Insurance Handbook for the Medical Office

Other | August 27, 2014

byMarilyn Fordney, Marilyn Fordney

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A complete guide to insurance billing and coding,Insurance Handbook for the Medical Office, 13th Editioncovers all the plans that are most commonly encountered in clinics and physicians' offices. Its emphasis on the role of the medical insurance specialist includes areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. Learning to fill in the claim form accurately is made easier by the use of icons for different types of payers, lists of key abbreviations, and numerous practice exercises. This edition provides the latest on hot topics such as ICD-10, healthcare reform, the new CMS-1500 form, and electronic claims. Trusted for more than 30 years, this proven reference from Marilyn Fordney prepares you to succeed as a medical insurance professional in any outpatient setting.

    • Emphasis on the business of running a medical officehighlights the importance of the medical insurance specialist in filing clean claims, solving problems, and collecting overdue payments.
  • Key terms and key abbreviationsare defined and emphasized, reinforcing your understanding of new concepts and terminology.
  • Detailed tables, boxes, and illustrationscall out key points and main ideas.
  • Unique!Color-coded iconsclarify information, rules, and regulations for different payers.
  • An Evolve companion websiteenhances learning with performance checklists, self-assessment quizzes, and theStudent Software Challengefeaturing cases for different payer types and an interactive CMS-1500 form to fill in.
  • A workbookcontains learning tips, practice exercises for key terms and abbreviations, review questions, study outlines, performance objectives, a chapter with practice tests, and critical thinking activities for hands-on experience with real-world cases.Available separately.
    • Updatedcoverage of key health insurance topicsincludes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, electronic claims, ICD-10, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, Meaningful Use, and CPT 2013.
    • UpdatedICD-10coding informationprepares you for the October 2014 ICD-10 implementation date.
    • Updated content on claim formsincludes block-by-block explanations and examples for the new CMS-1500 Claim Form.
    • Updatedguidelines for the filing and submission of electronic claimsinclude sample screenshots and prepare you for the future of the medical office.

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    From the Publisher

    A complete guide to insurance billing and coding,Insurance Handbook for the Medical Office, 13th Editioncovers all the plans that are most commonly encountered in clinics and physicians' offices. Its emphasis on the role of the medical insurance specialist includes areas such as diagnostic coding, procedural coding, Medicare, HIPAA, an...

    Format:OtherDimensions:680 pages, 1 × 1 × 1 inPublished:August 27, 2014Publisher:Elsevier CanadaLanguage:English

    The following ISBNs are associated with this title:

    ISBN - 10:0323226809

    ISBN - 13:9780323226806

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    Extra Content

    Table of Contents

    Unit 1: Career Roles and Responsibilities

    1. Role of an Insurance Billing Specialist

    2. Compliance, Privacy, Fraud, and Abuse in Insurance Billing

    Unit 2: The Claims Process

    3. Basics of Health Insurance

    4. Medical Documentation and the Electronic Health Record

    5. Diagnostic Coding

    6. Procedural Coding

    7. The Paper Claim CMS-1500 (02-12)

    8. The Electronic Claim

    9. Receiving Payments and Insurance Problem-Solving

    10. Office and Insurance Collection Strategies

    Unit 3: Health Care Payers

    11. The Blue Plans, Private Insurance, and Managed Care Plans

    12. Medicare

    13. Medicaid and Other State Programs

    14. TRICARE and Veterans' Health Care

    15. Workers' Compensation

    16. Disability Income Insurance and Disability Benefit Programs

    Unit 4: Inpatient and Outpatient Billing

    17. Hospital Billing

    Unit 5: Employment

    18. Seeking a Job and Attaining Professional Advancement

    Glossary

    Key Abbreviations