Insurance Handbook for the Medical Office
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INSURANCE HANDBOOK FOR THE MEDICAL OFFICE is a key text for medical administrative assisting, medical front office programs, or those who wish to become insurance billing specialists, claims assistance professionals, or electronic claims processors for physicians' practices and hospital outpatient clinics. Those already practicing in this area will also find this text beneficial, as will health claims examiner programs. The goal of this extremely up-to-date text is to increase efficiency and streamline administrative procedures for the most exasperating aspect of the doctor's office routine: insurance billing. This text offers guidance for all aspects of submitting, tracing, appealing, and transmitting claims for today's full range of health plans. Important coverage of diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, Managed Care, and more is presented. Additionally, a free CD-ROM featuring the HCFA-1500 claim form is included with the book. The CD-ROM contains 10 scored patient case studies with related insurance information so that the student can practice completing the HCFA-1500 claim form in a fun, interactive format.
Unit 1Career Role and Responsibilities1Role of an Insurance Billing Specialist2Unit 2The Claims Process2Basics of Health Insurance203Medical Documentation504Diagnostic Coding925Procedural Coding1146The Health Insurance Claim Form1547Electronic Data Interchange2368Receiving Payments and Insurance Problem Solving2589Office and Insurance Collection Strategies286Unit 3Health Care Payers10Managed Care Systems33011Medicare35012Medicaid and Other State Programs38613TRICARE and CHAMPVA39814Workers' Compensation42615Disability Income Insurance and Disability Benefits Programs466Unit 4Inpatient and Outpatient Billing16Hospital Billing488Unit 5Employment17Seeking a Job and Attaining Professional Advancement528App. AAddresses for Submitting Claims or Contracting State Insurance Commissioners and State Boards of Medical Examiners559App. BReference List of Audiotapes, Books, Newsletters, Periodicals, Software, and Videotapes593App. CMedi-Cal605App. DHow to Use the Student Software Challenge: Installation and Operating Instructions627Glossary633Index650
