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Computers in the Medical Office

by
Edition:
8th
ISBN13:

9780073402130

ISBN10:
0073402133
Format:
Paperback
Pub. Date:
7/1/2012
Publisher(s):
McGraw-Hill Science/Engineering/Math
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Summary

Computers in the Medical Office 8eis the best-selling text for training students using full-featured and current Medisoft Version 17 Patient Billing software. McGraw-Hill publishes the most titles to train students on Medisoft software. Our publishing relationship with Medisoft has been ongoing for 15 years. Computers in the Medical Office 8eoffers medical office training using current, realistic medical office cases while building transferable computerized medical billing and scheduling skills. Students who complete this course will learn the appropriate terminology and skills to use any patient billing software program with minimal additional training. As students progress through Medisoft, they learn to gather patient information, schedule appointments and enter transactions. The practical, systematic approach is based on real-world medical office activities. Go with the best. Go with the tried and true. Go with the Medisoft titles that will give you and your students the training and support you need to be successful. Go with McGraw-Hill's Computers in the Medical Office 8e.

Table of Contents

Part 1: INTRODUCTION TO COMPUTERS IN THE MEDICAL OFFICE

Chapter 1: Introduction to Health Information Technology and Medical Billing

1.1 THE INCREASING USE OF TECHNOLOGY IN HEALTHCARE

1.2 FUNCTIONS OF PRACTICE MANAGEMENT PROGRAMS

Creating and Transmitting Claims
Monitoring Claim Status
  
Receiving and Processing Payments
  

1.3 FUNCTIONS OF ELECTRONIC HEALTH RECORD PROGRAMS

Health Information and Data Elements
  
Results Management
  
Order Management
  
Decision Support
  
Electronic Communication and Connectivity
  
Patient Support
  
Administrative Processes
  
Reporting and Population Management
  
Advantages of Electronic Health Records
  

1.4 THE MEDICAL DOCUMENTATION AND BILLING CYCLE: PRE-ENCOUNTER

  
Step 1: Preregister Patients
  

1.5 THE MEDICAL DOCUMENTATION AND BILLING CYCLE: ENCOUNTER

Step 2: Establish Financial Responsibility
Step 3: Check In Patients
Step 4: Review Coding Compliance
Step 5: Review Billing Compliance
Step 6: Check Out Patients

1.6 THE MEDICAL DOCUMENTATION AND BILLING CYCLE: POST-ENCOUNTER

Step 7: Prepare and Transmit Claims
Step 8: Monitor Payer Adjudication
Step 9: Generate Patient Statements
Step 10: Follow Up Payments and Collections

1.7 THE IMPACT OF LEGISLATION: HIPAA

HIPAA Electronic Transaction and Code Sets Standards
HIPAA Privacy Requirements
HIPAA Security Requirements
State Regulation

1.8 THE IMPACT OF LEGISLATION: HITECH AND ACA

Health Information Technology for Economic and Clinical Health Act (2009)
Patient Protection and Affordable Care Act (2010)

Part 2: MEDISOFT ADVANCED TRAINING

Chapter 2: Introduction to Medisoft

2.1 THE MEDISOFT DATABASES

2.2 THE MEDISOFT MENUS

File Menu
Edit Menu
Activities Menu
Lists Menu
Reports Menu
Tools Menu
Window Menu
Help Menu
Exercise 2-1: Medisoft Menus

2.3 THE MEDISOFT TOOLBAR

Exercise 2-2: Toolbar Buttons

2.4 ENTERING, EDITING, SAVING, AND DELETING DATA IN MEDISOFT

Entering Data
Editing Data
Exercise 2-3: Editing Data
Saving Data
Deleting Data

2.5 CHANGING THE MEDISOFT PROGRAM DATE

Windows XP
Windows Vista and Windows 7

2.6 USING MEDISOFT HELP

Hints
Built-In
Exercise 2-4: Using Built-in Help

2.7 CREATING AND RESTORING BACKUP FILES

Creating a Backup File While Exiting Medisoft
Exercise 2-5: Backing Up
Restoring the Backup File
Exercise 2-6: Restoring a Backup File

2.8 MEDISOFT’S FILE MAINTENANCE UTILITIES

Rebuilding Indexes
Packing Data
Purging Data
Recalculating Patient Balances

2.9 USING MEDISOFT SECURITY FEATURES TO ENSURE HIPAA AND HITECH COMPLIANCE

User Logins and Audit Controls
Auto Log Off and Unapproved Codes

Chapter 3: Scheduling

3.1 THE OFFICE HOURS WINDOW

Program Options
Entering and Exiting Office Hours

3.2 ENTERING APPOINTMENTS

Exercise 3-1: Entering an Appointment, Leila Patterson
Exercise 3-2: Entering an Appointment, Elizabeth Jones
Exercise 3-3: Looking up a Provider and Entering an Appointment

3.3 BOOKING FOLLOW-UP APPOINTMENTS

Exercise 3-4: Booking an Appointment with a Follow-up

3.4 SEARCHING FOR AVAILABLE TIME SLOTS

Exercise 3-5: Searching for Open Time, Ramos
Exercise 3-6: Searching for Open Time, Klein

3.5 ENTERING APPOINTMENTS FOR NEW PATIENTS

Exercise 3-7: Entering an Appointment for a New Patient

3.6 BOOKING REPEAT APPPOINTMENTS

Exercise 3-8: Booking Repeat Appointments

3.7 RESCHEDULING AND CANCELING APPPOINTMENTS

Exercise 3-9: Rescheduling Appointments

3.8 VERIFYING INSURANCE ELIGIBILITY AND BENEFITS

Eligibility Verification Icons
Exercise 3-10: Verifying a Patient’s Eligibility

3.9 CHECKING PATIENTS IN AND OUT

Exercise 3-11: Checking In a Patient

3.10 CREATING AN OVERDUE BALANCE REPORT FOR PATIENTS WITH APPOINTMENTS

Exercise 3-12: Creating an Overdue Balance Report

3.11 CREATING A PATIENT RECALL LIST

Adding a Patient to the Recall List
Exercise 3-13: Adding a Patient to the Recall List

3.12 CREATING PROVIDER BREAKS

Exercise 3-14: Entering a Provider Break

3.13 VIEWING AND PRINTING SCHEDULES

Exercise 3-15: Viewing a Provider Schedule
Applying Your Skills 1: Enter an Appointment for a New Patient
Applying Your Skills 2: Search for an Open Time
Applying Your Skills 3: Preview a Physician’s Schedule

Chapter 4: Entering Patient Information

4.1 HOW PATIENT INFORMATION IS ORGANIZED IN MEDISOFT

4.2 ENTERING NEW PATIENT INFORMATION

Name, Address Tab
Exercise 4-1: Chart Numbers
Other Information Tab
Payment Plan Tab
Exercise 4-2: Adding a New Patient
Adding an Employer to the Address List
Exercise 4-3: Adding an Employer

4.3 SEARCHING FOR PATIENT INFORMATION

Search for and Field Option
Exercise 4-4: Search Using Field Box
Locate Buttons Option
Exercise 4-5 Search Using Locate Button

4.4 EDITING PATIENT INFORMATION

Exercise 4-6: Editing Patient Information
Applying Your Skills 4: Entering a New Patient

Chapter 5: Working with Cases

5.1 UNDERSTANDING CASES

When to Set Up a New Case
Case Examples

5.2 NAVIGATING CASES IN MEDISOFT

Case Command Buttons
The Case Dialog Box

5.3 ENTERING PATIENT AND ACCOUNT INFORMATION

Personal Tab
Exercise 5-1: Entering Data in the Personal Tab
Account Tab
Exercise 5-2: Entering Data in the Account Tab

5.4 ENTERING INSURANCE INFORMATION

Policy 1 Tab
Exercise 5-3: Entering Data in the Policy 1 Tab
Policy 2 Tab
Policy 3 Tab
Medicaid and Tricare Tab

5.5 ENTERING HEALTH INFORMATION

Diagnosis Tab
Exercise 5-4: Entering Data in the Diagnosis Tab
Condition Tab
Exercise 5-5: Entering Data in the Condition Tab

5.6 ENTERING OTHER INFORMATION

Miscellaneous Tab
Comment Tab
Exercise 5-6: Entering Data in the Comment Tab
EDI Tab

5.7 EDITING CASE INFORMATION

Exercise 5-7: Editing a Case
Exercise 5-8: Copying a Case
Applying Your Skills 5: Creating a Case for a New Patient

Chapter 6: Entering Charge Transactions and Patient Payments

6.1 UNDERSTANDING CHARGES, PAYMENTS, AND ADJUSTMENTS

6.2 SELECTING A PATIENT AND CASE

Chart
Case
Additional Information

6.3 ENTERING CHARGE TRANSACTIONS

Buttons in the Charges Area of the Transaction Entry
Dialog Box
Color Coding in Transaction Entry
Saving Charges
Editing Transactions
Exercise 6-1: Entering a Charge for Hiro Tanaka
Exercise 6-2: Entering a Charge for Elizabeth Jones

6.4 ENTERING PAYMENTS MADE AT THE TIME OF AN OFFICE VISIT

Applying Payments to Charges
Saving Payment Information
Exercise 6-3: Entering a Copayment
Exercise 6-4: Entering Charges and Copayment

6.5 PRINTING WALKOUT RECEIPTS

Exercise 6-5: Creating a Walkout Receipt

6.6 PROCESSING A PATIENT REFUND

Exercise 6-6: Processing a Refund

6.7 PROCESSING A NONSUFFICIENT FUNDS (NSF) CHECK

Exercise 6-7: Processing an NSF Check
Applying Your Skills 6: Add a Diagnosis and Enter
Procedure Charges

Chapter 7: Creating Claims

7.1 THE BASICS OF MEDICAL INSURANCE

Types of Health Plans

7.2 THE ROLE OF CLAIMS IN THE BILLING CYCLE

Medical Necessity
Clean Claims
CMS-1500 and X12 837 Health Care Claim
Exercise 7-1: Exploring the CMS-1500 in Medisoft Help

7.3 CLAIM MANAGEMENT IN MEDISOFT

7.4 CREATING CLAIMS

Exercise 7-2: Creating Claims

7.5 LOCATING CLAIMS

Exercise 7-3: Using the List Only Feature

7.6 EDITING CLAIMS

Carrier 1 Tab
Carrier 2 and Carrier 3 Tabs
Transactions Tab
Comment Tab
EDI Note Tab
Exercise 7-4: Reviewing a Claim

7.7 CHANGING THE STATUS OF A CLAIM

Exercise 7-5: Changing Claim Status

7.8 ELECTRONIC CLAIMS WORKFLOW

Exercise 7-6: Perform an Electronic Claim Edit Check

7.9 SENDING ELECTRONIC CLAIM ATTACHMENTS

Applying Your Skills 7:Reviewing Claims

Chapter 8: Posting Payments and Creating Patient Statements

8.1 THIRD-PARTY REIMBURSEMENT OVERVIEW

Indemnity Plan Example
Managed Care Example
Medicare Participating Example

8.2 REMITTANCE ADVICE (RA) PROCESSING

Claim Adjustments and Denials
Processing Payments

8.3 ENTERING INSURANCE PAYMENTS IN MEDISOFT

The Deposit List Dialog Box
The Deposit Dialog Box
Exercise 8-1: Entering a Deposit: ChampVA

8.4 APPLYING INSURANCE PAYMENTS TO CHARGES

Exercise 8-2: Applying Payments to Charges: ChampVA
Exercise 8-3: Entering a Deposit and Applying Payments: East Ohio PPO
Exercise 8-4: Entering a Deposit and Applying Payments: Blue Cross and Blue Shield

8.5 PROCESSING A PATIENT PAYMENT RECEIVED BY MAIL

Exercise 8-5: Entering a Patient Payment Received by Mail

8.6 ENTERING CAPITATION PAYMENTS

Exercise 8-6: Entering a Capitation Payment
Exercise 8-7: Entering a Zero Amount Payment
Exercise 8-8: Adjusting a Capitated Account

8.7 CREATING STATEMENTS

Statement Management Dialog Box
Create Statements Dialog Box
Exercise 8-9: Creating Statements

8.8 EDITING STATEMENTS

General Tab
Transactions Tab
Comment Tab
Exercise 8-10: Reviewing a Statement

8.9 PRINTING STATEMENTS

Selecting a Format
Selecting the Filters and Printing the Statements
Exercise 8-11: Printing Statements
Applying Your Skills 8: Enter Insurance Payments
Applying Your Skills 9: Create Statements

Chapter 9: Creating Reports

9.1 CREATING REPORTS IN MEDISOFT

Selecting Print Options
Selecting Data for a Report

9.2 THE IMPORTANCE OF ACCOUNTS RECEIVABLE REPORTS

Daily Reports
Monthly Reports

9.3 CREATING DAY SHEETS

Patient Day Sheet
Exercise 9-1: Printing a Patient Day sheet
Procedure Day Sheet
Payment Day Sheet

9.4 CREATING ANALYSIS REPORTS

Billing/Payment Status Report
Practice Analysis Report
Exercise 9-2: Save a Practice Analysis Report as a PDF File
Insurance Analysis Report
Referring Provider Report
Referral Source Report
Unapplied Payment/Adjustment Report
Unapplied Deposit Report
Co-payment Report
Outstanding Co-Payment Report
Appointment Eligibility Analysis—Detail and Summary
Electronic Claims Analysis—Detail and Summary

9.5 CREATING PATIENT LEDGER REPORTS

Exercise 9-3: Printing a Patient Account Ledger

9.6 CREATING STANDARD PATIENT LIST REPORTS

Exercise 9-4: Printing a Patient by Insurance Carrier List

9.7 NAVIGATING IN MEDISOFT REPORTS

The Medisoft Reports Menus
The Medisoft Reports Toolbar
The Medisoft Reports Find Report Box
The Medisoft Reports Help Feature

9.8 CREATING AGING REPORTS

Exercise 9-5 Printing a Patient Aging Report

9.9 CREATING CUSTOM REPORTS

Exercise 9-6: Printing a List of Patients
Exercise 9-7: Printing a List of Procedure Codes

9.10 USING REPORT DESIGNER

Exercise 9-8: Modifying a Report
Applying Your Skills 10: Print a Patient Day Sheet
Applying Your Skills 11: Print an Insurance Payment by Type Report

Chapter 10: Collections in the Medical Office

10.1 FOLLOWING UP ON INSURANCE CLAIMS

Prompt Payment Laws
Working Claim Denials
Aging Insurance Claims
Resubmitting Claims

10.2 THE IMPORTANCE OF A FINANCIAL POLICY

10.3 LAWS GOVERNING PATIENT COLLECTIONS

Using Payment Plans

10.4 WORKING WITH COLLECTION AGENCIES

Exercise 10-1: Posting a Payment from a Collection Agency

10.5 WRITING OFF UNCOLLECTIBLE ACCOUNTS

Exercise 10-2: Writing Off a Patient Balance

10.6 USING A PATIENT AGING REPORT FOR COLLECTIONS

Exercise 10-3: Identifying Overdue Accounts

10.7 ADDING AN ACCOUNT TO THE COLLECTION LIST

Using the Collection List Window
Entering a Tickler Item
Exercise 10-4: Creating a Tickler

10.8 CREATING COLLECTION LETTERS

Exercise 10-5: Creating a Collection Letter

10.9 CREATING A COLLECTION TRACER REPORT

Exercise 10-6: Creating a Collection Tracer Report
Applying Your Skills 12: Print a Patient Aging Report
Applying Your Skills 13: Add a Patient to the Collection List
Applying Your Skills 14: Create a Collection Letter

Part 3: APPLYING YOUR SKILLS

Chapter 11: Appointments and Registration

Exercise 11-1: Scheduling an Appointment: Lawana Brooks
Exercise 11-2: Scheduling an Appointment: Edwin Hsu
Exercise 11-3: Scheduling an Appointment: Anthony Battistuta
Exercise 11-4: Scheduling an Appointment: Stewart Robertson
Exercise 11-5: Scheduling an Appointment: Hannah Syzmanski
Exercise 11-6: Making an Appointment Change
Exercise 11-7: Juggling Schedules
Exercise 11-8: Scheduling an Appointment: Michael Syzmanski
Exercise 11-9: Print a Provider Schedule

Chapter 12: Cases, Transactions, and Claims

Exercise 12-1: Entering Transactions
Exercise 12-2: An Unscheduled Visit
Exercise 12-3: Changing a Transaction Record
Exercise 12-4: Scheduling an Appointment: Diane Hsu
Exercise 12-5: Entering Charges and Payments: Stewart Robertson
Exercise 12-6: Entering Charges and Payments: Diane Hsu
Exercise 12-7: Entering Charges and Payments: Michael Syzmanski
Exercise 12-8: Entering and Applying an Insurance Carrier Payment
Exercise 12-9: Creating Insurance Claims
Exercise 12-10: Finding a Patient’s Balance

Chapter 13: Reports and Collections

Exercise 13-1: Creating a Patient Day Sheet Report
Exercise 13-2: Creating a Patient Aging Report
Exercise 13-3: Creating a Practice Analysis Report
Exercise 13-4: Adding Items to the Collection List
Exercise 13-5: Create Collection Letters

Chapter 14: Putting It All Together

Exercise 14-1: Scheduling Appointments
Exercise 14-2: Rescheduling and Canceling Appointments
Exercise 14-3: Printing Schedules
Exercise 14-4: Creating Cases
Exercise 14-5: Entering Transactions
Exercise 14-6: Creating Claims
Exercise 14-7: Entering Insurance Payments
Exercise 14-8: Creating Patient Statements
Exercise 14-9: Printing Reports
Exercise 14-10: Entering Collection Agency and Patient Payments
Exercise 14-11: Reviewing Overdue Accounts
Exercise 14-12: Adding Patients to the Collection List and Creating Collection Letters

Part 4: SOURCE DOCUMENTS

Glossary

Index



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