Gain real-world practice in insurance billing and coding! Corresponding to the chapters in Fordney’s Insurance Handbook for the Medical Office, 13th Edition, this workbook provides realistic, hands-on exercises that help you apply concepts and develop critical thinking skills. Study tools include chapter overviews, key terms, chapter review exercises, and case study assignments.
- Key terms and abbreviations lists at the beginning of each chapter provide a quick reference to the health insurance terminology you need to know.
- Critical thinking assignments help you connect theory to practice with real-world scenarios.
- Self-study exercises – including matching, true/false, multiple-choice, mix and match, and fill-in-the-blank questions – help you practice important concepts.
- Performance objectives make learning easy by highlighting what you need to accomplish in each chapter.
- Study outlines focus your review by listing key points for each chapter
- UPDATED content reflects changes in the text, ensuring you have the latest guidelines and regulations for medical insurance billing and coding available.
- UPDATED coverage of key health insurance topics includes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, meaningful use, and CPT 2013.
- NEW CMS-1500 (02-12) claim form includes block-by-block explanations and examples.
- UPDATED ICD-10 coding information prepares you for the ICD-10 transition.
- UPDATED self-assessment quizzes on Evolve test your knowledge of the material in each chapter.
- UPDATED guidelines for the filing and submission of electronic claims include sample screenshots, preparing you for the future of the medical office.
Unit 1: Career Roles and Responsibilities
1. Role of an Insurance Billing Specialist
2. Compliance, Privacy, Fraud, and Abuse in Insurance Billing
Unit 2: The Claims Process
3. Basics of Health Insurance
4. Medical Documentation and the Electronic Health Record
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 3: Health Care Payers
11. The Blue Plans, Private Insurance, and Managed Care Plans
13. Medicaid and Other State Programs
14. TRICARE and Veterans’ Health Care
15. Workers’ Compensation
16. Disability Income Insurance and Disability Benefit Programs
Unit 4: Inpatient and Outpatient Billing
17. Hospital Billing
Unit 5: Employment
18. Seeking a Job and Attaining Professional Advancement
Appendix A: College Clinic Office Policies and Mock Fee Schedule
Appendix B: Medicare Level II HCPCS Codes
Appendix C: ICD-10-PCS Section 0 Medical and Surgical, Character 3, Operation Definitions
Appendix D: ICD-10-PCS Section 0 Medical and Surgical, Character 5, Approach Definitions