Outcomes in Coding Practice: A Roadmap from Provider to Payer, 1st Edition

  • Annette Butler
  • ISBN-10: 140189898X  |  ISBN-13: 9781401898984
  • 368 Pages
  • © 2010 | Published
  • List Price = $ 82.95
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Intended to demystify the payment of insurance claims, Outcomes in Coding Practice: A Roadmap from Provider to Payer provides insight into coding from the payer perspective. By understanding the rules, laws and contracts HMO, PPOs or Medicare must consider when payment decision are made, you will be able to make the correct coding choices and improve the claim to payment ratio for your medical office. Coverage includes the Correct Coding Initiative, HMO and PPO contracts, Medicare and Medicaid, CPT Modifiers, how to improve compliance and manage provider disputes

Features and Benefits

  • Many Examples found throughout the book clearly explain the content
  • Short case studies found in every chapter, draw from actual real-life experiences, and allow you to apply the chapter concepts
  • Critical Thinking exercises to assess your comprehension
  • Professional Corner offers ideas and activities that you can apply in the work setting to enhance your knowledge of coding and the available tools
  • StudyWARE software, available online, offers coding case studies and hundreds of review questions presented in game format to make learning fun and interactive

Table of Contents

Chapter 1: The Correct Coding Initiative.
Chapter 2: Health Maintenance Organization (HMO) Contracts.
Chapter 3: Preferred Provider Organizations.
Chapter 4: Fee Schedules.
Chapter 5: Medicare.
Chapter 6: Medicaid.
Chapter 7: CPT Modifiers.
Chapter 8: Usual, Customary, and Reasonable.
Chapter 9: CPT Conventions to Be Considered.
Chapter 10: Provider Disputes and Balance Billing.
Chapter 11: Compliance and Audits.
Chapter 12: Noncontracted Providers.


All supplements have been updated in coordination with the main title. Select the main title's "About" tab, then select "What's New" for updates specific to title's edition.

For more information about these supplements, or to obtain them, contact your Learning Consultant.

Instructor Supplements

Instructor's Manual  (ISBN-10: 1401898998 | ISBN-13: 9781401898991)

Student Supplements

Outcomes in Coding Practice: A Roadmap from Provider to Payer (Book Only)  (ISBN-10: 1111318727 | ISBN-13: 9781111318727)

List Price = $82.95  | CengageBrain Price = $82.95  | College Bookstore Wholesale Price = $62.25