Combines financial principles unique to the health care setting with the methods and process for reimbursement (including coding, reimbursement strategies, compliance, financial reporting, case mix index, and external auditing). It explains the revenue cycle in detail, correlating it with regular management functions; and covers reimbursement from the initial point of care through claim submission and reconciliation.This text reflects changes to the Affordable Care Act, Managed Care Organizations, new coding initiatives, new components of the revenue cycle (from reimbursement to compliance), updates to regulations surrounding health care fraud and abuse, changes to the Recovery Audit Contractors (RAC) program, and more.

Introduction to healthcare finance -- Financial management -- Introduction to claims processing -- Government payer types -- Affordable Care Act -- Managed-care organizations -- Medicare prospective payment systems -- Hospital outpatient prospective payment system -- Coding for the non-health information management professional -- Revenue cycle management -- Healthcare fraud and abuse -- Electronic health records and meaningful use -- Government incentive programs -- Recovery audit contractors -- Introduction to the mechanics of hierarchical conditio categories from a CMS perspective -- The application of HCC in a physican practice and lessons learned.