Description: A Guide to Health Insurance Billing, Second Edition is an introduction to medical billing, covering everything from patient registration to claims submission, with an emphasis on HIPAA issues. This valuable resource includes introductory concepts, examples, and application exercises designed to show you the basics of insurance billing. You will become familiar with health insurance terminology, understand the legal implications of insurance billing, develop a basic understanding of medical coding systems, and accurately complete insurance claim forms. Product Benefits: - Updated to include information about the UB-92 form and UB-04 form
- Provides guidelines for completing blocks of the CMS-1500 form and UB-92 form
- New material on HIPAA, Privacy Rule, and Security Rule
- Ten new case study coding challenges
- Learning objectives and key words, abbreviations, and phrases identify essential information in each chapter
- Twenty case studies to be used with free CD-ROM software, complete with source documents for insurance claims submission
- Three chapters dedicated to diagnostic and procedural coding
- Numerous examples, tables, figures, and exercises reinforce basic concepts
Table of Contents: Chapter 1 The Insurance Billing Specialist
Chapter 2 Legal Aspects of Insurance Billing
Chapter 3 Introduction to Health Insurance
Chapter 4 International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
Chapter 5 International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)
Chapter 6 Current Procedural Terminology (CPT) and Healthcare Common Procedure
Chapter 7 Developing An Insurance Claim
Chapter 8 Common CMS-1500 Completion Guidelines
Chapter 9 Common UB-92 (HCFA-1450) Completion Guidelines
Chapter 10 Electronic Data Interchange (EDI)
Chapter 11 Blue Cross/Blue Shield
Chapter 12 Medicare
Chapter 13 Medicaid
Chapter 14 TRICARE and CHAMPVA
Chapter 15 Workers Compensation
Appendix A Superiorland Clinic Practice Manual
Assignments: Case Study 2-1 Through Case Study 2-10
Appendix B
References
Glossary
Index |
