Medical Insurance : An Integrated Claims Process Approach

by Valerius, Joanne; Bayes, Nenna; Newby, Cynthia; Seggern, Janet

• ISBN13: 9780073402031
• ISBN10: 0073402036
• Edition: 4th
• Format: Paperback
• Copyright: 2009-01-29
• Publisher: Career Education

Summary

The fourth edition of Medical Insurance: An Integrated Claims Process Approach is designed for medical insurance courses. The textbook provides medical assisting, medical insurance, and health information technology students with the knowledge and skills needed to successfully perform insurance and billing related duties...The chapters� organization follows the medical billing process to enhance learning, moving from a comprehensive introductory chapter through processing RA/EOBs and handling patient collections. Every chapter has extensive illustrations, forms, and exercises to develop the required competencies as well as exercises to 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. New for this edition is a text-specific workbook which provides both review and applications of each textbook chapter..

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