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Medical Insurance ISE

8th Edition

1260568644 · 9781260568646

By Joanne Valerius, Nenna L. Bayes, Cynthia Newby, Amy L. Blochowiak

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Preface

Acknowledgments

Part 1 WORKING WITH MEDICAL INSURANCE AND BILLING

Chapter 1-Introduction to the Medical Billing Cycle

Chapter 2- Electronic Health Records, HIPAA, and HITECH: Sharing and Protecting Patients' Health Information

Chapter 3-Patient Encounters and Billing Information

Part 2 CLAIM CODING

Chapter 4- Diagnostic Coding: Introduction to ICD-10-CM

Chapter 5- Procedural Coding: CPT and HCPCS

Chapter 6-Visit Charges and Compliant Billing

Part 3 CLAIMS

Chapter 7-Health Care Claim Preparation and Transmission

Chapter 8-Private Payers/BlueCross BlueShield

Chapter 9-Medicare

Chapter 10-Medicaid

Chapter 11- TRICARE and CHAMPVA

Chapter 12-Workers' Compensation and Disability/Automotive Insurance

Part 4 CLAIM FOLLOW-UP AND PAYMENT PROCESSING

Chapter 13-Payments (RAs), Appeals, and Secondary Claims

Chapter 14-Patient Billing and Collections

Chapter 15- Primary Case Studies

Chapter 16-RA/Secondary Case Studies

Part 5 HOSPITAL SERVICES

Chapter 17-Hospital Billing and Reimbursement

The Eighth edition of Medical Insurance: A Revenue Cycle Process Approach emphasizes the revenue cycle—ten steps that clearly identify all the components needed to successfully manage the medical insurance claims process . The cycle shows how administrative medical professionals “follow the money .” Medical insurance specialists must be familiar with the rules and guidelines of each health plan in order to submit proper documentation, which then ensures that offices receive maximum, appropriate reimbursement for services provided . Learn the skills you need for your health professions career using multiple digital resources . Read and study the content more effectively—spending more time on topics you don’t know and less time on the topics you do by using SmartBook®, McGraw-Hill Education’s revolutionary adaptive learning technology

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