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ISBN 10: 1266234578
ISBN 13: 9781266234576
Author: J. D. Valerius, N. L. Bayes; C. Newby, A. L. Blochwiak
Medical Insurance: A Revenue Cycle Process Approach emphasizes the revenue 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.”
Part 1 WORKING WITH MEDICAL INSURANCE AND BILLING
Chapter 1 Introduction to the Revenue 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: ICD-10-CM
Chapter 5 Procedural Coding: CPT and HCPCS
Chapter 6 Visit Charges and Compliant Billing
Part 3 CLAIMS
Chapter 7 Healthcare Claim Preparation and Transmission
Chapter 8 Private Payers/ACA Plans
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
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Tags: Joanne Valerius, Nenna Bayes, Cynthia Newby, Amy Blochowiak, Medical Insurance, Revenue Cycle, Process Approach