RENT TEXTBOOKS

Part 1 Introduction to Polaris Medical Group

Welcome

Statement of Purpose

Organization and Staff

Medical Records

Guidelines for Maintaining Confidentiality

Information in the Medical Record

Polaris Medical Group Compliance Program

Your Role as a Patient Services Specialist

Qualities and Attitudes of the PSS

General Responsibilities

Your Typical Day at Family Medical Group

Scheduling Patients for Appointments

Recording and Maintaining Patient Information

Main... MOREtaining a Third-Party Payer Information

Educating Patients and Responding to Patient Inquiries

Recording Charges, Payments and Adjustments

Generating Insurance Claims

Checking for and Recording Incoming Referrals

Generating Financial Reports

Updating CPT and ICD-9 Codes in the Database

Quiz: Part 1

Part 2 Polaris Medical Group Policy and Procedure Manual

Reading Acknowledgment

Contents

Practice Information

Equal Employment Opportunity, Nondiscrimination, and Affirmative Action Statement

Types of Employment

Wages and Compensation

Pay Rates

Overtime Compensation

Pay Dates

Employee Time Records

Performance Evaluations

Employee Benefits

Employee Grievances

Resignation, Termination, Discharge, and Cobra Benefits

Resignation

Termination

Discharge

Cobra Benefits

Personnel Conduct Issues

Contributions and Solicitations

Identification Badges

Inclement Weather Conditions

Sexual Harassment

Dress Code

Smoking and Tobacco Use

Substance Abuse

Personal Telephone Calls and Visits

Universal Precautions

Office Hours and Attendance

Definitions of Absences

Scheduled Absences

Unscheduled Absences

Lateness/Leaving Early

Excused Absences

Unexcused Absences

Attendance Policy

Telephone Procedures

Recording Telephone Calls

Screening Telephone Calls

Taking Telephone Messages

Handling Emergency Telephone Calls

Symptoms/Complaints Considered Emergencies

Office Visit Procedures

Confidentiality

Confidentiality Policy

Confidentiality Guidelines

Receptioning

Gathering Patient Information

Information Obtained from New Patients over the Telephone

Information from Other Sources

Verifying Insurance CoverageGuidelines

Checking for Preauthorization Requirements

Checking for Referral Requirements

Concluding the Patient's Visit

Appointments

Scheduling Appointments

Patient Flow

Scheduling Allotments

Payment for Services

The Billing ProcessBilling Codes, Patient Statements, and Place of Service Codes

Insurance Claims

Billing Guidelines

Review of RAs

Patient Billing Disputes

Daily Reports

Guidelines for Medicare, Medicaid, and Workers' Compensation

MedicareMedigap InsuranceMedicare Managed Care Plans

Medicaid

Workers' Compensation

Insurance Information Pages

Standard Health Care, Inc., Traditional Plan

Blue Cross and Blue Shield of Ohio, Traditional Plan

Tricare HMO

Columbus Medical Care PPO

Cigna Healthplan HMO

Aetna Health Plans, Ohio HMO-Network

Ohio Insurance Company, Traditional Plan

Nationwide Medicare, Parts A and B

Nationwide Medicare HMO

Ohio Department of Human Services, Medicaid

Blue Cross and Blue Shield of Ohio, Workers' Compensation

Quiz: Part 2

Part 3 On the Job

Week 1, Day 1

Medisoft Training Topic 1: Entering Guarantors Who Are Not Patients

Week 1, Day 2

Week 1, Day 3

Week 1, Day 4

Week 1, Day 5

Medisoft Training Topic 2: Entering Referrals

Medisoft Training Topic 3: Entering a Primary Care Provider Outside the Practice

Medisoft Training Topic 4: Using Quick Balance

End of Week 1 Job

Week 2, Day 1

Medisoft Training Topic 5: Entering Prior Authorization Numbers

Week 2, Day 2

Medisoft Training Topic 6: Entering Additional Diagnosis Codes

Week 2, Day 3

Medisoft Training Topic 7: Closing Cases

Medisoft Training Topic 8: Entering Visit Authorization Numbers

Week 2, Day 4

Medisoft Training Topic 9: Entering Additional Procedure Codes

Week 2, Day 5

End of Month Jobs

Medisoft Training Topic 10: Printing a Billing/Payment Status Report

Part 4 Source Documents

Glossary

Index