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Insurance Handbook for the Medical Office » (11st Edition)

Book cover image of Insurance Handbook for the Medical Office by Marilyn Fordney

Authors: Marilyn Fordney
ISBN-13: 9781437701289, ISBN-10: 1437701280
Format: Paperback
Publisher: Elsevier Health Sciences
Date Published: September 2009
Edition: 11st Edition

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Author Biography: Marilyn Fordney

Marilyn Takahashi Fordney, CMA-AC, CMT, Formerly Instructor of Medical Insurance, Medical Terminology, Medical Machine Transcription, and Medical Office Procedures, Ventura College, Ventura, CA.

Book Synopsis

INSURANCE HANDBOOK FOR THE MEDICAL OFFICE is a key text for medical administrative assisting, medical front office programs, or those who wish to become insurance billing specialists, claims assistance professionals, or electronic claims processors for physicians' practices and hospital outpatient clinics. Those already practicing in this area will also find this text beneficial, as will health claims examiner programs. The goal of this extremely up-to-date text is to increase efficiency and streamline administrative procedures for the most exasperating aspect of the doctor's office routine: insurance billing. This text offers guidance for all aspects of submitting, tracing, appealing, and transmitting claims for today's full range of health plans. Important coverage of diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, Managed Care, and more is presented. Additionally, a free CD-ROM featuring the HCFA-1500 claim form is included with the book. The CD-ROM contains 10 scored patient case studies with related insurance information so that the student can practice completing the HCFA-1500 claim form in a fun, interactive format.

Table of Contents

Unit 1Career Role and Responsibilities
1Role of an Insurance Billing Specialist2
Unit 2The Claims Process
2Basics of Health Insurance20
3Medical Documentation50
4Diagnostic Coding92
5Procedural Coding114
6The Health Insurance Claim Form154
7Electronic Data Interchange236
8Receiving Payments and Insurance Problem Solving258
9Office and Insurance Collection Strategies286
Unit 3Health Care Payers
10Managed Care Systems330
11Medicare350
12Medicaid and Other State Programs386
13TRICARE and CHAMPVA398
14Workers' Compensation426
15Disability Income Insurance and Disability Benefits Programs466
Unit 4Inpatient and Outpatient Billing
16Hospital Billing488
Unit 5Employment
17Seeking a Job and Attaining Professional Advancement528
App. AAddresses for Submitting Claims or Contracting State Insurance Commissioners and State Boards of Medical Examiners559
App. BReference List of Audiotapes, Books, Newsletters, Periodicals, Software, and Videotapes593
App. CMedi-Cal605
App. DHow to Use the Student Software Challenge: Installation and Operating Instructions627
Glossary633
Index650

Subjects