Synopses & Reviews
Prepare for career success with this trusted introduction to the world of health insurance billing and the dynamic, growing field of health information management. A GUIDE TO HEALTH INSURANCE BILLING, Fourth Edition, provides a thorough, practical overview of key principles and current practices, from patient registration to claims submission. Now updated to reflect the latest trends, technology, terminology, legal and regulatory guidelines, and coding systems--including ICD-10--the new edition also features a dynamic full-color layout. The text also includes abundant exercises, examples, case studies, and activities focused on real-world applications, including step-by-step procedures for generating, processing, and submitting health insurance claims to commercial, private, and government insurance programs. An access code for SimClaim interactive online billing software is also provided; this program puts billing skills to the test with case studies that require form completion.
About the Author
Associate Professor, Northern Michigan University (Retired in 2003) Bio: With over 25 years experience in health information management, Marie A. Moisio, MA, RHIA was Associate Professor, Northern Michigan University (Retired in 2003). 15 years teaching experience medical billing; medical coding; health information processing. Moisio work includes Director, Health Information Department(s): 400-bed regional medical center; 450-bed regional psychiatric treatment facility. She was consultant for several long-term care facilities and physicians¿ offices; health information management; compliance; coding practices; auditing insurance claims and documentation in the patients¿ records. She has offered several workshops about the legal aspects of health information management and documentation. Moisio has written Medical Terminology for Insurance and Coding and Co-Authored Medical Terminology: A Student Centered Approach; Understanding Laboratory and Diagnostic Tests.
Table of Contents
1. The Insurance Billing Specialist. 2. Legal Aspects of Insurance Billing. 3. Introduction to Health Insurance. 4. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM/PCS). 5. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). 6. Current Procedural Terminology (CPT) and Healthcare Common Procedure. 7. Developing An Insurance Claim. 8. Common CMS-1500 Completion Guidelines: Private/Commercial Insurance. 9. Electronic Claims Submission. 10. UP-04 (CMS-1450) Completion Guidelines. 11. Blue Cross/Blue Shield. 12. Medicare. 13. Medicaid. 14. TRICARE and CHAMPVA. 15. Workers Compensation. Appendix A: Superiorland Clinic Practice Manual. Appendix B: Assignments: Case Study 2-1 Through Case Study 2-10. Appendix C: Abbreviations. References. Glossary. Index.