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The Concepts and Principles of Hospital Reimbursement Now Available from Productivity Press
Hospital Reimbursement: Concepts and Principles supplies a clear understanding of the concepts and principles that drive the revenue cycle within a hospital setting.
The book explains the technical aspects of reimbursement in language that is easy to comprehend. It illustrates the complexities of the hospital revenue cycle and explains the Medicare and Medicaid financial models in detail. The text also addresses the Medicaid reimbursement methodology, the formulation of the Medicare blend rate, the computation of both DSH and IME, as well as other third-party payers. It also:
Covers the full range of services and procedures for which a hospital can receive reimbursement
Explains the difference between a for-profit and not-for-profit hospital
Contains chapters devoted to Statements of Operations (Income Statement) and Statements of Financial Position (Balance Sheet)
Examines governmental cost reporting—including Worksheets A, A-6, A-8, A-8-2, B-1, B Part 1, C Part 1, D-3, D-5, and E Part A
Supplying readers with a foundation in coding principles, the text also includes a model for calculating the financial impact of variations in patient length of stay. It discusses the DRG and APC reimbursement models and details the computation of an outlier payment. In addition, it walks the reader step-by-step through the creation of a mock Medicare cost report for a sample hospital.
About the Author
Kyle Herbert has over 12 years of healthcare accounting experience, and he is licensed as both a CPA (certified public accountant) and a CMA (certified management accountant). Kyle received his undergraduate degree from the University of Richmond and his master’s degree in business administration from The Citadel. In addition to these academic achievements, Kyle attained fellowships with both the Healthcare Financial Management Association and the American College of Healthcare Executives.
Kyle is a member of the American Institute of Certified Public Accountants, the Institute of Management Accountants, the South Carolina Society of Accountants, and the South Carolina Association of CPAs.
Readers can email Mr. Herbert with questions or comments at: kyle.herbert@
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ISBN 9781439898949, June 2012, 272 pp, $69.95