Medical Insurance: A Revenue Cycle Process Approach
7th Edition
Published on 16. February 2016
Book
Paperback/Softback
605 pages
978-0-07-784027-3 (ISBN)
Description
The seventh edition of Medical Insurance: An Integrated Claims Process Approach emphasizes the medical billing 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. The claims case studies can be completed via CMS-1500 form activities or by using simulated Medisoft exercises, both available in Connect, McGraw-Hill's homework and assessment platform. 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 LearnSmart and SmartBook, McGraw-Hill's revolutionary adaptive learning technology.
More details
Edition
7th edition
Language
English
Place of publication
New York
United States
Publishing group
McGraw-Hill Education - Europe
Target group
College/higher education
Dimensions
Height: 274 mm
Width: 216 mm
Thickness: 23 mm
Weight
1198 gr
ISBN-13
978-0-07-784027-3 (9780077840273)
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
Persons
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, 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 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, bachelors degrees in both business administration and marketing from Lakeland College, and a masters 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).
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, 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 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, bachelors degrees in both business administration and marketing from Lakeland College, and a masters 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).
Content
Preface AcknowledgmentsPart 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-CMChapter 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