The Practice of Health Claims Examining
2nd Edition
Published on 7. November 2006
Book
Paperback/Softback
300 pages
978-0-13-219389-4 (ISBN)
Description
Formally known as Exercises in Health Claims Examining, The Practice of Health Claims Examining, 2e, contains a simulated work program to help you experience the real life situations that a claims examiner experiences on a daily basis. This book is created for use in conjunction with ICDC Publishing's Guide to Health Claims Examining. Some of the exercises in the simulated work portion of the book are based upon concepts learned in the Guide to Health Claims Examining (i.e., procedures for processing claims, interpretation of contracts, understanding UCR and deductibles, etc.). This book alone should not be considered a complete text for learning health claims examining. It is suggested that a trainee take a complete health claims examining course prior to using this book. The simulated work portion of this text incorporates concepts which are not taught by simple data entry, for example UCR calculations, privacy guidelines, client record keeping, correspondence, and manual completion of claims processing. This text is designed to allow the student to work through the material at their own pace.
More details
Edition
2nd edition
Language
English
Place of publication
United States
Publishing group
Pearson Education (US)
Target group
Professional and scholarly
Dimensions
Height: 276 mm
Width: 216 mm
Weight
885 gr
ISBN-13
978-0-13-219389-4 (9780132193894)
Copyright in bibliographic data and cover images is held by Nielsen Book Services Limited or by the publishers or by their respective licensors: all rights reserved.
Schweitzer Classification
Other editions
Previous edition
ICDC Publishing Inc.
Exercises in Health Claims Examining
Book
09/2006
Pearson
€35.26
Article exhausted; check for reprint
Content
Table Of Contents
Section 1. Introduction
Let's Begin
Setting Up Your Desk
Family Files
Section 2. Simulated Work Program
About the Claims 5
Day 1 - April 1, CCYY
Day 2 - April 2, CCYY
Day 3 - April 3, CCYY
Day 4 - April 4, CCYY
Day 5 - April 5, CCYY
Section 3. Documents
Document 1 - Confidential Disclosure Agreement
Document 2 - Time Sheet
Document 3 - Ball Insurance Carriers Contract
Document 4 - Rover Insurers Inc. Contract
Document 5 - Winter Insurance Corporation Contract
Document 6 - Summer Insurance Company Contract
Document 7 - Assistant Surgeon's List
Document 8 - Eligibility Information Sheet (Dunnitt, D. Jobb)
Document 9 - Eligibility Information Sheet (Poole, Gene)
Document 10 - Eligibility Roster /Ball Insurance Carriers (January)
Document 11 - Eligibility Roster/Ball Insurance Carriers (February)
Document 12 - Eligibility Information Sheet (Allity, Ray)
Document 13 - Eligibility Roster/Winter Insurance Carriers (March)
Document 14 - Eligibility Information Sheet (Waite, Hugh)
Document 15 - Eligibility Roster/Winter Insurance Carriers (January)
Document 16 - Relative Value Study
Document 17 - Eligibility Information Sheet (O'Gen, Pat N.)
Document 18 - Eligibility Roster/Rover Insurers, Inc. (January)
Document 19 - Eligibility Information Sheet (Pendent, Codie)
Document 20 - Network Provider Listing/Rover Insurers, Inc. (February)
Document 21 - Eligibility Information Sheet (Attricks, Sherry)
Document 22 - Eligibility Roster/Rover Insurers, Inc. (March)
Document 23 - Eligibility Roster/Winter Insurance Carriers (February)
Document 24 - Eligibility Information Sheet (Knose, Al Weighs)
Document 25 - Beginning Financials
Document 26 - Eligibility Information Sheet (Theroad, Kent C.)
Document 27 - Network Provider Listing/Rover Insurers, Inc. (January)
Document 28 - Eligibility Information Sheet (Cupp, Hick)
Document 29 - Eligibility Roster/Rover Insurers, Inc. (February)
Document 30 - Eligibility Information Sheet (Early, Brighton)
Document 31 - UCR Conversion Factor Report Medical
Document 32 - Eligibility Information Sheet (Fever, Cab N.)
Document 33 - Eligibility Information Sheet (Hart, Shay Kee)
Document 34 - Eligibility Roster/Ball Insurance Carriers (March)
Document 35 - Eligibility Information Sheet (Fraide, B.A.)
Document 36 - Network Provider Listing/Rover Insurers, Inc. (March)
Document 37 - CMS-1500: O'Gen, Ox
Document 38 - CMS-1500: Attricks, Petey
Document 39 - CMS-1500: Attricks, Petey
Document 40 - CMS-1500: Pendent, Dee
Document 41 - CMS-1500: Dunnitt, D. Jobb
Document 42 - Revised Eligibility Roster /Winter Insurance Carriers (January)
Document 43 - Revised Eligibility Roster /Ball Insurance Carriers (January)
Document 44 - Ball Insurance Carriers: Memo
Document 45 - CMS-1500: Allity, Mort
Document 46 - CMS-1500: Poole, Carla
Document 47 - CMS-1500: Knose, Ima
Document 48 - CMS-1500: Knose, Ron E.
Document 49 - CMS-1500: Poole, Gene
Document 50 - Note from Mr. B. Lawg
Document 51 - Family Benefits Tracking Sheet
Document 52 - CMS-1500: Pendent, Dee
Document 53 - CMS-1500: Theroad, Kent C.
Document 54 - CMS-1500: Tired, Barry
Document 55 - CMS-1500: Dunnitt, V. Iris
Document 56 - CMS-1500: Fever, Ty Phoid
Document 57 - CMS-1500: Pendent, Codie
Document 58 - CMS-1500: Akenja-Nearing, Jeanette
Document 59 - CMS-1500: Knose, Ron E.
Document 60 - CMS-1500: Allity, Mort
Document 61 - CMS-1500: Poole, Carla
Document 62 - Eligibility Information Sheet (Cupp, Phillip D.)
Document 63 - CMS-1500: Attricks, Sherry
Document 64 - CMS-1500: Dunnitt, Candy
Document 65 - CMS-1500: Attricks, Petey
Document 66 - CMS-1500: Pendent, Andy
Document 67 - CMS-1500: Pendent, Codie
Document 68 - CMS-1500: Dunnitt, D. Jobb
Document 69 - CMS-1500: Pendent, Dee
Document 70 - CMS-1500: Dunnitt, D. Jobb
Document 71 - CMS-1500: Waite, Hugh
Document 72 - CMS-1500: O'Gen, Cass N.
Document 73 - Note: Incorrect Payment Worksheets
Document 74 - Payment Worksheet: Chance, Luke E.
Document 75 - Payment Worksheet: Chance, Luke E.
Document 76 - Coordination of Benefits: Chance, Luke E.
Document 77 - Medicare Remittance Notice
Document 78 - CMS-1500: Cupp, Phillip D.
Document 79 - CMS-1500: Hart, Shay Kee
Document 80 - CMS-1500: Hart, Brooke N.
Document 81 - CMS-1500: Hart, Brooke N.
Document 82 - CMS-1500: Waite, Hugh
Document 83 - CMS-1500: Knose, Ron E.
Document 84 - CMS-1500: O'Gen, Cass N.
Document 85 - CMS-1500: Allity, Rhea
Document 86 - CMS-1500: Waite, P. Lisa
Document 87 - Memo: Winter Insurance Company
Document 88 - Memo: Rover Insurers, Inc.
Document 89 - CMS-1500: Attricks, Petey
Document 90 - CMS-1500: Attricks, Sherry
Document 91 - CMS-1500: Allity, Rhea
Document 92 - CMS-1500: Waite, P. Lisa
Document 93 - CMS-1500: Akenja-Nearing, Jeanette
Document 94 - CMS-1500: O'Gen, Cass N.
Document 95 - CMS-1500: Fore-Theroad, Juana
Document 96 - CMS-1500: Theroad, Kent C.
Document 97 - CMS-1500: Theroad, Ian N.
Document 98 - CMS-1500: Theroad, Ian N.
Document 99 - CMS-1500: Fore-Theroad, Juana
Document 100 - CMS-1500: Theroad, Donette
Document 101 - CMS-1500: Pendent, Dee
Document 102 - CMS-1500: Poole, Wade N.
Document 103 - CMS-1500: Knose, Beane Andy
Document 104 - Letter from Mr. I Will Wright
Document 105 - CMS-1500: Theroad, Ian N.
Document 106 - CMS-1500: Theroad, Ian N.
Document 107 - CMS-1500: Waite, Hugh
Document 108 - CMS-1500: Fore-Theroad, Juana
Document 109 - CMS-1500: Fore-Theroad Juana
Document 110 - UB-92: Pendent, Codie
Document 111 - UB-92: Allity, Rhea
Document 112 - UB-92: Attricks, Sherry
Document 113 - UB-92: Akenja-Nearing, Jeanette
Document 114 - UB-92: Poole, Wade N.
Document 115 - UB-92: Poole, Gene
Document 116 - UB-92: Allity, Mort
Document 117 - CMS-1500: Dunnitt, D. I.
Document 118 - CMS-1500: Dunnitt, D. I.
Document 119 - CMS-1500: Fraide, Jose
Document 120 - CMS-1500: Poole, Carla
Document 121 - CMS-1500: Theroad, Ian N.
Document 122 - CMS-1500: Pendent, Codie
Document 123 - CMS-1500: Theroad, Ian N.
Document 124 - Dental Claim Form: Early, Brighton
Document 125 - Dental Claim Form: O'Gen, Cass N.
Document 126 - Dental Claim Form: Poole, Carla
Document 127 - Dental Claim Form: Waite, Ova
Document 128 - Dental Claim Form: Attricks, Sherry
Document 129 - Dental Claim Form: Poole, Gene
Document 130 - Dental Claim Form: Attricks, Petey
Document 131 - CMS-1500: Theroad, Ian N.
Document 132 - CMS-1500: Theroad, Ian N.
Document 133 - CMS-1500: Waite, Hugh
Document 134 - CMS-1500: Fore-Theroad, Juana
Document 135 - CMS-1500: Fore-Theroad, Juana
Document 136 - CMS-1500: Fore-Theroad, Juana
Document 137 - CMS-1500: Waite, P. Lisa
Document 138 - CMS-1500: Attricks, Petey
Document 139 - Medicare Remittance Notice
Document 140 - CMS-1500: Harps, Evan Lee
Document 141 - CMS-1500: Cupp, Phillip D.
Document 142 - CMS-1500: Fraide, Jose
Document 143 - CMS-1500: Attricks, Sherry
Document 144 - CMS-1500: O'Gen, Cass N.
Document 145 - CMS-1500: Theroad, Ian N.
Document 146 - CMS-1500: Akenja-Nearing, Jeanette
Document 147 - CMS-1500: Theraod, Ian N.
Document 148 - CMS-1500: Waite, Hugh
Document 149 - Dental Claim Form: Dunnitt, Candy
Document 150 - Dental Claim Form: Dunnit, D. I.
Document 151 - Dental Claim Form: Waite, Hugh
Document 152 - Dental Claim Form: Akenja-Nearing, Jeanette
Document 153 - Dental Claim Form: Poole, Carla
Document 154 - Dental Claim Form: Attricks, Petey
Document 155 - Dental Claim Form: Attricks, Sherry
Document 156 - Dental Claim Form: O'Gen, Cass N.
Document 157 - CMS-1500: Dunnitt, D. I.
Document 158 - CMS-1500: Waite, P. Lisa
Document 159 - CMS-1500: Theroad, Ian N.
Document 160 - CMS-1500: Poole, Carla
Document 161 - CMS-1500: Fore-Theroad, Juana
Document 162 - CMS-1500: Fore-Theroad, Juana
Document 163 - CMS-1500: O'Gen, Cass N.
Document 164 - CMS-1500: Fraide, Jose
Document 165 - CMS-1500: Fore-Theroad, Juana
Document 166 - CMS-1500: Theroad, Kent C.
Document 167 - CMS-1500: Theroad, Ian N.
Document 168 - CMS-1500: Theraod, Ian N.
Document 169 - CMS-1500: O'Gen, Pat N.
Document 170 - CMS-1500: Waite, Ova
Document 171 - CMS-1500: Attricks, Sherry
Document 172 - CMS-1500: Fever, Scarlet
Document 173 - CMS-1500: Fever, Scarlet
Document 174 - CMS-1500: Fraide, Jose
Document 175 - CMS-1500: Fraide, Jose
Document 176 - CMS-1500: Fraide, Jose
Document 177 - UB-92: Hart, Brooke N.
Document 178 - UB-92: Attricks, Petey
Document 179 - UB-92: Waite, P. Lisa
Document 180 - UB-92: O'Gen, Cass N.
Document 181 - UB-92: Fore-Theroad, Juana
Document 182 - UB-92: Theroad, Kent C.
Document 183 - UB-92: Theroad, Ian N.
Document 184 - UB-92: Waite, Hugh
Document 185 - UB-92: Fever, Scarlet
Document 186 - CMS-1500: Dunnitt, Candy
Document 187 - CMS-1500: Dunnitt, D. Jobb
Document 188 - CMS-1500: Poole, Wade N.
Document 189 - CMS-1500: Waite, P. Lisa
Document 190 - CMS-1500: Knose, Beane Andy
Document 191 - Medicare Remittance Notice
Document 192 - CMS-1500: Cupp, Hick
Document 193 - CMS-1500: Cupp, Phillip D.
Document 194 - CMS-1500: Hart, Shay Kee
Document 195 - CMS-1500: Cupp, Phillip D.
Document 196 - CMS-1500: Cupp, Phillip D.
Document 197 - CMS-1500: Dunnitt, Candy
Document 198 - CMS-1500: Dunnitt, D. Jobb
Document 199 - CMS-1500: Theroad, Kent C.
Document 200 - CMS-1500: Theroad, Donette
Document 201 - CMS-1500: Fore-Theroad, Juana
Document 202 - CMS-1500: Theraod, Ian N.
Section 4. Forms
Payment Worksheet
Inventory/Production Sheet
Authorization for Treatment Form
Payment Demand Letter
TPL Possible Further Information Request
Right of Reimbursement Claims Form
TPL Investigation Questionnaire
Third Party Liability Reimbursement Agreement
Preexisting Condition Form
Telephone Information Sheet
Claim Office Referral Sheet
Coordination of Benefits Calculation Worksheet
Request for Additional Information Form