Medical Insurance: An Integrated Claims Process Approach
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The fourth edition of Medical Insurance: An Integrated Claims Process Approach is designed for medical insurance courses. The textbook provides medical assisting, medical insurance, and health information technology students with the knowledge and skills needed to successfully perform insurance and billing related duties.The chapters’ organization follows the medical billing process to enhance learning, moving from a comprehensive introductory chapter through processing RA/EOBs and handling patient collections. Every chapter has extensive illustrations, forms, and exercises to develop the required competencies as well as exercises to improve underlying essential math and communications skills. This text also provides a fundamental understanding of diagnostic and procedural coding needed to submit claims in compliance with payers’ requirements. New for this edition is a text-specific workbook which provides both review and applications of each textbook chapter.
PART 1 WORKING WITH MEDICAL INSURANCE AND BILLINGCHAPTER 1 INTRODUCTION TO THE MEDICAL BILLING PROCESSCHAPTER 2 HIPAA AND MEDICAL RECORDSCHAPTER 3 PATIENT ENCOUNTERS AND BILLING INFORMATIONPART 2 CLAIM CODINGCHAPTER 4 DIAGNOSTIC CODING: INTRODUCTION TO ICD-9-CMCHAPTER 5 PROCEDURAL CODING: INTRODUCTION TO CPTCHAPTER 6 PROCEDURAL CODING: INTRODUCTION TO HCPCSPART 3 CLAIM PREPARATIONCHAPTER 7 VISIT CHARGES AND COMPLIANT BILLINGCHAPTER 8 HEALTH CARE CLAIM PREPARATION AND TRANSMISSIONPART 4 PAYERSCHAPTER 9 PRIVATE PAYERS/BLUE CROSS AND BLUE SHIELDCHAPTER 10 MEDICARECHAPTER 11 MEDICAIDCHAPTER 12 TRICARE AND CHAMPVACHAPTER 13 WORKERS'COMPENSATION AND DISABILITYPART 5 PAYMENT PROCESSINGCHAPTER 14 PAYMENTS (RAs/EOBs), APPEALS, AND SECONDARY CLAIMSCHAPTER 15 PATIENT BILLING AND COLLECTIONSPART 6 HOSPITAL SERVICESCHAPTER 16 HOSPITAL BILLING AND REIMBURSEMENTPART 7 CLAIM CASE STUDIESCHAPTER 17 PRIMARY CLAIM CASESCHAPTER 18 EOB/RA/SECONDARY CLAIM CASESGUIDE TO MEDISOFTAppendix A Medical Billing and Coding Careers Appendix B Place of Service CodesAppendix C Medical Specialities and Taxonomy CodesAppendix D Professional Web Sites Appendix E Forms Appendix F HIPAA FAQs ABBREVIATIONSGLOSSARY INDEX
