ISBN:
9780443108785
Copyright:
2026
Publication Date:
10-31-2024
Imprint:
Saunders
List Price:
$145.99
Fordney's Medical Insurance and Billing, 17th Edition
by Linda M. Smith, CPC, CPC-1, CEMC, PCS, CMBS
Paperback
ISBN:
9780443108785
Copyright:
2026
Publication Date:
10-31-2024
Imprint:
Saunders
List Price:
$145.99
In Stock
Most review copies are eBooks – how fast!
A review copy request is most likely to be fulfilled as an eBook on VitalSource rather than a print product, unless no eBook is available. eBooks become available in as little as a few hours. Print products will take between 7 and 10 days to arrive. To request a print copy, please contact us through the Evolve Support Center for further assistance or contact your Education Solutions Consultant.
Any student who attempts to request a review copy will be reported to the school's faculty and administration.
Help your students gain the skills they need to succeed in insurance coding and billing Fordney’s Medical Insurance and Billing, 17th Edition helps students master the insurance billing specialist’s role and responsibilities in areas such as diagnostic coding, procedural coding, HCPCs coding, medical documentation, billing, and collection. Using clear explanations, this book covers all types of insurance coverage commonly encountered in hospitals, physicians’ offices, and clinics. Step-by-step guidelines lead readers through the submission of electronic claims and paper claims, as well as the job search and professional advancement. Trusted for more than 30 years, this market-leading text is a complete guide to becoming an efficient insurance billing specialist.
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- NEW HCPCs Coding chapter covers ambulance billing, supply billing, and certificates of medical necessity.
- NEW! Content on professionalism includes customer service, conflict management, diversity awareness, leadership, and other competencies to help students become effective, engaged, and highly functioning employees.
- NEW! Additional content on medical decision making helps students select the appropriate evaluation and management codes under the current documentation guidelines.
- NEW! Additional examples of CMS claims include those from Blue Shield and Automobile Insurance.
- NEW! Updates to credentialing include those specific to Medicare, Medicaid, and Workers’ Compensation.
- Coverage of medical documentation, diagnostic coding, and procedural coding provides students with the foundation and skills needed to work in a physician’s office as well as ambulatory and inpatient settings.
- Coverage of the role and responsibilities of the insurance billing specialist emphasizes advanced job opportunities and certification.
- Chapter on HIPAA compliance as well as Compliance Alerts highlight important HIPAA compliance issues and the latest regulations.
- Step-by-step procedures detail common responsibilities of the insurance billing specialist and coder.
- Key terms and abbreviations are defined and emphasized, reinforcing understanding of new concepts and terminology.
- Color-coded icons denote and clarify information, rules, and regulations for each type of payer.
- Insights From The Field includes more interviews with experienced insurance billing specialists, providing a snapshot of their career paths and offering advice to the new student.
- Scenario boxes help apply concepts to real-world situations.
- Quick Review sections summarize chapter content and also include review questions.
- Discussion Points provide the opportunity for students and instructors to have interesting and open dialogues related to the chapter’s content.
- Student Software Challenge on the Evolve website offers practice with filling out interactive CMS-1500 forms.
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Unit 1 Career Role and Responsibilities
1 Role of an Insurance Billing Specialist
2 Privacy, Security, and HIPAA
3 Compliance, Fraud, and Abuse
Unit 2 Introduction to Health Insurance
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, Automobile, and Liability Insurance
10 Disability Income Insurance and Disability Benefit Programs
Unit 3 Documentation and Coding for Professional Services
11 Medical Documentation and the Electronic Health Record
12 ICD-10-CM Coding
13 CPT Coding
14 HCPCS Level II Coding
Unit 4 Claims Submission in the Medical Office
15 The Paper Claim CMS 1500
16 The Electronic Claim
Unit 5 Revenue Cycle Management
17 Receiving Payments and Insurance Problem-Solving
18 Collection Strategies
Unit 6 Health Care Facility Billing
19 Introduction to Health Care Facilities and Ambulatory Surgery Centers
20 Billing for Health Care Facilities
Unit 7 Employment
21 Seeking a Job and Attaining Professional Advancement
Key Abbreviations
Glossary
Index
In Stock
Most review copies are eBooks – how fast!
A review copy request is most likely to be fulfilled as an eBook on VitalSource rather than a print product, unless no eBook is available. eBooks become available in as little as a few hours. Print products will take between 7 and 10 days to arrive. To request a print copy, please contact us through the Evolve Support Center for further assistance or contact your Education Solutions Consultant.
Any student who attempts to request a review copy will be reported to the school's faculty and administration.