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Groups Discussions Quotes Ask the Author To see what your friends thought of this book,This book is not yet featured on Listopia.There are no discussion topics on this book yet. Oct 27 - Dec 1Our payment security system encrypts your information during transmission. We don’t share your credit card details with third-party sellers, and we don’t sell your information to others. Used: GoodUsed book in good conditions. Limited notes and highlighting may be present. May show signs of normal shelf wear and bends on corners and edges. Item may be missing CDs or access codes. Ships directly from Amazon.Something we hope you'll especially enjoy: FBA items qualify for FREE Shipping and Amazon Prime. Learn more about the program. Please try again.Please try again.Please try again. Then you can start reading Kindle books on your smartphone, tablet, or computer - no Kindle device required. Register a free business account To calculate the overall star rating and percentage breakdown by star, we don’t use a simple average. Instead, our system considers things like how recent a review is and if the reviewer bought the item on Amazon. It also analyzes reviews to verify trustworthiness. Hi! Sign In We have a wide variety of textbooks, tradebooks, and fiction titles,Our program is as easy as 1-2-3 and offers super competitive prices. To help, we provided some of our favorites. So does Alibris. See one of the largest collections of Classical Music around. Changes daily. Alibris has millions of books at amazingly low prices. Share your stories and reviews with other customers! Check out these wonderful and insightful posts from our editors Ninth Costs may vary based on destination. For personal use only. All rights reserved. All rights in images of books or other publications are reserved by the original copyright holders. Resources This comprehensive, inviting book presents the latest code sets, coding guidelines, and health plan claims completion instructions.
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Students examine managed care, legal and regulatory issues, coding systems and compliance, reimbursement, clinical documentation improvement, coding for medical necessity, and common health insurance. Updates address new legislation that impacts health care, including changes to the Affordable Care Act (Obamacare); ICD-10-CM, CPT, and HCPCS level II coding; revenue cycle management; and individual health plans. An accompanying workbook provides application assignments; case studies; review; and CMRS, CPC-P, and CPB mock exams. In addition, the author has updated all material to reflect the latest changes.The software works seamlessly with Chapters 11 through 17, providing important hands-on reinforcement of concepts. In addition, the workbook contains additional case studies for student practice.HIPAA Alerts draw attention to the impact of this legislation on privacy and security requirements for patient health information.End-of-chapter reviews reinforce learning. They offer multiple-choice with a coding completion fill-in-the-blank format for coding chapters. Answers to chapter reviews are available for your convenience. Case studies in the software present billing data and patient histories. Students complete data entry on CMS-1500 claims and receive immediate feedback.Boldfaced key terms appear throughout each chapter to help learners master the technical vocabulary associated with claims processing.Answers to exercises are available for your convenience in checking work.Numerous examples, skill-building exercise and detailed content prepares students for challenges and ongoing changes they will encounter on the job. STUDENTS PRACTICE COMPLETING BOTH MANUAL AND ONLINE CLAIMS. CMS-1500 claims appear throughout the text to provide valuable practice with manual claims completion. The UB-04 claim appears in chapter 11 with its claims completion instructions.Ms.
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Green held the position of SUNY Distinguished Teaching Professor in the physical and life sciences department at the State University of New York, College of Technology for more than 30 years. An active member of the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA), Ms. Green has been recognized both for her excellence in teaching and for her significant contributions to the health information management profession. She has earned numerous awards, including the State University of New York Chancellor’s Award for Excellence in Teaching, Alfred State College’s Alumni Association Teacher of the Year, Who’s Who Among America’s Teachers and AHIMA’s FORE Triumph Educator Award. Ms. Green is a registered health information administrator (RHIA), a fellow of the American Health Information Management Association (FAHIMA) and a certified procedural coder (CPC). She earned an M.P.S. degree from Alfred University and a B.S. from Daemen College. Ms. Green has authored three popular textbooks related to coding, revenue management and health information management. Lesson is timed appropriately. Good mention of optical scanning guidelines (and) national provider identifier. This chapter provides good detail on all portions of the form. It might have been removed, renamed, or did not exist in the first place. Search for: Search for: Recent Posts Hello world. Recent Comments A WordPress Commenter on Hello world. Today we publish over 30 titles in the arts and humanities, social sciences, and science and technology. Cambridge, MA 02139Rarely is such a comprehensive text so clear and accessible. Martin Saavedra Assistant Professor of Economics, Oberlin College Rather than offer details about health systems without providing a theoretical context, Health Economics combines economic concepts with empirical evidence to enhance readers' economic understanding of how health care institutions and markets function.
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The theoretical and empirical approaches draw heavily on the general field of applied microeconomics, but the text moves from the individual and firm level to the market level to a macroeconomic view of the role of health and health care within the economy as a whole. The book takes a global perspective, with description and analysis of institutional features of health sectors in countries around the world. This second edition has been updated to include material on the U.S. Patient Protection and Affordable Care Act, material on the expansion of health insurance in Massachusetts, and an evaluation of Oregon's Medicaid expansion via lottery. The discussion of health care and health insurance in China has been substantially revised to reflect widespread changes there. Tables and figures have been updated with newly available data. Also new to this edition is a discussion of the health economics literature published between 2010 and 2015. The text includes readings, extensive references, review and discussion questions, and exercises. A student solutions manual offers solutions to selected exercises. Downloadable supplementary material is available for instructors. He is coauthor of The Price of Smoking (2004) and Medical Malpractice (2008) and coeditor of Incentives and Choices in Health Care (2008), all published by the MIT Press.Rarely is such a comprehensive text so clear and accessible. Martin Saavedra Assistant Professor of Economics, Oberlin College Every chapter is solidly grounded in economic analysis, accessible to those fresh to economics, and a trustworthy guide for those interested in more advanced studies. Thomas McGuire Professor of Health Economics, Department of Health Care Policy, Harvard Medical School. Washington (DC): National Academies Press (US); 1997. Show details Institute of Medicine (US) Committee on Comprehensive School Health Programs in Grades K-12; Allensworth D, Lawson E, Nicholson L, et al., editors.
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Washington (DC): National Academies Press (US); 1997. Some of the factors that contribute to these variations include student needs, community resources for health care, available funding, local preference, leadership for providers of school health services, and the view of health services held by school administrators and other key decisionmakers in the school systems. There is similarity, however, in the types of services offered from one school system to the next, which is likely the result of several factors. A majority of states have state school nurse consultants, many of whom have distributed sample policy and procedure manuals from their state department of health or education or both, to guide the development and delivery of health services in local settings. The National Association of School Nurses has defined roles and standards for school nurses (Proctor et al., 1993) and provides a system for disseminating information and training to nurses who practice in schools. The American School Food Service Association has recently released standards for school foodservice and nutrition practices (American School Food Service Association, 1995). Similarly, organizations such as the National Association of School Psychologists, the American School Counselor Association, and the National Association of Social Workers have published position statements and standards for their professions. The American School Health Association (ASHA), through its interdisciplinary committees, has studied the advantages and disadvantages of different services, the organization and delivery of services, and the roles of various school health service providers. Subsequently, ASHA publications have brought this information to the attention of state and local health and education agencies.
The American Academy of Pediatrics, working closely with national representatives of the school health services sector as well as the community health system, periodically updates a school health manual, School Health: Policy and Practice, that serves both as another unifying force and as an informal mechanism for ensuring local program quality (American Academy of Pediatrics, 1993). Within this document are the following seven goals of a school health program: View in own window Goal 1 Ensure access to primary health care. Goal 3 Provide mandated screening and immunization monitoring. Goal 4 Provide systems for identification and solution of students' health and educational problems. Goal 5 Provide comprehensive and appropriate health education. Goal 6 Provide a healthful and safe school environment that facilitates learning. Goal 7 Provide a system of evaluation of the effectiveness of the school health program. Recently, findings from national surveys conducted by the Division of Adolescent and School Health (DASH) of the Centers for Disease Control and Prevention (CDC), the Office of School Health at the University of Colorado Health Sciences Center in Denver, and other groups show that most schools do provide some type of school health services and that a degree of consistency does exist in the kinds of services delivered from one school system to the next. SHPPS reports that most school districts require screening and follow-up in at least one grade, with vision (96 percent), hearing (95.4 percent), and scoliosis (88.2 percent) being the most common of the required screenings. Almost all districts keep student health records on file and monitor student immunization status, and most districts also keep student medical emergency and medical information forms on file. The Closer Look survey provided the profile of the types of school health services currently delivered across the country, as shown in Table 4-1. TABLE 4-1 Health Services Provided in the Schools.
According to A Closer Look, two health services appear to be provided almost universally by school districts, first aid (98.7 percent) and administration of medications (97.1 percent). Other commonly provided services include such health screenings as height, weight, vision, and hearing (86.8 percent); child abuse evaluations and follow-up (82.8 percent); and evaluation of emotional or behavioral problems (80 percent). The three next most commonly provided services are for children with special needs: monitoring of vital signs (77.7 percent), application and cleaning of dressings (76.8 percent), and development of the health component of the Individualized Education Plan (75.6 percent). In view of the health problems cited in earlier chapters of this report, it is interesting to note that only slightly more than half of the districts were found to provide mental health counseling and nutrition counseling, and less than 40 percent con duct health risk appraisal to determine life-style practices. The committee has not attempted to reconcile these figures with those reported by SHPPS, which states that 89.2 percent of senior high schools and 84.4 percent of middle or junior high schools provide individual counseling. The latter figures could refer to counseling with primarily an academic focus, which schools may be more inclined to offer, although there is certainly overlap between academic and mental health problems. Data from A Closer Look indicate that the types of services available to students do not appear to vary substantially by the size of the school district. The Need for School Health Services Since schools bring large numbers of students and staff together, prudence dictates that—as in any workplace—a system must be in place to deal with such issues as first aid, medical emergencies, and detection of contagious conditions that could spread a group situation.
Unlike other workplaces, however, a system must also be established in schools to provide routine administration of medications, since students—especially young students—may not be able to assume this responsibility themselves, and concern for substance abuse has led to policies in most schools that prohibit older students from administrating their own medication. Laws pertaining to special education students 2 require that schools provide the services necessary for these students to receive an appropriate education. Such services might include monitoring vital signs, changing dressings, catheterization, tube feeding, or administering oxygen. The school must also provide services to non-special education students with chronic health problems—such as asthma, diabetes, and seizures—in order that they can be educated. Schools have little or no choice in providing such services, for they are dictated either by legislative mandate or by precautions pertaining to risks and liability. Services such as screenings and immunizations are also widely accepted as belonging in the schools, with the motivation having to do more with access, efficiency, and economies of scale than with liability. Since schools are where children spend a significant portion of their time, schools are seen by many observers as the logical site for services that are based on public health principles of population-based prevention. There is some debate, however, about the relative benefits and disadvantages of a population-based versus a selective high-risk approach, which targets preventive services only toward children at high risk. The population-based approach has the advantage of producing a large potential impact on the population as a whole, but a major disadvantage is that the benefits are frequently very small for the individual.
Another potential disadvantage is that all interventions have a finite risk of unintended adverse side effects, which are also amplified along with benefits in the population-based approach, possibly resulting in an unfavorable benefit-risk ratio. Depending on the health issue, one approach may be superior to the other, or a combination of the two may be appropriate. For example, the National Cholesterol Education program recommends a population-based approach for implementing dietary guidelines for children, combined with a high-risk approach to blood lipid screening targeted only at children considered at risk based on family history (Starfield and Vivier, 1995). Further, schools are strategically positioned to serve in the public health battle against the resurgence of infectious diseases, such as tuberculosis and hepatitis. Another feature of school health services—one that is often overlooked—is its potential for expanding the knowledge base. School health services can be a rich source of data for studying the relation between health status and learning capacity, and for assessing unmet needs and monitoring the health status of children and adolescents. Given the above needs and benefits, a basic health services program must be in place in all schools. The issues currently generating much discussion and debate, however, are the role of the school in providing access to primary care, the appropriate lead agency for the more traditional basic school health services, the advantages and disadvantages of a population-focused versus a high-risk approach to the delivery of health services in schools, and the need to develop an integrated system of school health services. The role of the school in providing access to primary care is a particularly difficult and critical issue. Since schools are a public system whereas health care is predominately private, there appears to be a fundamental mismatch between the two systems.
Many students already have their own source of primary care, but a significant and growing segment of the student population does not. Those students without access to primary care are usually poor and are often at greatest risk of academic failure. Special Needs Due to Poverty Chapter 1 of this report documents some of the major problems facing children and adolescents in this country—the new social morbidities, changing family structures, limited access to health care, and lack of health insurance. Poverty is the common denominator among many of these problems. Research has identified an explicable link between poverty and health outcomes. Children in poverty are much less likely than their affluent peers to receive an excellent or very good health rating, and they visit their health care provider fewer times in a year. Low-income families, facing routine pediatric care costs that consume a large fraction of their annual income, may decide they cannot afford health care until their children's treatment leads to unnecessary hospitalization and valuable days lost from school (see Table 4-2 ). For example, preventable hospitalizations for pneumonia, asthma, and ear, nose, and throat infections are up to four times higher for poor children than for who are not poor children (Center for Health Economics Research, 1993). Poor children are also more likely to be limited in school or play activities by chronic health problems and to suffer more severe consequences than their more affluent peers when afflicted by the same illness (Newacheck et al., 1995). TABLE 4-2 Relative Frequency of Health Problems in Low-Income Children Compared with Other Children. Relative Frequency of Health Problems in Low-Income Children Compared with Other Children It is estimated that as many as 12 million children under the age of 18 have no health insurance, or approximately 17 percent of all children in that population (American Medical Association Council on Scientific Affairs, 1990).
Millions more have inadequate plans that fail to cover even basic preventive services, such as immunizations (National Health Education Consortium, 1992). Although progress has been made in establishing publicly financed community health centers in inner cities and rural areas, school-age youth rarely visit these facilities until their health problems reach crisis stage. Although Medicaid is intended to provide services for poor children, variations in state Medicaid policies have left almost 40 percent of children who live in poverty without access to basic primary and preventive care (Solloway and Budetti, 1995). Possible changes in the system imply even greater uncertainty about the role Medicaid will play in providing universal coverage for poor children and adolescents (Newacheck et al., 1995). Absenteeism among students is clearly associated with school failure (Wolfe, 1985). Research has shown that students who miss more than 10 days of school in a 90-day semester have trouble remaining at their grade level (Klerman, 1988). In particular, children who are poor are two to three times more likely to miss school due to their illnesses (Starfield, 1982). Indeed, children with health problems are disproportionately poor students on the verge of academic failure. Youth frequently must miss valuable class time in order to get care for their illnesses during the regular office hours of public and private health professionals. In fact, a recent study found that students utilizing public clinics missed entire days of school per appointment (Kornguth, 1990). Studies have also found that people living in poverty are twice as likely to have mental health problems; hence, low-income children are especially affected by the absence of accessible mental health care (Starfield, 1982). Given these findings, it appears that the lack of accessible primary care has a high cost, in terms of both health and education outcomes.
Providing primary care to needy students at the school site has been proposed to be efficient and cost-effective in the long run, in order to improve academic performance and detect health problems early before they require more expensive treatment. Then the difficult question naturally follows: Would all students, not only those in poverty, benefit from availability of convenient, accessible basic primary care services at school, provided by professionals specially trained to deal with their age level. In their studies of school-based health centers (SBHCs) in northern California, Brindis and coworkers found that a higher proportion of students who already had conventional private insurance or health maintenance organization (HMO) coverage utilized the SBHC than those without other coverage, suggesting that ease of access and an understanding staff are perhaps more important factors in utilization than the mere lack of other source of care (Brindis et al., 1995). (The surprisingly greater rate of utilization for students who already have insurance may possibly be attributed to their greater awareness of the importance of health care, parental encouragement, or understanding how to access the system.) Also, many working parents apparently appreciate the convenience of their children being able to receive basic health care at school (U.S. General Accounting Office, 1994b). If the school is seen as the most effective site for providing a set of basic primary services, how can these services be organized. These are questions without easy answers—or possibly, with different answers depending on the community. Some of these issues are considered in greater depth later in this chapter. Overview Of Basic School Services The following section provides a summary of typical services found in the school setting. These services tend to be the most common and basic, although many schools may not provide all of the services described in this section.
For the sake of organization, services have been divided into three categories: health care services, mental health or pupil services, and nutrition and foodservice. It should be emphasized that boundaries between categories are not sharp, and considerable overlap and interaction among services exist. For each category, there is a description of the service, information about the personnel who provide the service, and a review of some of the important issues in that field. Much of the material in this section came from the discussion at the committee's third meeting and was contributed by representatives of various professional organizations who served on a panel on services at that meeting. The committee has not attempted to assess the professional standards, recommended student-professional ratios, or other issues in this section for validity or adequacy; instead, this section is intended simply to transmit the contributed information. For further details, the professional organizations can be contacted directly. 3 Additional information may also be obtained from the University of Colorado School Health Resource Services project, which maintains an extensive reference collection of profiles of school health services programs from school districts throughout the country. Health Care Services Nurses and Nurse Practitioners Services Provided. As mentioned earlier in this chapter, standards for school nursing have been established by the National Association of School Nurses.
The school nurse typically provides population-based primary prevention and health care services, including physical and mental health assessment and referral for care; development and implementation of health care plans for students with special health care needs; health counseling; mandated screenings, such as vision, hearing, and immunization status; monitoring the presence of infectious conditions among students and enforcing public health precautions to prevent spread of infections and infestations; skilled nursing services for students with complex health care needs; case management of students with chronic and special health care needs; outreach to students and their families; interpretation of the health care needs of students to school personnel; development and implementation of emergency care plans and provision of emergency care and first aid; serving as liaison for the school, parents, and community health agencies; collaboration with other school professionals—particularly counselors, psychologists, and social workers—to address the health, developmental, and educational needs of students; and for nurse practitioners only, the provision of primary care, including prescribing medications when allowed under the State Nurse Practice Act. The traditional model for school nursing provides for a school nurse, typically in an office or health room, with or without an aide. The National Association of School Nurses and other organizations in the National Nursing Coalition for School Health have prepared and distributed standards of nursing practice that guide the services nurses deliver in schools (Proctor et al., 1993). A single nurse may also be shared among several schools. In School Health: Policy and Practice, the American Academy of Pediatrics has analyzed the various nurse staffing patterns which are listed in Table 4-3. TABLE 4-3 Nursing Staffing Patterns for School Health Services. Personnel.
The professional training required for school nurses varies, depending on location and changing economic conditions. The American Academy of Pediatrics (1993) reported in 1993 that only 38 states required school nurses to be registered nurses, and only 19 required the attainment of specific school nurse certification. SHPPS found that although only 8 percent of all states required school nurses to be certified through the American Nurses Association or the National Association of School Nurses, 62 percent of states offered their own certification for school nurses. Of those states offering certification, 66 percent required it for employment as a school nurse. Health aides are employed in 76 percent of states, but only 8 percent of these states required prior technical training for health aides (Small et al., 1995). The Closer Look investigation reports similar findings. In some school districts, school nurses are employees of the school system; in others, school nurses are provided by the local health department or another agency. The National Association of School Nurses recommends a ratio of one school nurse per 750 students. In recent years, there has been interest in expanding the school nursing function through the use of nurse practitioners, nurses with additional training (generally at the master's level) who are certified by state laws to provide a range of primary care services. School-based nurse practitioners can perform physical examinations, prescribe certain medications with physician protocols, and frequently serve as the anchor provider in school-based clinics. The drive for independence from physicians has characterized the nurse practitioner movement (Clawson and Osterweis, 1993); however, school-based nurse practitioners usually have a backup relationship with a licensed physician in the community. Other graduate programs prepare school nurses for administrative and management roles, as well as for mental health positions in schools.