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Tables of Contents for The Pharmacist's Guide to Compensation for Patient-care Services
Chapter/Section Title
Page #
Page Count
Preface
ix
Acknowledgments
xi
History of Payment for Pharmacy Services
1
6
Understanding the Insurance Industry
7
8
Medicare, Medicaid, and Pharmacy Services
15
8
Disease Coding: ICD Codes
23
4
Procedural Coding: CPT and HCPCS Codes
27
22
Professional Pharmacy Services Codes
49
4
The HCFA-1500 Claim Form
53
8
The Pharmacist Care Claim Form
61
4
Documentation
65
8
Generating New Revenue Streams for Institutions, Daniel H. Albrant
73
6
Fraud and Abuse
79
6
When Your Claims Are Rejected
85
138
Appendixes
Appendixes A Glossary
91
2
Appendixes B Evidence of the Value of the Pharmacist
93
5
Appendixes C HCFA-1500 Health Insurance Claim Form
98
3
Appendixes D Medicare Provider/Supplier Enrollment Applications
101
43
Appendixes E Medicare Part A Intermediaries and Part B Carriers
144
11
Appendixes F State Medicaid Directors
155
4
Appendixes G Contact and Ordering Information
159
1
Appendixes H Pharmacist Care Claim Form
160
2
Appendixes I HCFA-1450 (UB-92) Claim Form
162
3
Appendixes J Medicare 1997 Documentation Guidelines for Evaluation and Management Services
165
51
Appendixes K Sample Medical Necessity Forms
216
7
Index
223