

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


Give students a solid foundation in insurance billing and coding! Trusted for more than 30 years, Fordney’s Medical Insurance equips students with the medical insurance skills they need to succeed in any of today’s outpatient settings. The 15th edition has been expanded to include inpatient insurance and billing and ambulatory surgical center billing. Updated 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 Insurance 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 accurately guide your students through the process of filling out claim forms. In addition, SimChart® for the Medical Office (SCMO) activities on the companion Evolve websitegive students the opportunity to practice using electronic medical records.
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- Interactive exercises and activities provide frequent opportunities to recall and recognize medical insurance concepts.
- Gradable quizzes and exams provide you with proof of mastery and highlight areas which may require further study.
- Claims processing activities help you understand how crucial completing a clean claim form is for both the patient and the medical office.
- Reading references connect this online course with the Fordney’s Medical Insurance and Billing textbook, providing practice with applying the book’s concepts.
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- 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.
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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
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Linda M. Smith, CPC, CPC-1, CEMC, PCS, CMBS, Consultant/Educator, MedOffice Resources, Greene, New York.