Links to Reimbursement Web Sites




The following list contains links to articles and Web sites that address reimbursement issues. Web sites are constantly changing addresses; if you find that any of these links do not lead to the resource described, please contact the Webmaster.



HCFA Issues Instructions Implementing NP/CNS Reimbursement

An update concerning the Health Care Financing Administration and reimbursement at Nursingworld


Coding and Documentation Made Easier

An article by Carole Guillaume, MD, which sets forth helpful guidelines for coding.


Exam Documentation: Charting Within the Guidelines

An article by Robert L. Edsall and Kent J. Moore about the HCFA's new documentation guidelines.


American Medical Association House of Delegates

A resolution concerning the "Recission of the Balanced Budget Act Provision on Nurse Practitioner Payment and Billing Enhancements."


Primary Care Health Practitioner Incentive Act Passes

Legal updates from the American College of Nurse Practitioners.


Sections of HR2015 Related to Medicare Reimbursement for NPs

Selected sections of the HR2015 document, located at the American College of Nurse Practioners.


Medicare's Program Integrity Home Page

An official goverment site addressing Medicare fraud and abuse.


Health Hippo

An excellent resource for policy and regulatory materials related to health care.


Learning Modules for Medicare Reimbursement

HCFA has online learning modules for you to work through. Warning: You need considerable space on your hard drive to download these files. They contain Powerpoint interactive learning experiences, which are detailed and interesting. You can exit form them at any point. You would download them onto the C drive of your own computer.

Particularly interesting would be the first 3 modules and the 5th modules (HCFA-1500).

 

Case Studies about Nurse Practitioner Legal Liability

Visit this site for thorough discussion of liability with actual cases described.

 

HIPAAdvisory Site

Visit this site to learn about the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Regulations will be implemented in the near future which will affect all health care practices, particularly related to electronic medical records.

 

Summary from US Department of Justics regarding Health Care Fraud

This is a thorough discussion of fraud and consumer protection programs, with application to internet/e-commerce issues.

 

HCFA Interpretative Document regarding Medicaid Eligibility

This is a detailed explanation of issues related to recent changes in welfare-to-work legislation and the Children’s Health Insurance Program (CHIP) and how Medicaid eligibility is determined.

 

NCQA Reports about MCOs (managed care organizations)

This site has numerous links and reports about quality care indicators and studies.

 

MEDSCAPE Site…get Updated Information delivered to your computer!

This free service requires you to register online; you then receive email updates specific to your practice and interests. "Ask the Experts" columns are very well researched.

 

Nurse Anesthesia Update

The American Association of Nurse Anesthetists has a great deal of information about specific issues related to CRNA practice.

To view reactions of anesthesiologists to the HCFA Rule of June 2000 that removes physician supervision of CRNA, go to:

http://www.asahq.org/hcfa/president.ssi