BN.com Gift Guide

Guide to Medical Billing / Edition 2

Paperback (Print)
Used and New from Other Sellers
Used and New from Other Sellers
from $46.00
Usually ships in 1-2 business days
(Save 14%)
Other sellers (Paperback)
  • All (2) from $46.00   
  • New (1) from $46.00   
  • Used (1) from $46.00   
Close
Sort by
Page 1 of 1
Showing All
Note: Marketplace items are not eligible for any BN.com coupons and promotions
$46.00
Seller since 2005

Feedback rating:

(371)

Condition:

New — never opened or used in original packaging.

Like New — packaging may have been opened. A "Like New" item is suitable to give as a gift.

Very Good — may have minor signs of wear on packaging but item works perfectly and has no damage.

Good — item is in good condition but packaging may have signs of shelf wear/aging or torn packaging. All specific defects should be noted in the Comments section associated with each item.

Acceptable — item is in working order but may show signs of wear such as scratches or torn packaging. All specific defects should be noted in the Comments section associated with each item.

Used — An item that has been opened and may show signs of wear. All specific defects should be noted in the Comments section associated with each item.

Refurbished — A used item that has been renewed or updated and verified to be in proper working condition. Not necessarily completed by the original manufacturer.

New
Upper Saddle River, NJ 2004 Softcover New Condition Brand New Quantity Available: 1. ISBN: 0131718495. ISBN/EAN: 9780131718494. Inventory No: 1560741103.

Ships from: Burgin, KY

Usually ships in 1-2 business days

  • Canadian
  • International
  • Standard, 48 States
  • Standard (AK, HI)
  • Express, 48 States
  • Express (AK, HI)
Page 1 of 1
Showing All
Close
Sort by

More About This Textbook

Product Details

  • ISBN-13: 9780131718494
  • Publisher: Pearson
  • Publication date: 5/4/2005
  • Edition description: Older Edition
  • Edition number: 2
  • Pages: 480
  • Product dimensions: 8.50 (w) x 10.80 (h) x 0.80 (d)

Table of Contents

(Note: Each chapter contains a Summary, Assignments, Questions for Review , and Honors Certification)

1. Introduction.

The Historical Perspective

Job Roles and Duties

The Medical Team

Types of Healthcare Settings

Technology and the Medical Biller

Attitudes that Make a Successful

Medical Biller

Workplace Professionalism

Interpersonal Skills

Professional Appearance

Stress

Pre-Vacation Work Planning

Detail Orientation

Certification Programs for Medical Billers

Exercises 1 - 1 through 1 - 3

2. Time Management and Prioritizing.

Prioritization

Pressure Projects

Time Management

Counting Time Backwards

Overlapping Projects

Exercises 2 - 1 through 2 - 2

3. Legal Issues.

Privacy Guidelines

Fraud

HIPAA and Fraud and Abuse

Embezzlement

Disclaimers

Legal Damages

Medical Ethics

Subpoenas

Instances in Which the Patient Should

Be Notified and the File Notated

4. Clinical Records Management.

Medical Charts

Filing the Chart

Medical Documentation Rules

Signature Cards

Retention of Records

Storing Medical Records

Electronic Medical Charting

Computerized Files

Record Transfers

5. Medical Documentation Forms.

Patient Information Sheet

Release of Information Form

Assignment of Benefits Form

Patient History Form

Insurance Verification

Additional Suggestions

Exercise 5 - 1

6. Contract Interpretation.

Blue Cross/ Blue Shield

Contract Provisions

Contract Benefits

Exclusions

Allowed Amounts

Pre-Certification of Inpatient Admissions

Utilization Review

Second Surgical Opinion Consultations

Exercises 6 - 1 through 6 - 5

Sample Insurance Contract

7. Medicare.

TEFRA/DEFRA

Medicare Eligibility

Providers of Service

The Two Parts of Medicare

Approved or Reasonable Charges

Billing Medicare Services

Assignment of Benefits

Coordinating Medicare w/Other Insurance

Estimating Medicare Coverage

Diagnosis-Related Group Billing

Medicare Denials

Medicare Advance Notice

The Medicare Appeals Process

Medical Fraud and Abuse

Medicare Supplement

Medicare and Veterans

Medicare and Managed Care

Medicare Notice of Non-Coverage

Medicare Timeliness Reports

Exercise 7 - 1

8. Medicaid.

Medicaid Billing Procedures

Treatment Authorization Request

Reimbursement from Medicaid

9. Workers' Compensation.

Employee Activities

Time Limits

Types of Claims

Benefits of Workers' Compensation

Workers' Compensation Reform

Medical Service Order

Patient Records

Doctor's First Report

Subsequent Progress Reports

Physician's Final Report

Delay of Adjudication

Billing for Workers' Compensation

Delinquent Claims

Fraud and Abuse

Third Party Liability

Liens

Reversals

Exercise 9-1

10. Managed Care.

Rising Health Care Costs

Decreasing Costs

Managed Care

HMO Coverage

Preferred Provider Organizations

Billing Managed Care

Groups/IPAs

Capitation Payments

Patient Charts

HMO Appointment Scheduling

Authorizations, Referrals, and Second Opinions

Denial of Service to Members

Member Grievances and Complaints

Transfers

Disenrollment

Continuing Care

Miscellaneous Services

Facility Requirements

Sanctions

Claim Payments

11. Miscellaneous Billing Procedures.

Billing for Service

Determining the Proper Billing Amount

Billing Forms

Additional Suggestions

Billing Tips/ Issues

Special Services

Maximum Reimbursement Tips

Collecting the Patient Portion

Patient Claim form

Coordination of Benefits

COB With Health Maintenance Organizations

TRICARE

Exercise 11 - 1

12. Patient Accounting.

Accounts Payable/ Receivable

The Ledger Card

Insurance Payments

Posting Payments

Balance Billing

Follow-Ups

Collections

Collections Procedures

Small Claims Court

Exercise 12 - 1

13. Office Accounting.

Petty Cash

Office Reports

14. Terminology.

Insurance Terminology

Provider Abbreviations

Medical Abbreviations

Medical Symbols

Exercises 14 - 1 through 14 - 4

15. Reference Books.

ICD-9

CPT/RVS

HCPCS

Physicians' Desk Reference

Medical Dictionary

Merck Manual

Exercises 15 - 1 through 15 - 4

16. ICD-9.

History of the ICD-9

Contents of the ICD-9

How to Use the ICD-9

General Guidelines

Main Terms

Exceptions

V Codes238

E Codes

Signs and Symbols Used in the ICD-D

Billing Tips

ICD-10

Exercises 16 - 1 through 16 - 5

17. CPT Coding.

Using the CPT

Semicolons in the CPT

Signs and Symbols Used in the CPT

Using the CPT Index

Modifiers

Unlisted Codes

Evaluation and Management Codes

Anesthesia

Surgery

Radiology/X-ray

Pathology/Laboratory

Medicine

Billing Tips

Exercises 17 - 1 through 17 - 10

18. HCPCS Coding.

General Information

Coding Using the HCPCS Manual

Sections of the HCPCS Manual

Transportation Services

Medical and Surgical Supplies

Miscellaneous and Experimental

Enteral and Parenteral Therapy

Temporary Hospital Outpatient PPS

Dental Procedures

Durable Medical Equipment

Procedures and Professional Services

Rehabilitative Services

Drugs Administered Other than Oral Method

Immunosuppressive Drugs

Chemotherapy Drugs

Temporary Codes for DMERCs

Orthotic Procedures

Prosthetic Procedures

Medical Services

Pathology/Laboratory

Temporary Codes

Diagnostic Radiology Services

Private Payer Codes

State Medicaid Agency Codes

Vision Services

Hearing Services

Modifiers

Exercises 18 - 1 through 18 - 2

19. Medications and the PDR.

Generic vs. Brand Name Drugs

Service Plans

Physicians' Desk Reference

Definitions

Symbols

Exercises 19 - 1 through 19 - 3

20. CMS-1500.

Item # and Item Name/ Description

Item 24B, Place of Service

Tips on Completing the CMS-1500

Exercise 20 - 1

21. UB-92 Hospital Billing Form.

Item# and Item Name/Description

Item 4, Type of Bill

Item 19, Type of Admission

Item 20, Source of Admission

Item 22, Patient Status

Items 24-30, Condition Codes

Items 32-35, Occurrence Codes

Item 33, Occurrence

Span Codes and Dates

Items 39-41, Value Codes and Amounts

Item 42, Hospital Revenue Codes

Item 53, Assignment of Benefits

Item 59, Relationship

Item 64, Employment Status Code

Exercise 21 - 1

Appendix 21 - 1 Hospital Revenue Codes

22.Hospital Billing.

Which Claim Form Is Right?

Charge Description Masters

Entering Charges

How Billing Affects Other Departments

Preauthorization, Pre-certifications and Utilization Reviews

Ambulatory Surgical Centers

23. Medical Reports.

Abstracting From Medical Records

Triage Reports

Operative Reports

Diagnostic Testing Reports

Medical History and Physical

Examination Reports

Exercises 23 - 1 through 23 - 20

Appendix 23 - 1

24. Claims Submission Process.

Clean Claims

Incomplete Data Master List

Submission Time Limits

Optical Scanning Guidelines

Submitting the Claims

Electronic Claims Submission

Billing Reports

Tracer Claims/ Delinquent Claims

Denied Claims

Re-submissions

Adjusted Claims

Appeals

Balance Billing Patients for Downcoded or Denied Claims

State Insurance Commissioner

25. Calculator Basics.

Key Descriptions

Printer Tape Symbols

Exercises 25 - 1 through 25 - 4

26. General Office Procedures.

Mail

Ordering Supplies

Office Machines

Tickler Files

27. Customer Service/Patient Relations.

Understanding Needs

Attitudes and Feelings

First Impressions and Image

Characteristics of Client Relations

Customer Service Job Functions

The Art of Listening

Handling Difficult Clients

Handling Unwanted Callers

Professionalism

Telephone Techniques

Phone Calls

Telephone Etiquette

Maintaining an Appointment Calendar

Exercises 27 - 1 through 27 - 7

28. Computer Basics.

The Computer

The Monitor

The Keyboard

Frustration Free Computing

Computer Terms

29. Correspondence for the Medical Office.

The Opening

The Body

The Closing

Correspondence Containing Negative Content

Format of the Letter

Memos

Postal Abbreviations

Exercises 29 - 1 through 29 - 2

30. Job Search Preparation.

Job Search Objectives

Uniqueness

Target Audience

Build Your Database

The Resume

The Cover Letter

Marketing Yourself

The Job Interview

Getting Paid What You Are Worth

Exercise 30 - 1

Resume Questionnaire

Sample Resume # 1

Sample Cover Letter # 1

Sample Resume # 2

Sample Resume # 3

Read More Show Less

Customer Reviews

Be the first to write a review
( 0 )
Rating Distribution

5 Star

(0)

4 Star

(0)

3 Star

(0)

2 Star

(0)

1 Star

(0)

Your Rating:

Your Name: Create a Pen Name or

Barnes & Noble.com Review Rules

Our reader reviews allow you to share your comments on titles you liked, or didn't, with others. By submitting an online review, you are representing to Barnes & Noble.com that all information contained in your review is original and accurate in all respects, and that the submission of such content by you and the posting of such content by Barnes & Noble.com does not and will not violate the rights of any third party. Please follow the rules below to help ensure that your review can be posted.

Reviews by Our Customers Under the Age of 13

We highly value and respect everyone's opinion concerning the titles we offer. However, we cannot allow persons under the age of 13 to have accounts at BN.com or to post customer reviews. Please see our Terms of Use for more details.

What to exclude from your review:

Please do not write about reviews, commentary, or information posted on the product page. If you see any errors in the information on the product page, please send us an email.

Reviews should not contain any of the following:

  • - HTML tags, profanity, obscenities, vulgarities, or comments that defame anyone
  • - Time-sensitive information such as tour dates, signings, lectures, etc.
  • - Single-word reviews. Other people will read your review to discover why you liked or didn't like the title. Be descriptive.
  • - Comments focusing on the author or that may ruin the ending for others
  • - Phone numbers, addresses, URLs
  • - Pricing and availability information or alternative ordering information
  • - Advertisements or commercial solicitation

Reminder:

  • - By submitting a review, you grant to Barnes & Noble.com and its sublicensees the royalty-free, perpetual, irrevocable right and license to use the review in accordance with the Barnes & Noble.com Terms of Use.
  • - Barnes & Noble.com reserves the right not to post any review -- particularly those that do not follow the terms and conditions of these Rules. Barnes & Noble.com also reserves the right to remove any review at any time without notice.
  • - See Terms of Use for other conditions and disclaimers.
Search for Products You'd Like to Recommend

Recommend other products that relate to your review. Just search for them below and share!

Create a Pen Name

Your Pen Name is your unique identity on BN.com. It will appear on the reviews you write and other website activities. Your Pen Name cannot be edited, changed or deleted once submitted.

 
Your Pen Name can be any combination of alphanumeric characters (plus - and _), and must be at least two characters long.

Continue Anonymously

    If you find inappropriate content, please report it to Barnes & Noble
    Why is this product inappropriate?
    Comments (optional)