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Author Richards, Cynthia A.

Title Coding basics : medical billing and reimbursement fundamentals / Cynthia A. Richards.

Publication Info. Australia ; Clifton Park, NY : Delmar Cengage Learning, [2010]
©2010

Copies

Location Call No. Status
 Plainville Public Library - Non Fiction  651.5 RIC    DUE 04-06-24
Description xxiv, 310 pages ; : illustrations, forms ; 28 cm. + 2 CD-ROM (4 3/4 in.).
Series Coding basics series
System Details System requirements: Computer with CD-ROM drive; Microsoft Windows 98 SE, Windows 2000, Windows XP, or Windows Vista; Pentium PC 500 MHz or higher (750 MHz recommended); 64 MB of RAM (128 MB recommended); 32 MB free hard drive space; monitor screen resolution 800 x 600 pixels; 16-bit color (thousands of colors); mouse; printer with 16 MB memory recommended.
Bibliography Includes bibliographical references (page 275) and index.
Contents Reviewers -- Preface -- How to use text -- Acknowledgements -- 1: Reimbursement Specialist -- Career as a reimbursement specialist -- Job description -- Accounts receivable -- Personal qualifications -- Certifications -- Job market -- 2: Office Procedures -- Office training -- Information exchange -- Medical record -- Office equipment -- Office policies and HIPAA -- Professionalism -- 3: Patient Information -- Review -- Clean claims -- Office dynamics -- Making the appointment -- Check in -- Clinical services -- Checkout -- Claim submission -- Cash flow -- 4: CMS-1500 Form -- Patient information -- CMS-1500 form -- CMS-1500 form layout -- Instructions for completing the form -- CMS-1500 form submission -- Multiple insurances -- 5: Health Insurance -- Reimbursement terminology -- Managed care -- Types of managed care -- Credentialing -- 6: Medicare -- Medicare overview -- History of Medicare -- Medicare eligibility -- Medicare plans -- Medigap -- Medicare as a secondary payer -- Medicare secondary payer questionnaire -- Medicare reimbursement -- Participating physicians -- Medicare rules and regulations -- Excluded services -- Rules and regulations resources -- Fraud and abuse -- Reimbursement process -- Billing Medicare on the CMS-1500 form -- 7: Blue Cross Blue Shield, Medicaid, TRICARE, Commercial, And Workers' Compensation Insurances -- Blue Cross Blue Shield -- History of Blue Cross Shield -- Blue Cross Blue Shield plans -- Physician participation -- Medicaid -- Medicaid eligibility -- Covered services -- Medicaid claim submission -- TRICARE -- History of TRICARE insurance -- TRICARE plans -- TRICARE billing -- CHAMPVA -- Commercial insurances -- Workers' compensation -- History of workers' compensation insurance -- Federal workers' compensation programs -- State workers' compensation programs -- Office procedures -- Insurance summary --
8: Coding Overview Of CPT And ICD-9-CM Coding -- ICD-9-CM coding -- History of ICD-9-CM coding -- ICD-9-CM updates -- ICD-10 -- ICD-9-CM manual -- Steps to coding -- Volume 2: Index and tabular listings -- Volume 1: Tabular list of diseases -- ICD-9-CM guidelines -- CPT coding -- CPT manual -- CPT manual format -- CPT modifiers -- CPT unlisted codes -- Additional information in the CPT manual -- Coding with the CPT manual -- HCPCS National Level II Codes -- 9: Charge Entry -- Encounter forms -- Patient flow in the medical office -- Auditing -- Documentation -- Fraud vs abuse -- Compliance training -- 10: Payment Entry -- Payment entry -- Explanation of benefits -- Payment posting -- Denials and rejections -- Secondary insurances -- 11: Problem Solving -- Understanding reimbursement problems -- Appeals -- Talking with the insurance company -- 12: Aged Trial Balance Reports -- Account receivable -- Aged Trial Balance Reports -- Billing cycle -- Implementation of the Aged Trial Balance Report -- Resulting reimbursement problems -- 13: Collections -- Collections -- Payment at the time of service -- Outstanding balances -- Write-offs -- Collection agencies -- Federal and state collection laws -- 14: Resumes And Interviews -- Resume -- Resume basics -- Contact information -- Objective -- Summary of qualifications -- Education -- Skills -- Experience -- Cover letter -- Interview -- Professional presentation -- Preparing for the interview -- Interview questions -- Interview process -- Thank you letter -- Appendix 1: Case studies -- Appendix 2: Internet links -- Appendix 3: Forms -- Appendix 4: Medical terminology review -- Roots, prefixes, and suffixes -- Roots -- Prefixes -- Suffixes -- Glossary -- Index.
Summary From the Publisher: Coding Basics: Medical Billing and Reimbursement Fundamentals is part of a series designed to provide you with the foundation to work in today's medical office. This installment features real-world claim forms and reports for hands-on practice to build the skills you need to acquire an entry-level job in today's medical office. Billing and reimbursement concepts are presented clearly and concisely, with opportunities for practice throughout.
Note SIMClaim student practice software, version 1.1, provides practice using the CMS-1500 claim forms; Encoder Pro software (30-day free trial, version 5.4.1, D2009/DELM) allows user to look up ICD-9-CM, CPT, and HCPCS level II codes.
Subject Medical records -- Management.
Medicine -- Terminology -- Code numbers.
Nosology -- Code numbers.
Medical claims processing industry -- Code numbers.
Health insurance claims.
Medical offices.
Medical fees.
Medicine -- Practice -- Economic aspects.
Healthcare Common Procedure Coding System.
Forms and Records Control -- methods.
Insurance Claim Reporting -- Terminology.
Reimbursement Mechanisms -- Terminology.
Added Title Medical billing and reimbursement fundamentals
Spine Title Medical billing & reimbursement fundamentals
ISBN 9781428318021
142831802X
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