Insurance Handbook for the Medical Office,14th Edition
Stay up on the latest in insurance billing and coding with Marilyn Fordney’s Insurance Handbook for the Medical Office, 14th Edition. Trusted for more than 30 years, this market-leading handbook equips you to succeed as medical insurance specialist in any of today’s outpatient settings. Coverage emphasizes the role of the medical insurance specialist in areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. As with previous editions, all the plans that are most commonly encountered in clinics and physicians’ offices are incorporated into the text, as well as icons for different types of payers, lists of key abbreviations, and numerous practice exercises that assist you in accurately filling out claim forms. This new edition also features expanded coverage of ICD-10, electronic medical records, electronic claims submission, and the HIPAA 5010 — keeping you one step ahead of the latest practices and protocols of the profession.
- Key terms are defined and emphasized throughout the text to reinforce understanding of new concepts and terminology.
- Separate chapter on HIPAA Compliance in Insurance Billing, as well as Compliance Alerts throughout the text highlights important HIPAA compliance issues to ensure readers are compliant with the latest regulations.
- Emphasis on the business of running a medical office and the importance of the medical insurance specialist details the importance of the medical insurance specialist in the business of the medical office.
- Increased focus on electronic filing/claims submission prepares readers for the industry-wide transition to electronic claims submission.
- Separate chapter on documentation in the medical office covers the principles of medical documentation and the rationales for it.
- Service to Patient features in most chapters offer examples of good customer service.
- User resources on the Evolve companion website feature performance checklists, self-assessment quizzes, the Student Software Challenge (with cases on different payer types and an interactive CMS-1500 (02-12) form to fill in).
- NEW! Expanded coverage of ICD-10 prepares users to code ICD-10 with the planned effective date of October 2015.
- NEW! Added information on the electronic medical record and electronic claims submission — including information on the HIPAA 5010 — equips users for the transition between paper and electronic methods of medical records and links the CMS-1500 (02-12) form to the electronic submissions process.
- NEW! SimChart for the Medical Office (SCMO) application activities on the companion Evolve website adds additional functionality to the insurance module on the SCMO roadmap.
Unit One: Career Roles and Responsibilities 1. Role of an Insurance Billing Specialist 2. HIPAA Compliance in Insurance Billing
Unit Two: The Claims Process 3. Basics of Health Insurance 4. Medical Documentation 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 Three: Health Care Payers 11. The Blue Plans, Private Insurance and Managed Care Plans 12. Medicare 13. Medicaid and Other State Programs 14. TRICARE and CHAMPVA 15. Worker’s Compensation 16. Disability Income Insurance and Disability Benefit Insurance
Unit Four: Inpatient and Outpatient Billing 17. Hospital Billing
Unit Five: Employment 18. Seeking a Job and Attaining Professional Advancement
Marilyn Fordney, CMA-AC, Formerly, Instructor of Medical Insurance, Medical Terminology, Medical Machine Transcription, and Medical Office Procedures, Ventura College, Ventura, CA