Combined text and workbook format keeps the content self-contained and easy to manage.
Full-color format allows readers to identify colors and icons with individual payers, helping them to easily follow and learn specific payer rules and procedures.
An appendix of block-by-block coverage, with full-color examples of the HCFA-1500 insurance claim form, facilitates understanding and effective learning.
Photographs, quotes, and short biographies of real insurance billing specialists appear in each chapter, offering real-world perspectives on insurance billing.
A separate chapter on documentation in the medical office is devoted to this critical topic.
Exercise sections within the text encourage readers to stop and recall or apply what they've learned to help master key concepts.
Section I: Career and Professionalism Chapter 1 A Career as an Insurance Billing Specialist
Section II: Basics of Health Insurance Chapter 2 Fundamentals of Health Insurance Coverage Chapter 3 Source Documents and the Insurance Claim Cycle
Section III: Coding Insurance Claims Chapter 4 Coding Diagnoses Chapter 5 Coding Procedures Part I: Introduction to Evaluation and Management Services Chapter 6 Coding Procedures Part II: Anesthesia, Surgery, Radiology, Pathology/Laboratory, and Medicine
Section IV: Claim Submission Chapter 7 Documentation and the Medical Record Chapter 8 The Health Insurance Claim Form: Completion and Submission Chapter 9 Fees: Private Insurance and Managed Care
Section V: Insurance Programs Chapter 10 The Medicaid Program Chapter 11 The Medicare Program Chapter 12 The TRICARE and CHAMPVA Programs Chapter 13 Workers' Compensation Coverage and other Disability Programs
Section VI: Receiving Payment and Problem Solving Chapter 14 Patient Billing and Credit/Collection Practices Chapter 15 Tracking Reimbursement and Simple Solutions to Unpaid Claims
Appendices A College Clinic Medical Practice Simulation B College Clinic Mock Fee Schedule C Medicare's National HCPCS Level II Codes and Modifiers D HCFA-1500 Claim Form Instructions and Insurance Templates E Glossary F College Clinic Form File G Student Software Challenge Installation and Operating Instructions
Marilyn Fordney, CMA-AC, Formerly, Instructor of Medical Insurance, Medical Terminology, Medical Machine Transcription, and Medical Office Procedures, Ventura College, Ventura, CA and Linda L. French, CMA-C, NCICS, CPC, Business Consultant and Instructor of Medical Insurance Procedures and Medical Terminology, Simi Valley Adult School and Career Institute, Simi Valley, CA; Ventura College, Ventura, CA; Oxnard College, Oxnard, CA
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