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Uniform Billing A Guide to Claims Processing

by: Rizzo, Christina D.

Uniform Billing A Guide to Claims Processing

by: Rizzo, Christina D.

ISBN 13:
9780827382237
ISBN 10:
0827382235
Edition: 1st
Format: Paperback
Copyright: 12/30/1999
Publisher: CENGAGE Delmar Learning
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Summary

Is a comprehensive learning tool for processing insurance claim forms for inpatient and outpatient services for acute, subacute, long-term care, specialty and clinic facilities using the Uniform Bill 92 or UP-92 (HCFA-1450 form).

Preface

vii

SECTION 1 THE UB-92: WORKING WITH FORM LOCATORS

(108)

Introduction to the UB-92: Form Locators 1-31

(26)

The UB-92 Billing Form

(4)

Form Locator Descriptions

(15)

Challenge Exercises

(6)

UB-92: Form Locators 32-41

(12)

Challenge Exercises

(3)

UB-92: Form Locators 42-49

(42)

Challenge Exercises

(6)

UB-92: Form Locators 50-86

(26)

Challenge Exercises

101

(8)

SECTION 2 THE ACUTE CARE FACILITY

109

(124)

Services Rendered in the Hospital Setting

111

(46)

Inpatient Services

112

(1)

Ambulatory Surgery Center

113

(1)

Clinic Services

114

(1)

Outpatient Services

114

(9)

Challenge Exercises

123

(34)

The Internal Network of a Hospital

157

(22)

Preadmission Functions

158

(1)

Admitting

159

(1)

Patient Accounts

159

(9)

Social Services

168

(1)

Health Information

168

(1)

Utilization Management and Quality Management

169

(1)

Computer Systems

170

(1)

Challenge Exercises

171

(8)

Exploring Covered Services and Rates

179

(28)

Medicare and Medicare Secondary Payer (MSP) Regulations

180

(13)

Medicaid Program Administration

193

(2)

Workers' Compensation, Liability, and Auto Accident Cases

195

(2)

Group Health Insurance, Managed Care, and HMO Plans

197

(1)

Challenge Exercises

198

(9)

Coding and Reimbursement Systems

207

(26)

HCPCS Coding System

208

(5)

ICD-9-CM

213

(4)

Reimbursement Systems

217

(1)

Challenge Exercises

218

(15)

Glossary

221

(12)

APPENDICES

233

(80)

Appendix I Abbreviated Instructions for Completing UB-92 Form Locators

233

(8)

Appendix II HCPCS Level II National Modifiers

241

(6)

Appendix III Type of Bill (FL4)

247

(4)

Appendix IV Source of Admission (FL20)

251

(2)

Appendix V Condition Codes (FL24--FL 30)

253

(4)

Appendix VI Occurrence Codes and Dates (FL32)

257

(2)

Appendix VII Value Codes and Amounts (FL39--FL 41 A and B)

259

(2)

Appendix VIII Revenue Codes

261

(16)

Accommodation Revenue Codes (10X--21X)

261

(2)

Ancillary Revenue Codes (22X--99X)

263

(14)

Appendix IX Disk Procedure Manual/Case Studies

277

(36)

Disk Procedure Manual

278

(1)

Introduction

278

(1)

Using this Procedure Manual

278

(1)

Section I: General Program Instructions

278

(7)

Section II: Completing Claim Forms

285

(6)

Section III: Tutorial for Blank Form Mode

291

(9)

Hints for Using the Software Program

300

(2)

File Naming Conventions

302

(1)

Case Studies

302

(11)

Index

313

Amazon no longer offers textbook rentals. We do!

Uniform Billing A Guide to Claims Processing

Uniform Billing A Guide to Claims Processing

9780827382237

0827382235

Summary

Table of Contents

Supplemental Materials

Write a Review

Amazon no longer offers textbook rentals. We do!

Uniform Billing A Guide to Claims Processing

Uniform Billing A Guide to Claims Processing

9780827382237

0827382235

Summary

Table of Contents

Supplemental Materials

Write a Review

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