- Features completely updated information that reflects the many changes in the insurance industry. - Contains a new chapter on UB-92 insurance billing for hospitals and outpatient facilities. - Includes a new appendix, Quick Guide to HIPAA for the Physician's Office, to provide a basic overview of the important HIPAA-related information necessary on the job.
A bestseller for over 25 years, this text helps users excel at all aspects of insurance billing: submitting, tracing, appealing, and transmitting claims. Its comprehensive coverage also includes important information on diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, Managed Care, and more. This edition has been reviewed by industry experts and carefully updated to reflect recent changes in the industry - including the addition of special HIPAA Compliance Alerts throughout the book to help users comply with important governmental privacy regulations. Instructor resources are available; please contact your Elsevier sales representative for details. Icons help students identify each insurance payer with a specific color and graphic, making the learning process more effective. Emphasizes procedural (CPT and HCPCS) and diagnostic (ICD-9-CM) coding and documentation since they are the keystones to obtaining maximum reimbursement. Block-by-block teaching approach organized by payer category for the CMS-1500 claim form facilitates understanding, effective learning, and greater productivity. Detailed examples and samples of completed insurance forms help students see how knowledge is applied in the real world. Accompanying CD-ROM of practice software bound in the back of the book features the CMS-1500 claim form and 10 scored patient case studies with related insurance information to simulate real-life situations. Updated to reflect recent changes in the industry. Special sections highlight areas pertinent to HIPAA regulations.
A complete guide to insurance billing and coding, Insurance Handbook for the Medical Office, 13th Edition covers all the plans that are most commonly encountered in clinics and physicians’ offices. Its emphasis on the role of the medical insurance specialist includes areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. Learning to fill in the claim form accurately is made easier by the use of icons for different types of payers, lists of key abbreviations, and numerous practice exercises. This edition provides the latest on hot topics such as ICD-10, healthcare reform, the new CMS-1500 form, and electronic claims. Trusted for more than 30 years, this proven reference from Marilyn Fordney prepares you to succeed as a medical insurance professional in any outpatient setting. Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist in filing clean claims, solving problems, and collecting overdue payments. Key terms and key abbreviations are defined and emphasized, reinforcing your understanding of new concepts and terminology. Detailed tables, boxes, and illustrations call out key points and main ideas. Unique! Color-coded icons clarify information, rules, and regulations for different payers. An Evolve companion website enhances learning with performance checklists, self-assessment quizzes, and the Student Software Challenge featuring cases for different payer types and an interactive CMS-1500 form to fill in. A workbook contains learning tips, practice exercises for key terms and abbreviations, review questions, study outlines, performance objectives, a chapter with practice tests, and critical thinking activities for hands-on experience with real-world cases. Available separately. Updated coverage of key health insurance topics includes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, electronic claims, ICD-10, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, Meaningful Use, and CPT 2013. Updated ICD-10 coding information prepares you for the October 2014 ICD-10 implementation date. Updated content on claim forms includes block-by-block explanations and examples for the new CMS-1500 Claim Form. Updated guidelines for the filing and submission of electronic claims include sample screenshots and prepare you for the future of the medical office.
Stay up on the latest in insurance billing and coding with Marilyn Fordney s Insurance Handbook for the Medical Office, 14th Edition.Trusted for more than 30 years, this market-leading handbook equips you to succeed as medical insurance specialist in any of today s outpatient settings. Coverage emphasizes the role of the medical insurance specialist in areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. As with previous editions, all the plans that are most commonly encountered in clinics and physicians offices are incorporated into the text, as well as icons for different types of payers, lists of key abbreviations, and numerous practice exercises that assist you in accurately filling out claim forms. This new edition also features expanded coverage of ICD-10, electronic medical records, electronic claims submission, and the HIPAA 5010 keeping you one step ahead of the latest practices and protocols of the profession.Key terms are defined and emphasized throughout the text to reinforce understanding of new concepts and terminology.Separate chapter on HIPAA Compliance in Insurance Billing, as well as Compliance Alerts throughout the text highlights important HIPAA compliance issues to ensure readers are compliant with the latest regulations. Emphasis on the business of running a medical office and the importance of the medical insurance specialist details the importance of the medical insurance specialist in the business of the medical office.Increased focus on electronic filing/claims submission prepares readers for the industry-wide transition to electronic claims submission.Separate chapter on documentation in the medical office covers the principles of medical documentation and the rationales for it."Service to Patient" features in most chapters offer examples of good customer service.User resources on the Evolve companion website feature performance checklists, self-assessment quizzes, the Student Software Challenge (with cases on different payer types and an interactive CMS-1500 (02-12) form to fill in). NEW! Expanded coverage of ICD-10 prepares users to code ICD-10 with the planned effective date of October 2015.NEW! Added information on the electronic medical record and electronic claims submission including information on the HIPAA 5010 equips users for the transition between paper and electronic methods of medical records and links the CMS-1500 (02-12) form to the electronic submissions process.NEW! SimChart for the Medical Office (SCMO) application activities on the companion Evolve website adds additional functionality to the insurance module on the SCMO roadmap."
Gain real-world practice in insurance billing and coding with Fordney’s Workbook for Insurance Handbook for the Medical Office, 14th Edition. This user-friendly workbook features realistic, hands-on exercises to help you apply concepts and develop critical thinking skills. Study tools include performance objectives, key terms, abbreviation lists, study outlines, critical thinking assignments, and more. Performance objectives are carried throughout the chapter to help users identify what needs to be accomplished for that chapter. Critical thinking assignments contains questions in the form of short, real-world vignettes to assist users in applying theory learned from the textbook. Self-study exercises include fill-in-the-blank, mix-and-match, multiple-choice, and true/false questions. Key terms and abbreviations lists at beginning of each chapter help to teach and reinforce new concepts and terminology. Study outlines covering the key points for each chapter in the textbook guide effective note taking during classroom lecture. NEW! Updated content reflects changes in the main text.
Stay up on the latest in insurance billing and coding with Marilyn Fordney s Insurance Handbook for the Medical Office, 14th Edition.Trusted for more than 30 years, this market-leading handbook equips you to succeed as medical insurance specialist in any of today s outpatient settings. Coverage emphasizes the role of the medical insurance specialist in areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. As with previous editions, all the plans that are most commonly encountered in clinics and physicians offices are incorporated into the text, as well as icons for different types of payers, lists of key abbreviations, and numerous practice exercises that assist you in accurately filling out claim forms. This new edition also features expanded coverage of ICD-10, electronic medical records, electronic claims submission, and the HIPAA 5010 - keeping you one step ahead of the latest practices and protocols of the profession.Key terms are defined and emphasized throughout the text to reinforce understanding of new concepts and terminology.Separate chapter on HIPAA Compliance in Insurance Billing, as well as Compliance Alerts throughout the text highlights important HIPAA compliance issues to ensure readers are compliant with the latest regulations. Emphasis on the business of running a medical office and the importance of the medical insurance specialist details the importance of the medical insurance specialist in the business of the medical office.Increased focus on electronic filing/claims submission prepares readers for the industry-wide transition to electronic claims submission.Separate chapter on documentation in the medical office covers the principles of medical documentation and the rationales for it."Service to Patient" features in most chapters offer examples of good customer service.User resources on the Evolve companion website feature performance checklists, self-assessment quizzes, the Student Software Challenge (with cases on different payer types and an interactive CMS-1500 (02-12) form to fill in). NEW Expanded coverage of ICD-10 prepares users to code ICD-10 with the planned effective date of October 2015.NEW Added information on the electronic medical record and electronic claims submission - including information on the HIPAA 5010 - equips users for the transition between paper and electronic methods of medical records and links the CMS-1500 (02-12) form to the electronic submissions process.NEW SimChart for the Medical Office (SCMO) application activities on the companion Evolve website adds additional functionality to the insurance module on the SCMO roadmap."
This concise, practical text-workbook provides extensive real-world practice with the universal medical insurance claim form, the HCFA 1500. Includes flow charts, claims processing forms, and medical reports. Coding and billing content is based on industry practice and addresses electronic claims and a variety of compliance issues. The text provides a brief introduction to MediSoft Advanced Patient Billing Software.
Offering guidance for all aspects of submitting, tracing, appealing, and transmitting claims for today's full range of health plans, this essential reference streamlines administrative procedures and increases office efficiency during the insurance billing process. The 9th edition has been completely updated to include the latest information on essential topics such as the HIPAA regulations, diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, and more. In addition, this trusted resource of choice for medical insurance specialists is now printed in full color and contains a CD-ROM that features Altapoint software that simulates the billing process and provides "real world" experience.
