MP: Capstone Billing Simulation with Student Data Disk / Edition 1

MP: Capstone Billing Simulation with Student Data Disk / Edition 1

by Susan Sanderson, Cynthia Newby, Cynthia Newby

ISBN-10: 0073022594

ISBN-13: 9780073022598

Pub. Date: 07/01/2004

Publisher: McGraw-Hill Higher Education

Product Details

McGraw-Hill Higher Education
Publication date:
Edition description:
Older Edition
Product dimensions:
10.70(w) x 8.50(h) x 0.10(d)

Table of Contents

Part 1 Introduction to Polaris Medical Group
Statement of Purpose
Organization and Staff
Medical Records
Guidelines for Maintaining Confidentiality
Information in the Medical Record
Polaris Medical Group Compliance Program
Your Role as a Patient Services Specialist
Qualities and Attitudes of the PSS
General Responsibilities
Your Typical Day at Family Medical Group
Scheduling Patients for Appointments
Recording and Maintaining Patient Information
Maintaining a Third-Party Payer Information
Educating Patients and Responding to Patient Inquiries
Recording Charges, Payments and Adjustments
Generating Insurance Claims
Checking for and Recording Incoming Referrals
Generating Financial Reports
Updating CPT and ICD-9 Codes in the Database
Quiz: Part 1
Part 2 Polaris Medical Group Policy and Procedure Manual
Reading Acknowledgment
Practice Information
Equal Employment Opportunity, Nondiscrimination, and Affirmative Action Statement
Types of Employment
Wages and Compensation
Pay Rates
Overtime Compensation
Pay Dates
Employee Time Records
Performance Evaluations
Employee Benefits
Employee Grievances
Resignation, Termination, Discharge, and Cobra Benefits
Cobra Benefits
Personnel Conduct Issues
Contributions and Solicitations
Identification Badges
Inclement Weather Conditions
Sexual Harassment
Dress Code
Smoking and Tobacco Use
Substance Abuse
Personal Telephone Calls and Visits
Universal Precautions
Office Hours and Attendance
Definitions of Absences
Scheduled Absences
Unscheduled Absences
Lateness/Leaving Early
Excused Absences
Unexcused Absences
Attendance Policy
Telephone Procedures
Recording Telephone Calls
Screening Telephone Calls
Taking Telephone Messages
Handling Emergency Telephone Calls
Symptoms/Complaints Considered Emergencies
Office Visit Procedures
Confidentiality Policy
Confidentiality Guidelines
Gathering Patient Information
Information Obtained from New Patients over the Telephone
Information from Other Sources
Verifying Insurance Coverage Guidelines
Checking for Preauthorization Requirements
Checking for Referral Requirements
Concluding the Patient's Visit
Scheduling Appointments
Patient Flow
Scheduling Allotments
Payment for Services
The Billing Process Billing Codes, Patient Statements, and Place of Service Codes
Insurance Claims
Billing Guidelines
Review of RAs
Patient Billing Disputes
Daily Reports
Guidelines for Medicare, Medicaid, and Workers' Compensation
Medicare Medigap Insurance Medicare Managed Care Plans
Workers' Compensation
Insurance Information Pages
Standard Health Care, Inc., Traditional Plan
Blue Cross and Blue Shield of Ohio, Traditional Plan
Tricare HMO
Columbus Medical Care PPO
Cigna Healthplan HMO
Aetna Health Plans, Ohio HMO-Network
Ohio Insurance Company, Traditional Plan
Nationwide Medicare, Parts A and B
Nationwide Medicare HMO
Ohio Department of Human Services, Medicaid
Blue Cross and Blue Shield of Ohio, Workers' Compensation
Quiz: Part 2
Part 3 On the Job
Week 1, Day 1
Medisoft Training Topic 1: Entering Guarantors Who Are Not Patients
Week 1, Day 2
Week 1, Day 3
Week 1, Day 4
Week 1, Day 5
Medisoft Training Topic 2: Entering Referrals
Medisoft Training Topic 3: Entering a Primary Care Provider Outside the Practice
Medisoft Training Topic 4: Using Quick Balance
End of Week 1 Job
Week 2, Day 1
Medisoft Training Topic 5: Entering Prior Authorization Numbers
Week 2, Day 2
Medisoft Training Topic 6: Entering Additional Diagnosis Codes
Week 2, Day 3
Medisoft Training Topic 7: Closing Cases
Medisoft Training Topic 8: Entering Visit Authorization Numbers
Week 2, Day 4
Medisoft Training Topic 9: Entering Additional Procedure Codes
Week 2, Day 5
End of Month Jobs
Medisoft Training Topic 10: Printing a Billing/Payment Status Report
Part 4 Source Documents

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