9780073374918

Medical Insurance 5e provides students with the knowledge and skills needed to successfully perform insurance and billing related duties. Following the medical billing process, instruction moves from a comprehensive introductory chapter through processing RA/EOBs and handling patient collections. It has extensive illustrations, forms, and exercises to develop required competencies. Exercises improve underlying essential math and communications skills. This text also provides a fundamental understanding of diagnostic and procedural coding needed to submit claims in compliance with payers' requirements.

PART 1 WORKING WITH MEDICAL INSURANCE AND BILLING
CHAPTER 1 INTRODUCTION TO THE MEDICAL BILLING PROCESS
CHAPTER 2 HIPAA AND MEDICAL RECORDS
CHAPTER 3 PATIENT ENCOUNTERS AND BILLING INFORMATION
PART 2 CLAIM CODING
CHAPTER 4 DIAGNOSTIC CODING: INTRODUCTION TO ICD-9-CM
CHAPTER 5 PROCEDURAL CODING: INTRODUCTION TO CPT
CHAPTER 6 PROCEDURAL CODING: INTRODUCTION TO HCPCS
PART 3 CLAIM PREPARATION
CHAPTER 7 VISIT CHARGES AND COMPLIANT BILLING
CHAPTER 8 HEALTH CARE CLAIM PREPARATION AND TRANSMISSION
PART 4 PAYERS
CHAPTER 9 PRIVATE PAYERS/BLUE CROSS AND BLUE SHIELD
CHAPTER 10 MEDICARE
CHAPTER 11 MEDICAID
CHAPTER 12 TRICARE AND CHAMPVA
CHAPTER 13 WORKERS'COMPENSATION AND DISABILITY
PART 5 PAYMENT PROCESSING
CHAPTER 14 PAYMENTS (RAs/EOBs), APPEALS, AND SECONDARY CLAIMS
CHAPTER 15 PATIENT BILLING AND COLLECTIONS
PART 6 HOSPITAL SERVICES
CHAPTER 16 HOSPITAL BILLING AND REIMBURSEMENT
PART 7 CLAIM CASE STUDIES
CHAPTER 17 PRIMARY CLAIM CASES
CHAPTER 18 EOB/RA/SECONDARY CLAIM CASESGUIDE TO MEDISOFT
Appendix A Medical Billing and Coding Careers
Appendix B Place of Service Codes
Appendix C Medical Specialities and Taxonomy Codes
Appendix D Professional Web Sites
Appendix E Forms
Appendix F HIPAA FAQs
ABBREVIATIONS
GLOSSARY
INDEX

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Medical Insurance: An Integrated Claims Process Approach

Medical Insurance: An Integrated Claims Process Approach

0073374911

Summary

Table of Contents

CHAPTER 1 INTRODUCTION TO THE MEDICAL BILLING PROCESS

CHAPTER 2 HIPAA AND MEDICAL RECORDS

CHAPTER 3 PATIENT ENCOUNTERS AND BILLING INFORMATION

PART 2 CLAIM CODING

CHAPTER 4 DIAGNOSTIC CODING: INTRODUCTION TO ICD-9-CM

CHAPTER 5 PROCEDURAL CODING: INTRODUCTION TO CPT

CHAPTER 6 PROCEDURAL CODING: INTRODUCTION TO HCPCS

PART 3 CLAIM PREPARATION

CHAPTER 7 VISIT CHARGES AND COMPLIANT BILLING

CHAPTER 8 HEALTH CARE CLAIM PREPARATION AND TRANSMISSION

PART 4 PAYERS

CHAPTER 9 PRIVATE PAYERS/BLUE CROSS AND BLUE SHIELD

CHAPTER 10 MEDICARE

CHAPTER 11 MEDICAID

CHAPTER 12 TRICARE AND CHAMPVA

CHAPTER 13 WORKERS'COMPENSATION AND DISABILITY

PART 5 PAYMENT PROCESSING

CHAPTER 14 PAYMENTS (RAs/EOBs), APPEALS, AND SECONDARY CLAIMS

CHAPTER 15 PATIENT BILLING AND COLLECTIONS

PART 6 HOSPITAL SERVICES

CHAPTER 16 HOSPITAL BILLING AND REIMBURSEMENT

PART 7 CLAIM CASE STUDIES

CHAPTER 17 PRIMARY CLAIM CASES

CHAPTER 18 EOB/RA/SECONDARY CLAIM CASESGUIDE TO MEDISOFT

Appendix A Medical Billing and Coding Careers

Appendix B Place of Service Codes

Appendix C Medical Specialities and Taxonomy Codes

Appendix D Professional Web Sites

Appendix E Forms

Appendix F HIPAA FAQs

ABBREVIATIONS

GLOSSARY

INDEX

Supplemental Materials

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