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9780073374918

Medical Insurance: An Integrated Claims Process Approach

by ; ; ;
  • ISBN13:

    9780073374918

  • ISBN10:

    0073374911

  • Edition: 5th
  • Format: Paperback
  • Copyright: 2011-01-13
  • Publisher: McGraw-Hill Education
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Supplemental Materials

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Summary

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.

Table of Contents

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

Supplemental Materials

What is included with this book?

The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.

The Used, Rental and eBook copies of this book are not guaranteed to include any supplemental materials. Typically, only the book itself is included. This is true even if the title states it includes any access cards, study guides, lab manuals, CDs, etc.

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