Fordney’s Medical Insurance - Elsevier eBook on VitalSource, 15th Edition

• NEW! Expanded coverage of inpatient insurance billing, including diagnosis and procedural coding provides the student with the foundation and skills needed to work in the physician office, outpatient, and inpatient setting.
• NEW! Expanded coverage of Ambulatory Surgical Center (ASC) billing chapter provides the student 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 ensures that the student is provided with the knowledge needed to enter today's ever-changing and highly regulated healthcare environment.
• UNIQUE! Interactive UB-04 Form filler on Evolve gives students additional practice with Electronic Health Records.
• Separate chapter on HIPAA Compliance in Insurance Billing, as well as Compliance Alerts throughout highlights important HIPAA compliance issues to ensure students are compliant with the latest regulations.
• Separate chapter on documentation in the medical office covers the principles and rationales of medical documentation.
• Increased focus on electronic filing/claims submission prepares students for the industry-wide transition to electronic claims submission.
• Emphasis on the business of running a medical office and the importance of the medical insurance specialist prepares students for their role in the workplace.
• Detailed examples of potential situations throughout text signal students to be attentive to these types of occurrences.
• Specialized icons throughout text alert students to the connections and special considerations related to specific topics that medical insurance specialists need to be aware of.
• Procedures clearly outlined in step-by-step format detail common responsibilities of the medical insurance specialist.
• SimChart® for the Medical Office (SCMO) application activities on the companion Evolve website add additional functionality to the insurance module on the SCMO roadmap.
• Interactive UB-04 Form Filler provides practice with inpatient billing
• Key terms are defined and emphasized throughout the text to reinforce student understanding of new concepts and terminology.

• NEW! Expanded coverage of inpatient insurance billing, including diagnosis and procedural coding provides you with the foundation and skills needed to work in the physician office, outpatient, and inpatient setting.
• NEW! Expanded coverage of 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 ensures that you have the knowledge needed to enter today's ever-changing and highly regulated healthcare environment.

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