The definitive guide to starting a successful career in medical billing and coding With the healthcare sector growing at breakneck speed—it’s currently the largest employment sector in the U.S. and expanding fast—medical billing and coding specialists are more essential than ever. These critical experts, also known as medical records and health information technicians, keep systems working smoothly by ensuring patient billing and insurance data are accurately and efficiently administered. This updated edition provides everything you need to begin—and then excel in—your chosen career. From finding the right study course and the latest certification requirements to industry standard practices and insider tips for dealing with government agencies and insurance companies, Medical Billing & Coding For Dummies has you completely covered. Find out about the flexible employment options available and how to qualify Understand the latest updates to the ICD-10 Get familiar with ethical and legal issues Discover ways to stay competitive and get ahead The prognosis is good—get this book today and set yourself up with the perfect prescription for a bright, secure, and financially healthy future!
It does not matter how bad your financial situation seems to be, The Medical Bill Survival Guide will provide you with the knowledge to help yourself or your loved one. Medical bill anxiety is caused by miscommunications and misunderstandings. This book teaches easy, effective strategies for working with insurance companies, hospitals, doctors, and other healthcare providers.
Updated for 2018 ICD-10 guidelines, this 6 page laminated guide covers core essentials of coding clearly and succinctly. Author Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, AHIMA-approved ICD-10-CM/PCS trainer used her knowledge and experience to provide the largest number of valuable facts you can find in 6 pages, designed so that answers can be found fast with color coded sections, and bulleted lists. A must for students seeking coding certification and a great desktop refresher for professionals. 6-page laminated guide includes: General Coding & Legal Guidelines Coding Tips Conditions & Diagnoses Diagnosis Coding Pathology & Laboratory Reimbursement & Billing Tips Coding Evaluation & Management Services ICD-10 Terms, Notations & Symbols Wounds & Injuries Important Resources Anesthesia, Surgery & Radiology Diagnostic Coding
Make sure home health billing staff is well trained Home health care billing is a complicated task. Make sure that you are receiving all the payment you've earned, with accurate, compliant, and competent billing practices. The How-to Guide for Home Health Billing is your comprehensive guide to the many complex elements involved., helping you to provide the best training possible to billing staff and those who impact billing. You'll increase competence and confidence about billing requirements and practices. This book will help you: * Provide effective training for all billing staff, whether new to billing, or new to the home care system; along with tips for other agency staff such as therapists and nurses, who impact the billing process, on collaborating to ensure billing accuracy. * Focus on red flag areas and understand the complicated relationship between billing and coding/OASIS assessments. * The guide will give you the practical "nuts and bolts" education and information you need by taking difficult concepts and explaining them in an easy to understand way. * This step-by-step guide to billing not only covers Medicare, but also Medicaid and commercial insurance billing.
"This workbook explains the fundamentals of how to work effectively as a medical office insurance staff member. It introduces individuals to the various steps of filing a claim and the role that insurance staff members play in claims processing and thus in the organization's financial health"--Provided by publisher.
Master coding concepts related to medical necessity and report compliant codes for your services. Revenue loss, rework, payback demands—how much are medical necessity errors costing your practice? And that’s to say nothing of potential civil penalties. Get medical necessity wrong and it’s considered a “knowingly false” act punishable under the FCA. Stay liability-free and get reimbursed for your services with reliable medical necessity know-how. AAPC’s Coding for Medical Necessity Reference Guide provides you with step-by-step tutorials to remedy the range of documentation and coding issues at the crux of medical necessity claim errors. Learn how to integrate best practices within your clinical processes—including spot-checks and self-audits to identify problems. Benefit from real-world reporting examples, Q&A, and expert guidance across specialties to master coding for medical necessity. Learn how to lock in medical necessity and keep your practice safe and profitable: Avoid Medical Necessity Errors with CERT Smarts Rules to Improve Provider Documentation Denials? Pay Attention to Procedure/Diagnosis Linkage Nail Down the Ins and Outs of Time-based Coding Expert Guidance to Fend Off RAC Audits and Denials Beat E/M Coding Confusion with Payer Advice Improve Your ABN Know How with This FAQ
LAUNCH A CAREER IN MEDICAL CLAIMS BILLING The market for medical claim billers is growing exponentially. With legions of providers and an ever-expanding patient pool, health-care industry spending is expected to grow by 5.8 percent each year through 2024. By then, health-care spending will total $5.43 trillion and account for 19.6 percent of the gross domestic product. So let there be no doubt: Health care is big business and its growth shows no signs of slowing. This makes it the perfect time to start your own medical claims billing service.
Recoup lost time and revenue with denials management and appeals know-how. Claim denials can sink a profit margin. And given the cost of appeals, roughly $118 per claim, not all denials can be reworked. A practice submitting 50 claims a day at an average reimbursement rate of $200 per claim should bring in $10,000 in daily revenue. But if 10% of those claims are denied, and the practice can only appeal one, they lose $800 per day—upwards of $200K annually. Your medical claims are the lifeblood of operations. Don’t compromise your financial health. Learn how to preempt denials with the Denials Management & Appeals Reference Guide. This vital resource will equip you to get ahead of payers by simplifying the leading causes of denials and showing you how to address insufficient documentation, failing to establish medical necessity, coding and billing errors, coverage stipulations, and untimely filing. Rely on AAPC to walk you through the appeal process. We’ll help you establish protocols to avoid an appeals backlog and teach you how to identify and prioritize denials likely to win an appeal. What’s more, you’ll learn when a claim can be “reopened” to fix a problem. Collect the revenue your practice deserves with effective denials and appeals solutions: Know how to analyze your denials Defeat documentation and compliance issues for successful claims success Utilize payer policy for coverage clues Lock in revenue with face-to-face reimbursement guidance Refine efforts to avoid E/M claim denials Ace ICD-10 coding for optimum reimbursement Put an end to modifier confusion Stave off denials with CCI edits advice Navigate the appeals process like a pro And much more!
- Updated Claim Forms chapter covers the UB-04 claim form. - Updated information covers diagnosis and procedural coding, with guidelines and applications. - Updated claim forms and names are used throughout.
The Essential Guide to Coding in Otolaryngology: Coding, Billing, and Practice Management, Second Edition is a comprehensive manual on how to properly and compliantly code for both surgical and non-surgical services. It is a practical guide for all otolaryngology providers in the United States, including physicians early in their career requiring a working knowledge of the basics, experienced providers looking to understand the latest updates with ICD-10-CM and CPT changes, related specialists (audiology, speech pathology, and physician extenders) providing otolaryngologic health care, and office administrative teams managing coding and billing. Included are sections on how to approach otolaryngology coding for all subspecialties in both the office and operating room. Foundational topics, such as understanding the CPT and ICD-10-CM systems, use of modifiers, managing claim submissions and appeals, legal implications for the provider, coding for physician extenders, and strategies to optimize billing, are presented by experts in the field. Focused on a practical approach to coding, billing, and practice management, this text is user-friendly and written for the practicing physician, audiologist, speech pathologist, physician extender, and coder. The income and integrity of a medical practice is tied to the effectiveness of coding and billing management. As profit margins are squeezed, the ability to optimize revenue by compliant coding is of the upmost importance. The Essential Guide to Coding in Otolaryngology: Coding, Billing, and Practice Management, Second Edition is vital not only for new physicians but for experienced otolaryngologists. New to the Second Edition: * Strategies for integrating revised guidelines for coding and documenting office visits * New and evolving office and surgical procedures, including Eustachian tube dilation and lateral nasal wall implants * Updated coding for endoscopic sinus surgery and sinus dilation * Billing for telehealth visits * Revision of all sub-specialty topics reflecting changes in coding and new technologies * New and revised audiologic diagnostic testing codes Key Features * All chapters written by practicing otolaryngologists, health care providers, practice managers, legal experts, and coding experts * Discussion of the foundations of coding, billing, and practice management as well as advanced and complex topics * Otolaryngology subspecialty-focused discussion of office-based and surgical coding * Tips on how to code correctly in controversial areas, including the use of unlisted codes * A robust index for easy reference
