Medical Insurance: A Revenue Cycle Process Approach https://www.mheducation.com/cover-images/Jpeg_250-high/0077840275.jpeg?404URL=https://shop.mheducation.com/mhshopweb/images/no_cover_140.png
– Connect: A highly reliable, easy-to-use homework and learning management solution that embeds learning science and award-winning adaptive tools to improve student results.
- Emphasizes the medical office Revenue Cycle—ten steps that clearly identify components needed to systematically manage the medical insurance claims process.
- Includes collecting and posting co-payments as well as proper collections procedures.
- The claims cases can be completed via CMS-1500 form activities or by using simulated Medisoft exercises, both available in Connect.

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Table of Contents

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Program Details

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

Part 6 CLAIM CODING: ICD-9-CM

Chapter 18-Diagnostic Coding: Introduction to ICD-9-CM and ICD-10-CM

Appendix A Guide to Medisoft

Appendix B Guide to the Interactive Simulated CMS-1500 Form

Appendix C Place of Service Codes

Appendix D Professional Websites

Appendix E Forms

Abbreviations

Glossary

Index