. She received her PhD from 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.

 Elizabeth W. Woodcock

Elizabeth W. Woodcock, MBA, FACMPE, CPC

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 master of business administration in healthcare management from the Wharton School of Business of the University of Pennsylvania.

Table of Contents - The Physician Billing Process, 3rd Edition

The Changing Reimbursement Environment

The Revenue Cycle: An Overview

Pothole 1: The Patient Financial Clearance Process

Pothole 2: The Patient Check-in and Check-out Processes

Pothole 3: The Charge Capture Process

Pothole 4: The Coding Process

Pothole 5: The Charge Submission Process

Pothole 6: The Claims Management Process

Pothole 7: The Patient Statement Process

Pothole 8: The Payment and Denial Posting Process

Pothole 9: The Insurance Follow-up Process

Pothole 10: The Denial Management Process

Pothole 11: The Patient Collection Process

Pothole 12: The Contract and Reimbursement Management Process

Staffing the Revenue Cycle

Internal Controls for the Revenue Cycle

The Debate: Centralize, Decentralize, or Outsource Billing?

Leveraging Technology to Enhance the Revenue Cycle

Measuring and Analyzing the Revenue Cycle

Regulations Impacting the Revenue Cycle

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“They have done it again! Deborah Walker Keegan and Elizabeth Woodcock have written the ultimate primer for the physician billing process. This book provides a complete toolbox for both novice and experienced medical practice administrators to navigate the changing world of… the revenue cycle.”  –Robert Bush, FACMPE, vice president, MedHealth, Methodist Primary Care Network, Dallas

“This is the most complete, detailed and comprehensive book about the revenue cycle process that has ever been written. Walker Keegan and Woodcock are experts in their field, and the results of their efforts shine through these pages. Any medical practice looking to ensure that its billing processes are optimized will benefit from this well-presented guide. This practical, logical approach … is a game changer in revenue cycle management. I strongly recommend picking up a copy.” –
Eric Brodsky, FACMPE, director, billing and operations, Midwest Center for Women’s HealthCare, Northbrook, Ill.
The Physician Billing Process: Navigating Potholes on the Road to Getting Paid allows you to:
  • Diagnose and treat your revenue cycle
  • Ensure a healthy bottom line
  • Access a practical, easy-to-read manual
  • Benefit from timely and sound techniques for optimizing revenue performance

In addition, you'll benefit from:
  • Proven tools for benchmarking
  • Self-assessment guides
  • Policies and procedures information
  • Worksheets


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