Workbook for Fordney's Medical Insurance / Edition 15

by Linda M. Smith CPC, CPC-1, CEMC, PCS, CMBS

Overview

Gain real-world practice in insurance billing and coding! Corresponding to the chapters in Fordney's Medical Insurance, 15^th Edition, this workbook provides realistic, hands-on exercises that help you apply concepts and develop critical thinking skills. Study tools include chapter overviews, key terms, chapter review exercises, and case study assignments. Additionally, this workbook helps you develop a better understanding of the differences among the insurance programs when completing and electronically transmitting the 837 P or the CMS-1500 paper claim.

• Key terms and abbreviations lists at the beginning of each chapter provide a quick reference to the health insurance terminology you need to know.
• Performance objectives make learning easy by highlighting what you need to accomplish in each chapter.
• Study outlines focus review by listing key points for each chapter.
• Self-study exercises – including matching, true/false, multiple-choice, mix and match, and fill-in-the-blank questions – help you practice important concepts.
• Critical Thinking Assignments in the form of short, real-world vignettes prepare you for working in a real medical office and allow you to apply theory learned from the textbook.

• NEW! Expanded coverage of inpatient insurance billing, including ICD-10 coding and CMS provides you with the foundation and skills needed to work in the physician office, outpatient, and inpatient setting.
• NEW! Ambulatory Surgical Center (ASC) billing chapter provides you with the foundation and skills needed to work in this outpatient setting.
• NEW! Updated information on general compliance issues, HIPAA, Affordable Care Act and coding reflects changes to the main text.

Product Details

ISBN-13:	9780323594417
Publisher:	Elsevier Health Sciences
Publication date:	02/25/2019
Edition description:	New Edition
Pages:	400
Product dimensions:	8.40(w) x 10.80(h) x 1.10(d)

About the Author

Linda M Smith is the author of Fordney’s Medical Insurance, 16e and its accompanying workbook and online course. She has revised 3 editions of HIPAA Online. She has had over 40 years of experience in the healthcare industry as a business manager and is a Certified Professional Coder (CPC). She has also earned the credentials of E/M Specialist (CEMC) and is an approved Professional Medical Coding Curriculum Instructor (CPC-I) through the American Academy of Professional Coders (AAPC). Linda provides training privately to local organizations and is an instructor with various business and technical schools. She and her associates provide training in the areas of medical ethics, medical terminology, anatomy and physiology, and medical coding and billing. They provide continuing education workshops for the organizations mentioned above.

Table of Contents

Unit One: Career Role and Responsibilities 1. Role of an Insurance Billing Specialist 2. Privacy, Security and HIPAA 3. Compliance, Fraud and Abuse

Unit Two: Introduction to the Revenue Cycle Process 4. Basics of Health Insurance 5. The Blue Plans, Private Insurance, and Managed Care Plans 6. Medicare 7. Medicaid and other State Programs 8. Tricare and Veterans’ Health Care 9. Workers’ Compensation 10. Disability Income Insurance and Disability Benefit Programs

Unit Three: Documentation and Coding 11. Medical Documentation and the Electronic Health Record 12. Diagnostic Coding 13. Procedural Coding

Unit Four: Claims Submission in The Medical Office 14. The Paper Claim CMS-1500 15. The Electronic Claim

Unit Five: The Claim Follow Up and Payment Process 16. Receiving Payments and Insurance Problem Solving 17. Office and Insurance Collection Strategies

Unit Six: Healthcare Facility Billing 18. Ambulatory Surgical Center 19. Hospital Outpatient and Inpatient Billing    Unit Seven: Employment 20. Seeking a Job and Attaining Professional Advancement