Author: Marilyn Takahashi Fordney

Publisher: Saunders

Published: 2008

Total Pages: 746

ISBN-13: 9781416036661

Trusted by medical insurance specialists for more than 30 years, Insurance Handbook for the Medical Office helps you excel at all aspects of insurance billing for a full range of today's health care plans. This edition helps you keep pace with industry changes, featuring the latest information on HIPAA regulations, diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, and more. The accompanying Student Workbook with CD-ROM (sold separately) lets you practice "real world" billing with patient simulations using Altapoint and the Student Software Challenge. Procedural (CPT and HCPCS) and diagnostic (ICD-9-CM) coding and documentation are emphasized, since they are the keystones to obtaining maximum reimbursement. Key terms are bolded at first mention, explained within the context of the discussion, and defined in the glossary. Separate chapters on Electronic Data Interchange and HIPAA Compliance and Privacy in Insurance Billing provide essential knowledge of electronic claims filing, informing you of submission guidelines used in the majority of medical offices today. Icons clearly identify each insurance payer with a specific color and graphic, making specific information easy to locate. Compliance features located at appropriate points throughout most chapters offer tips to ensure compliance with correct billing and coding practice, particularly HIPAA and OIG. A separate chapter on documentation in the medical office describes how proper documentation can prevent penalties and refund requests, and help you prove compliance in the case of an audit or review. Detailed examples and samples of completed insurance forms show you how to apply knowledge in the real world. Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist's role in filing clean claims, solving problems that do occur, and collecting overdue payments. Service to Patient feature throughout the chapters focuses on ways to provide quality service to the patient as well as your co-workers. All content has been reviewed by industry experts and meticulously updated to reflect recent changes in insurance claim filing. In addition to the list of key terms at the beginning of each chapter, a separate list of key abbreviations clarifies common terms identified in the field primarily by their abbreviations. Key points at the end of each chapter briefly summarize important chapter content to help you better understand the subject matter.