Gain real-world practice in insurance billing and coding!Corresponding to the chapters in Fordney's Insurance Handbook for the Medical Office, 13th Edition, this workbook provides realistic, hands-on exercises that help you apply concepts and develop critical thinking skills. Study tools include chapter overviews, key terms, chapter review exercises, and case study assignments.
Key terms and abbreviations lists at the beginning of each chapter provide a quick reference to the health insurance terminology you need to know.
Critical thinking assignments help you connect theory to practice with real-world scenarios.
Self-study exercises - including matching, true/false, multiple-choice, mix and match, and fill-in-the-blank questions - help you practice important concepts.
Performance objectives make learning easy by highlighting what you need to accomplish in each chapter.
Study outlines focus your review by listing key points for each chapter
New to this Edition
UPDATED content reflects changes in the text, ensuring you have the latest guidelines and regulations for medical insurance billing and coding available.
UPDATED coverage of key health insurance topics includes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, meaningful use, and CPT 2013.
NEW CMS-1500 (02-12) claim form includes block-by-block explanations and examples.
UPDATED ICD-10 coding information prepares you for the ICD-10 transition.
UPDATED self-assessment quizzes on Evolve test your knowledge of the material in each chapter.
UPDATED guidelines for the filing and submission of electronic claims include sample screenshots, preparing you for the future of the medical office.
Unit 1: Career Roles and Responsibilities 1. Role of an Insurance Billing Specialist 2. Compliance, Privacy, Fraud, and Abuse in Insurance Billing Unit 2: The Claims Process 3. Basics of Health Insurance 4. Medical Documentation and the Electronic Health Record 5. Diagnostic Coding 6. Procedural Coding 7. The Paper Claim CMS-1500 (02-12) 8. The Electronic Claim 9. Receiving Payments and Insurance Problem-Solving 10. Office and Insurance Collection Strategies Unit 3: Health Care Payers 11. The Blue Plans, Private Insurance, and Managed Care Plans 12. Medicare 13. Medicaid and Other State Programs 14. TRICARE and Veterans' Health Care 15. Workers' Compensation 16. Disability Income Insurance and Disability Benefit Programs Unit 4: Inpatient and Outpatient Billing 17. Hospital Billing Unit 5: Employment 18. Seeking a Job and Attaining Professional Advancement Tests Appendix A: College Clinic Office Policies and Mock Fee Schedule Appendix B: Medicare Level II HCPCS Codes Appendix C: ICD-10-PCS Section 0 Medical and Surgical, Character 3, Operation Definitions Appendix D: ICD-10-PCS Section 0 Medical and Surgical, Character 5, Approach Definitions
By Marilyn Fordney, CMA-AC, Formerly, Instructor of Medical Insurance, Medical Terminology, Medical Machine Transcription, and Medical Office Procedures, Ventura College, Ventura, CA