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Workbook for Insurance Handbook for the Medical Office,9781416000976
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Workbook for Insurance Handbook for the Medical Office


Author(s): Fordney
ISBN10:  1416000976
ISBN13:  9781416000976
Format:  Paperback
Pub. Date:  11/17/2005
Publisher(s): ELSEVIER SAUNDERS PUBLISHING

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SummaryTable of Contents
The realistic, hands-on exercises in this workbook prepare students to work effectively in the managed care environment with all types of insurance claims. It presents self-study review questions and complete, competency-based tests. There are also easily removable sample practice forms, as well as case study information and practice exercises. Study icons help students identify and categorize assignment types (such as self-study, Internet assignments, and critical thinking exercises). New to this edition is a point system included in the workbook so that students can test themselves and gauge their understanding on a valued system.

  • Emphasizes procedural (CPT and HCPCS) and diagnostic (ICD-9-CM) coding and documentation since they are the keystones to obtaining maximum reimbursement.


  • Updated to reflect recent changes in the industry including more HIPAA Alerts throughout the text and a revised EDI chapter.
Instruction Guide to the Workbook ix
Learning Objectives ix
Instructions to the Student x
Key Terms x
Note Taking x
Self-Study Assignments x
Simulation Assignments xi
Medical Terminology and Abbreviations xi
Patient Records xi
Financial Records xi
CMS-1500 Claim Form xii
Performance Evaluation Checklist xii
Appendices xii
Student Reference Notebook xii
Content Suggestions from Workbook xii
Content Suggestions from Handbook xiii
Tests xv
Reference Material xv
Employee Insurance Procedure Manual xv
Practice Management and Billing Software xv
UNIT 1 Career Role and Responsibilities
Role of an Insurance Billing Specialist
1(6)
Compliance and the E-Health Initiative
7(12)
UNIT 2 The Claims Process
Basics of Health Insurance
19(15)
Medical Documentation
34(24)
Diagnostic Coding
58(28)
Procedural Coding
86(28)
The Paper Claim: CMS-1500
114(36)
Electronic Data Interchange: Transactions and Security
150(45)
Receiving Payments and Insurance Problem Solving
195(30)
Office and Insurance Collection Strategies
225(32)
UNIT 3 Health Care Payers
The Blues Plans, Private Insurance, and Managed Care Plans
257(30)
Medicare
287(74)
Medicaid and Other State Programs
361(26)
Tricare and Champva
387(39)
Workers' Compensation
426(33)
Disability Income Insurance and Disability Benefit Programs
459(28)
UNIT 4 Inpatient and Outpatient Billing
Hospital Billing
487(32)
UNIT 5 Employment
Seeking a Job and Attaining Professional Advancement
519(18)
Tests 537(64)
Appendix A College Clinic Office Policies and Mock Fee Schedule 601(32)
Appendix B Medicare Level II HCPCS Codes 633(14)
Appendix C Medi-Cal 647(9)
Appendix D Answers to Self-Study Review Questions for Chapters 656

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