Insurance Handbook for the Medical Office / Edition 12

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Insurance Handbook for the Medical Office is a key text for Medical Administrative Assisting, Medical Front Office programs, or those who wish to become insurance billing specialists, claims assistance professionals, or electronic claims processors for physicians' practices and hospital outpatient clinics. Those already practicing in this area will also find this text beneficial, as will health claims examiner programs. The goal of this extremely up-to-date text is to increase efficiency and streamline administrative procedures for the most exasperating aspect of the doctor's office routine - insurance billing. This text offers guidance for all aspects of submitting, tracing, appealing, and transmitting claims for today's full range of health plans. Important coverage of diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, Managed Care, and more is presented. Additionally, a free CD-ROM featuring the HCFA-1500 claim form is included with the book. The CD-ROM contains 10 scored patient case studies with related insurance information so that the student can practice completing the HCFA-1500 claim form in a fun, interactive format.

Features :

  • This edition of the Fordney text is full colour (and is the first text in this discipline to use this format). This full-color format will help the students identify each insurance payer with a specific color and icon, thus making the learning process more effective.
  • The text has been updated to reflect recent changes in procedural coding for government programs and the private sector.
  • Also in this edition, the text has been completely rewritten by the author to emphasize procedural (CPT and HCPCS) and diagnostic (ICD-9-CM) coding and documentation which are the keystones to obtaining maximum reimbursement.
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Product Details

  • ISBN-13: 9781437722567
  • Publisher: Elsevier Health Sciences
  • Publication date: 11/3/2011
  • Edition description: Older Edition
  • Edition number: 12
  • Pages: 704
  • Sales rank: 1,178,756
  • Product dimensions: 8.50 (w) x 10.90 (h) x 0.90 (d)

Table of Contents

Unit 1 Career Role and Responsibilities
1 Role of an Insurance Billing Specialist 2
Unit 2 The Claims Process
2 Basics of Health Insurance 20
3 Medical Documentation 50
4 Diagnostic Coding 92
5 Procedural Coding 114
6 The Health Insurance Claim Form 154
7 Electronic Data Interchange 236
8 Receiving Payments and Insurance Problem Solving 258
9 Office and Insurance Collection Strategies 286
Unit 3 Health Care Payers
10 Managed Care Systems 330
11 Medicare 350
12 Medicaid and Other State Programs 386
14 Workers' Compensation 426
15 Disability Income Insurance and Disability Benefits Programs 466
Unit 4 Inpatient and Outpatient Billing
16 Hospital Billing 488
Unit 5 Employment
17 Seeking a Job and Attaining Professional Advancement 528
App. A Addresses for Submitting Claims or Contracting State Insurance Commissioners and State Boards of Medical Examiners 559
App. B Reference List of Audiotapes, Books, Newsletters, Periodicals, Software, and Videotapes 593
App. C Medi-Cal 605
App. D How to Use the Student Software Challenge: Installation and Operating Instructions 627
Glossary 633
Index 650
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