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Getting Started In The Computerized Medical Office: Fundamentals And Practice,9781401830380

Getting Started In The Computerized Medical Office: Fundamentals And Practice

by
Edition:
1st
ISBN13:

9781401830380

ISBN10:
1401830382
Format:
Spiral Bound
Pub. Date:
1/25/2005
Publisher(s):
Cengage Learning
List Price: $172.95

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Summary

Getting Started in the Computerized Medical Office: Fundamentals and Practice appeals to those programs needing a more elementary software and approach for students who may not be as adept as others with technology. This reference provides basic hands-on computer skills in a modular unit so instructors can choose to omit it in their class or user it as a review. It allows total flexibility for teaching billing and office management separately and addressing the needs of students to learn medical software and basic computer skills.

Table of Contents

Foreword xiii
Preface xv
Acknowledgments xxv
About the Author xxvii
How to Use This Book xxviii
How to Use MOSS Software xxx
Introduction to Computers
1(32)
Objectives
1(1)
Types of Computers
2(1)
The Data Processing Cycle
2(2)
Software
4(2)
Applications Software
4(1)
Systems Software
5(1)
Hardware
6(4)
Drives
6(2)
Random Access Memory (RAM)
8(1)
Serial, Parallel, and USB Port Connections
8(1)
Devices for Internet Access
8(2)
Connecting and Installing Hardware
10(1)
Using The Computer: A Tour Of Windows
10(1)
Booting the Computer
10(1)
Let's Try It! Booting and Shutting Down the Computer
11(8)
The Microsoft Windows® Desktop
10(2)
Application and Document Windows
12(1)
Using Windows
12(4)
Dialog Boxes
16(2)
The Taskbar
18(1)
Let's Try It! Learning to Navigate Windows
19(2)
How Files Are Stored
21(2)
Windows® Explorer
22(1)
Let's Try It! Taking a Look at Windows Explorer
23(3)
Open and Save Dialog Boxes
24(2)
Let's Try It! Opening and Saving Files in Windows
26(1)
Final Notes
27(1)
Check Your Knowledge---Unit 1 Review
28(5)
Medical Practice-Management Software
33(38)
Objectives
33(1)
Components of a Practice-Management Software Application
34(8)
Patient Registration
34(1)
File Maintenance
35(1)
Procedure Posting
36(2)
Insurance Billing
38(1)
Posting Payments
39(1)
Patient Billing
40(2)
Report Generation (Running Reports)
42(1)
Appointment Scheduling
42(1)
Advantages and Disadvantages of Computers in the Medical Office
42(5)
Advantages of Computer Use
43(2)
Disadvantages of Computer Use
45(2)
Health Insurance Portability and Accountability Act (HIPAA)
47(4)
Using Thomson Delmar Learning's Medical Office Simulation Software
51(1)
Using the Software from the Book
51(1)
Using the Network Version in a Computer Laboratory or Classroom
51(1)
Let's Try It! Logon Procedure for MOSS Network Version
51(2)
Let's Try It! Navigating Thomson Delmar Learning's Medical Office Simulation Software
53(6)
Using Help Captions and Feedback Features
59(2)
Let's Try It! Data Entry Guidelines
61(4)
Final Notes
65(1)
Check Your Knowledge---Unit 2 Review
66(5)
Basic Management Concepts for Medical Administrative Staff
71(42)
Objectives
71(1)
The Back Office and the Front Office
71(1)
Basic Principles of Appointment Scheduling
72(8)
Established and New Patients
72(1)
Information Details for Appointment Scheduling
73(2)
Factors that Affect Appointment Scheduling
75(1)
Situations that Complicate Appointment Scheduling
76(1)
Appointment Scheduling Tools
77(3)
Let's Try It! Navigating the Appointment Scheduler
80(6)
Let's Try It! Scheduling Appointments for Established Patients
86(6)
Let's Try It! Scheduling Appointments for New Patients
92(6)
Let's Try It! Searching and Rescheduling Patient Appointments
98(4)
Let's Try It! Review and Practice: Scheduling Appointments
102(1)
Flow of the Office: The Information Cycle
103(6)
Preparing for Patient Visits: The Day Before Appointments
103(1)
Preparing Files for Established Patients
104(1)
Patient Hours: The Check-in and Check-out Process
105(3)
The Reimbursement Process
108(1)
Final Notes
109(1)
Check Your Knowledge---Unit 3 Review
109(4)
Fundamentals of Medical Insurance
113(26)
Objectives
113(1)
General Information about Medical Insurance
114(2)
Group and Individual Plans
116(1)
Common Types of Medical Insurance Plans
116(8)
Indemnity Plans
116(1)
Reimbursement and Indemnity Plans
117(2)
Managed-Care Plans
119(3)
Consumer-Driven Health Plans
122(2)
Medicare and Medicaid
124(6)
Important Details About Medicare
125(1)
The Original Medicare Plan
125(4)
Medicare + Choice Plans
129(1)
The Medicaid Program
130(1)
Insurance Plans Used for Book Simulations
130(4)
FlexiHealth PPO Plan
131(1)
Signal HMO Plan
131(1)
Medicare
132(1)
Century SeniorGap Plan
132(1)
Consumer One HRA
132(2)
Final Notes
134(1)
Check Your Knowledge---Unit 4 Review
134(5)
Patient Registration and Data Entry
139(58)
Objectives
139(1)
The Patient Registration Process
140(3)
The Registration Form
140(3)
Let's Try It! Registering Patients in the Office
143
Case Studies: New Patients
141(37)
Case Study 5--A--Montner, Martin
141(7)
Special Notes Regarding Case Study 5--A
148(1)
Case Study 5--B---Adams, Minnie
149(6)
Special Notes Regarding Case Study 5--B
155(1)
Case Study 5--C---Corbett, Melissa
155(5)
Case Study 5--D---Zuhl, Rodney
160(3)
Case Study 5--E---Tomanaga, Marie
163(6)
Case Study 5--F---Villanova, Ricky
169(2)
Case Study 5--G---Pradhan, Kabin
171(3)
Case Study 5--H---Beals, Kimberly
174(2)
Case Study 5--I---Kinzler, Linda
176(2)
Services Rendered Outside the Office
178(5)
The Physician as an Information Source
179(1)
New Patients at Outside Facilities
180(3)
Let's Try It! Patients at Outside Facilities
183(2)
Registering New Patients Who Receive Services Out-of-Office
185(9)
Case Study 5--J---Tate, Jason
185(1)
Case Study 5--K---Munoz, Geraldo
186(2)
Case Study 5--L---Ruhl, Mary
188(2)
Case Study 5--M---Mallory, Christina
190(2)
Case Study 5--N---Goodnow, Leona
192(2)
Final Notes
194(1)
Check Your Knowledge---Unit 5 Review
194(3)
Procedure Posting Routines
197(84)
Objectives
197(1)
Parts of the Superbill
198(2)
Let's Try It! Posting Procedure Charges
200(1)
Case Study 6--A---Posting Procedures: Practice, Patty
200(15)
Correcting Errors
206(2)
Posting Payments at the Time of Service
208(5)
Scheduling Follow-up Appointments
213(2)
Case Study 6--B---Manaly, Richard
215(4)
Case Study 6--C---Montner, Martin
219(4)
Case Study 6--D---Conway, John
223(3)
Case Study 6--E---Shektar, Paula
226(4)
Case Study 6--F---Villanova, Ricky
230(4)
Case Study 6--G---Adams, Minnie
234(3)
Case Study 6--H---Worthington, Cynthia
237(4)
Case Study 6--I---Zuhl, Rodney
241(3)
Case Study 6--J---Shinn, Robert
244(3)
Case Study 6--K---Pradhan, Kabin
247(2)
Case Study 6--L---Tomanaga, Marie
249(4)
Case Study 6--M---Beals, Kimberly
253(2)
Case Study 6--N---Gordon, Eric
255(1)
Case Study 6--O---Ybarra, Elane
256(2)
Case Study 6--P---Kinzler, Linda
258(2)
Case Study 6--Q---James, David
260(3)
Let's Try It! Posting Charges for Services Outside the Office
263(1)
Outside Facility Case Studies
263(4)
Case Study 6--R---Blanc, Francois
263(2)
Case Study 6--S---Chang, Xao
265(1)
Case Study 6--T---Pinkston, Anna
266(1)
Using Extended Billing Information
267(11)
Case Study 6--U---Tate, Jason
268(2)
Case Study 6--V---Munoz, Geraldo
270(3)
Case Study 6--W---Ruhl, Mary
273(2)
Case Study 6--X---Mallory, Christina
275(2)
Case Study 6--Y---Goodnow, Leona
277(1)
Final Notes
278(1)
Check Your Knowledge---Unit 6 Review
279(2)
Insurance Billing Routines
281(38)
Objectives
281(1)
The Claims Management Process
282(1)
Requirements for Insurance Claims Submission
283(1)
Provider Identification Numbers
284(1)
Insurance Claims Forms
284(8)
The CMS-1500 Claims Form
285(7)
Preparing Claims for Submission
292(1)
Let's Try It! Preparing Paper Claim Forms for Consumer HRA
293(4)
Let's Try It! Sending Medicare Claims Electronically
297(5)
Let's Try It! Sending Signal HMO Claims Electronically
302(4)
Let's Try It! Sending FlexiHealth PPO In-Network Claims Electronically
306(4)
Let's Try It! Sending FlexiHealth PPO Out-of-Network Claims Electronically
310(3)
Final Notes
313(1)
Check Your Knowledge---Unit 7 Review
314(5)
Posting Payments and Secondary Insurance Billing
319(56)
Objectives
319(1)
Payments from Insurance Companies
320(2)
Components of the Explanation of Benefits
320(2)
Posting Medicare Payments
322(1)
Let's Try It! Posting Medicare Payments---Minnie Adams
322(7)
Let's Try It! Posting Medicare Payments---All Patients
329(6)
Let's Try It! Applying Deductibles for Medicare
335(4)
Reading a General Explanation of Benefits (EOB)
339(1)
Let's Try It! Using a General EOB to Post Deductibles for Out-of-Network Services---Stanley Kramer
340(4)
Let's Try It! Using a General EOB to Post an In-Network FlexiHealth PPO Payment---Linda Kinzler
344(2)
Let's Try It! Posting Payments for Multiple Patients Listed on One EOB
346(6)
Let's Try It! Posting Payments from HRA Plans
352(5)
Coordination of Benefits and Secondary Billing
357(3)
Determining Primary and Secondary Payer
358(2)
Secondary Insurance Billing Routines
360(1)
Processing Secondary Insurance Claims
360(1)
Let's Try It! Sending Secondary Claims to Century SeniorGap
360(5)
Let's Try It! Preparing and Processing Secondary Claims---Richard Manaly
365(2)
Let's Try It! Preparing and Processing Secondary Claims---Mary Ruhl
367(2)
Let's Try It! Printing Secondary Claims for the Patient Record
369(1)
Final Notes
370(1)
Check Your Knowledge---Unit 8 Review
371(4)
Patient Billing and Collections
375(52)
Objectives
375(1)
Discussing Financials with Patients
376(2)
Let's Try It! Role Play Financial Discussions with Patients
378(1)
Preparing Patient Statements
379(3)
The Billing Cycle
379(1)
Dunning Messages
380(1)
Reports as Tools for Preparing Statements
381(1)
Let's Try It! Generating Reports for Evaluating Patient Accounts
382(8)
Let's Try It! Preparing Patient Statements with Dunning Messages
390(6)
Patient Payments by Mail
396(2)
Inspecting Payments
397(1)
Let's Try It! Posting Payments from Patients---Rodney Zuhl
398(4)
Let's Try It! Posting Payments---All Remaining Patients
402(9)
Christina Mallory
402(2)
Vito Mangano
404(2)
Jason Tate
406(1)
Cynthia Worthington
407(2)
Leona Goodnow
409(1)
Wilma Stearn
410(1)
Aging Patient Accounts and Collections
411(3)
The Collections Process
411(1)
Writing Collections Letters
412(2)
Let's Try It! Generating Reports for Aging Accounts
414(1)
Let's Try It! Writing Collections Letters
415(4)
Do's and Don'ts of Telephone Collections
418(1)
Let's Try It! Role-Play Telephone Collections Calls
419(3)
Final Notes
422(1)
Check Your Knowledge---Unit 9 Review
423(4)
Secondary Insurance Payments, Claims Follow-Up, and Dispute Resolution
427
Objectives
427(1)
Payments from Secondary Insurance Carriers
428(1)
Let's Try It! Posting Secondary Insurance Payments from Century SeniorGap---Geraldo Munoz and Marie Tomanaga
428(4)
Marie Tomanaga
432(3)
Let's Try It! Posting Secondary Insurance Payments from Medicaid---Francois Blanc, Xao Chang, and Anna Pinkston
435(5)
Let's Try It! Posting Secondary Insurance Payments from Medicare---Richard Manaly and Mary Ruhl
440(5)
Tracking and Follow-Up of Outstanding Insurance Claims
445(1)
Types of Problem Claims
445(2)
Disputing Payment Decisions
447(1)
Claims Review and Appeals
447(3)
Assertive Collections Tactics
450(2)
Let's Try It! Using Reports to Track Insurance Payments
452(2)
Let's Try It! Documenting Tracking and Follow-Up Information for Outstanding Insurance Claims
454(1)
Let's Try It! Rebilling Outstanding Insurance Claims after Follow-Up
455(1)
Final Notes
456(1)
Check Your Knowledge---Unit 10 Review
457


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