Main description:

Get hands-on practice in medical insurance billing and coding! Corresponding to the chapters in Fordney's Medical Insurance and Billing, 16th Edition, this workbook provides realistic exercises that help you apply concepts and develop the critical thinking skills needed by insurance billing specialists. Review questions reinforce your understanding of your role and responsibilities, and assignments ask you to complete claim forms by extracting information from patient records and properly selecting procedural and diagnostic codes. Not only will you master the CMS-1500 and 837P claim forms, but you will understand each stage of an insurance claim.

Self-study exercises reinforce your understanding with matching, true/false, multiple-choice, mix and match, and fill-in-the-blank questions, as well as critical thinking assignments.
Key terms and abbreviations at the beginning of each chapter provide a quick reference to the health insurance terminology you need to know.
Study outlines focus your review by listing the key points for each chapter.
Performance objectives make learning easier by highlighting what you need to accomplish in each chapter.
Critical Thinking assignments are based on short, real-world vignettes, preparing you to work in a real medical office and allowing you to apply theory learned from the textbook.
Updated mock fee schedules present the latest information available, for use in completing forms and activities.
Expanded coverage of inpatient insurance billing includes ICD-10 coding and CMS coding, ensuring that you are prepared to work in healthcare facility settings as well as the physician's office and outpatient settings.
Updated information on general compliance issues, HIPAA, the Affordable Care Act, and coding reflects changes to the Fordney's Medical Insurance and Billing, 16th Edition text.
Ambulatory Surgery Center chapter provides the foundation and skills needed for billing in this outpatient setting.

NEW! Additional procedures provide more practice, helping you remember the material.

Contents:

Unit One: Career Roles and Responsibilities

1. Role of an Insurance Billing Specialist

2. Privacy, Security and HIPAA

3. Compliance, Fraud and Abuse

Unit Two: Introduction to Health Insurance

4. Basics of Health Insurance

5. The Blue Plans, Private Insurance and Managed Care Plans

6. Medicare

7. Medicaid and Other State Programs

8. TRICARE and Veteran's Health Care

9. Workers Compensation

10. Disability Income Insurance and Disability Benefit Insurance

Unit Three: Documentation and Coding for Professional Services

11. Medical Documentation and the Electronic Health Record

12. Diagnostic Coding

13. Procedural Coding

Unit Four: Claims Submission in the Medical Office

14. The Paper Claim CMS-1500

15. The Electronic Claim

Unit Five: The Claim Follow-Up and Payment Process

16. Receiving Payments and Insurance Problem Solving

17. Collection Strategies

Unit Six: Healthcare Facility Billing

18. Ambulatory Surgery Center

19. Hospital Outpatient and Inpatient Billing

Unit Seven: Employment

20. Seeking a Job and Attaining Professional Advancement