Description |
xxiv, 310 pages ; : illustrations, forms ; 28 cm. + 2 CD-ROM (4 3/4 in.). |
Series |
Coding basics series
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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 -- |
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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.
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Medicine -- Terminology -- Code numbers.
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Nosology -- Code numbers.
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Medical claims processing industry -- Code numbers.
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Health insurance claims.
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Medical offices.
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Medical fees.
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Medicine -- Practice -- Economic aspects.
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Healthcare Common Procedure Coding System.
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Forms and Records Control -- methods.
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Insurance Claim Reporting -- Terminology.
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Reimbursement Mechanisms -- Terminology.
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Added Title |
Medical billing and reimbursement fundamentals |
Spine Title |
Medical billing & reimbursement fundamentals |
ISBN |
9781428318021 |
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142831802X |
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