The Practice of Health Claims Examining

by Publishing Inc., ICDC

• ISBN13: 9780132193894
• ISBN10: 0132193892
• Edition: 2nd
• Format: Paperback
• Copyright: 2006-10-11
• Publisher: Prentice Hall

Summary

Formally known as Exercises in Health Claims Examining, The Practice of Health Claims Examining, 2e, contains a simulated work program to help you experience the real life situations that a claims examiner experiences on a daily basis. This book is created for use in conjunction with ICDC Publishing'sGuide to Health Claims Examining. Some of the exercises in the simulated work portion of the book are based upon concepts learned in theGuide to Health Claims Examining(i.e., procedures for processing claims, interpretation of contracts, understanding UCR and deductibles, etc.). The simulated work portion of this book incorporates concepts which are not taught by simple data entry, for example UCR calculations, privacy guidelines, client record keeping, correspondence, and manual completion of claims processing.Trainees that have taken a complete health claims examining course. Health Information Management Professionals.

Table of Contents

IntroductionLet's Begin

Setting Up Your Desk

Family Files

Simulated Work ProgramAbout the Claims 5

Day 1 April 1, CCYY

Day 2 April 2, CCYY

Day 3 April 3, CCYY

Day 4 April 4, CCYY

Day 5 April 5, CCYY

Documents

Confidential Disclosure Agreement

Time Sheet

Ball Insurance Carriers Contract

Rover Insurers Inc. Contract

Winter Insurance Corporation Contract

Summer Insurance Company Contract

Assistant Surgeon's List

Eligibility Information Sheet

Eligibility Information Sheet

Eligibility Roster /Ball Insurance Carriers (January)

Eligibility Roster/Ball Insurance Carriers (February)

Eligibility Information Sheet

Eligibility Roster/Winter Insurance Carriers (March)

Eligibility Information Sheet

Eligibility Roster/Winter Insurance Carriers (January)

Relative Value Study

Eligibility Information Sheet

Eligibility Roster/Rover Insurers, Inc. (January)

Eligibility Information Sheet

Network Provider Listing/Rover Insurers, Inc. (February)

Eligibility Information Sheet

Eligibility Roster/Rover Insurers, Inc. (March)

Eligibility Roster/Winter Insurance Carriers (February)

Eligibility Information Sheet

Beginning Financials

Eligibility Information Sheet

Network Provider Listing/Rover Insurers, Inc. (January)

Eligibility Information Sheet

Eligibility Roster/Rover Insurers, Inc. (February)

Eligibility Information Sheet

UCR Conversion Factor Report Medical

Eligibility Information Sheet

Eligibility Information Sheet

Eligibility Roster/Ball Insurance Carriers (March)

Eligibility Information Sheet

Network Provider Listing/Rover Insurers, Inc. (March)

CMS-1500

CMS-1500

CMS-1500

CMS-1500

CMS-1500

Revised Eligibility Roster /Winter Insurance Carriers (January)

Revised Eligibility Roster /Ball Insurance Carriers (January)

Ball Insurance Carriers

CMS-1500

CMS-1500

CMS-1500

CMS-1500

CMS-1500

Note from

Family Benefits Tracking Sheet

CMS-1500

CMS-1500

CMS-1500

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