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Comprehensive Health Insurance : Billing, Coding and Reimbursement
by Vines-Allen, Deborah; Braceland, Ann; Rollins, Elizabeth; Miller, Susan H.Edition:
2nd
ISBN13:
9780132966894
ISBN10:
0132966891
Format:
Paperback
Pub. Date:
8/9/2012
Publisher(s):
Prentice Hall
List Price: $118.00
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Summary
COMPREHENSIVE HEALTH INSURANCE: BILLING, CODING & REIMBURSEMENT, 2/eprovides students with the knowledge and skills needed to work in a variety of medical billing and coding positions in the medical field. Comprehensive in approach, it covers the foundations of insurance, billing, coding and reimbursement. Students learn not only the submission of claims to the insurance carrier, but also reviewing medical records, verifying patient benefits, submitting a secondary claim, posting payments and appealing the insurance carrier's decision. This edition includes new chapters devoted to HIPAA and ICD-10-CM Medical Coding, as well as outstanding coverage of electronic records. Numerous case studies and patient files are included throughout and demonstrate refunds and appeals, auditing and compliance, Medicare calculations and professionalism.
Table of Contents
SECTION I: A CAREER IN HEALTH CARE
1. Introduction to Professional Billing and Coding Careers
SECTION II: THE RELATIONSHIP BETWEEN THE PATIENT, PROVIDER, AND CARRIER
2. Understanding Managed Care: Insurance Plans
3. Understanding Managed Care: Medical Contracts and Ethics
4. HIPAA: Health Insurance Portability and Accountability Act of 1996
SECTION III: MEDICAL CODING
5. ICD-9-CM Medical Coding
6. ICD-10-CM Medical Coding
7. Introduction to CPT and Place of Service Coding
8. Coding Procedures and Services
9. HCPCS and Coding Compliance
10. Auditing
SECTION IV: MEDICAL CLAIMS
11. Physician Medical Billing
12. Hospital Medical Billing
SECTION V: GOVERNMENT MEDICAL BILLING
13. Medicare Medical Billing
14. Medicaid Medical Billing
15. TRICARE Medical Billing
SECTION VI: ACCOUNTS RECEIVABLE
16. Explanation of Benefits and Payment Adjudication
17. Refunds and Appeals
SECTION VII: INJURED EMPLO YEE MEDICAL CLAIM
18. Workers' Compensation
SECTION VIII: USE OF MEDICAL PRACTICE MANAGEMENT SOFTWARE
19. Electronic Medical Claims Processing
