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Medical Insurance: A Revenue Cycle Process Approach https://www.mheducation.com/cover-images/Jpeg_400-high/1259608557.jpeg 8 2020 9781259608551 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
09781259608551
Medical Insurance: A Revenue Cycle Process Approach
Medical Insurance: A Revenue Cycle Process Approach

Medical Insurance: A Revenue Cycle Process Approach, 8th Edition

ISBN10: 1259608557 | ISBN13: 9781259608551
By Joanne Valerius, Nenna Bayes, Cynthia Newby, Amy Blochowiak, Janet Seggern

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* The estimated amount of time this product will be on the market is based on a number of factors, including faculty input to instructional design and the prior revision cycle and updates to academic research-which typically results in a revision cycle ranging from every two to four years for this product. Pricing subject to change at any time.

Additional Product Information:

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

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


Connect

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Available within Connect, SmartBook 2.0 is an adaptive learning solution that provides personalized learning to individual student needs, continually adapting to pinpoint knowledge gaps and focus learning on concepts requiring additional study. SmartBook 2.0 fosters more productive learning, taking the guesswork out of what to study, and helps students better prepare for class. With the ReadAnywhere mobile app, students can now read and complete SmartBook 2.0 assignments both online and off-line. For instructors, SmartBook 2.0 provides more granular control over assignments with content selection now available at the concept level. SmartBook 2.0 also includes advanced reporting features that enable instructors to track student progress with actionable insights that guide teaching strategies and advanced instruction, for a more dynamic class experience.

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About the Author

Joanne Valerius

Nenna Bayes

Nenna L. Bayes , AAS, BBA, M.Ed., CPC, has coauthored
and reviewed various titles within the medical administrative fields. She earned an
associate of applied business degree, a bachelor of business administration degree,
and a masters of arts in education from Morehead State University. During her tenure,
she has taught numerous courses within the administrative and medical administrative
curriculum. She is a professor in and the program coordinator for the Office
Systems Technology and Medical Information Technology programs at Ashland
Community and Technology College in Ashland, Kentucky, and has received many
teaching excellence awards. She is also a certified professional coder (CPC). Prior to
teaching, she worked in various medical office environments. Additionally, she is a
member of the American Academy of Professional Coders (AAPC) and the American
Health Information Management Association (AHIMA).
She lives in Flatwoods, Kentucky, with her husband and is blessed to have two
children and two granddaughters . She is actively involved in music and enjoys
camping in her leisure time.

Cynthia Newby

Cynthia Newby, CPC, CPC-P, is a long-serving author who works closely with McGraw-Hill Education instructional development staff to develop excellent MIBC programs. Cynthia is a graduate of Hood College and a trustee of that institution as well as her local animal shelter and library.

Amy Blochowiak

Amy L. Blochowiak, MBA, RHIT, ACS, AIAA, AIRC, ARA,FLHC, FLMI, HCSA, HIA, HIPAA, MHP, PCS, SILA-F, has coauthored and reviewed various textbooks within the medical administrative and insurance fields. She earned associate degrees in medical office mid-management and health information technology from Northeast Wisconsin Technical College, bachelor’s degrees in both business administration and marketing from Lakeland College, and a master’s degree in business administration from Lakeland College. She is currently the program director and instructor for the Healthcare Business Professional program at Northeast Wisconsin Technical College, where she sits on many committees and shares her passion for student success. Prior to teaching, she worked in various insurance industry roles for over 16 years. She is a member of the American Health Information Management Association (AHIMA).

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