Medical Insurance: A Revenue Cycle Process Approach

9th Auflage
ISBN: 978-1-265-16671-7
Verlag: McGraw Hill LLC

Buch, Englisch, 608 Seiten, Format (B × H): 216 mm x 272 mm, Gewicht: 1111 g

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.”

Autoren/Hrsg.

Valerius, Joanne

Bayes, Nenna L

Bayes, Nenna

Newby, Cynthia

Blochowiak, Amy L

Blochowiak, Amy

Fachgebiete

• Wirtschaftswissenschaften Betriebswirtschaft Betriebswirtschaft: Theorie & Allgemeines

Inhaltsverzeichnis

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

Über Autor(innen)

Bayes, Nenna
Nenna L. Bayes, AAS, BBA, M.Ed., CPC, has coauthored
and reviewed various titles within the medical administrative fields. She earned an
associate of applied business degree, a bachelor of business administration degree,
and a masters of arts in education from Morehead State University. During her tenure,
she has taught numerous courses within the administrative and medical administrative
curriculum. She is a professor in and the program coordinator for the Office
Systems Technology and Medical Information Technology programs at Ashland
Community and Technology College in Ashland, Kentucky, and has received many
teaching excellence awards. She is also a certified professional coder (CPC). Prior to
teaching, she worked in various medical office environments. Additionally, she is a
member of the American Academy of Professional Coders (AAPC) and the American
Health Information Management Association (AHIMA).
She lives in Flatwoods, Kentucky, with her husband and is blessed to have two
children and two granddaughters. She is actively involved in music and enjoys
camping in her leisure time.

Newby, Cynthia
Cynthia Newby, CPC, CPC-P, is a long-serving author who works closely with McGraw-Hill Education instructional development staff to develop excellent MIBC programs. Cynthia is a graduate of Hood College and a trustee of that institution as well as her local animal shelter and library.

Blochowiak, Amy
Amy L. Blochowiak, MBA, RHIT, ACS, AIAA, AIRC, ARA,FLHC, FLMI, HCSA, HIA, HIPAA, MHP, PCS, SILA-F, has coauthored and reviewed various textbooks within the medical administrative and insurance fields. She earned associate degrees in medical office mid-management and health information technology from Northeast Wisconsin Technical College, bachelor’s degrees in both business administration and marketing from Lakeland College, and a master’s degree in business administration from Lakeland College. She is currently the program director and instructor for the Healthcare Business Professional program at Northeast Wisconsin Technical College, where she sits on many committees and shares her passion for student success. Prior to teaching, she worked in various insurance industry roles for over 16 years. She is a member of the American Health Information Management Association (AHIMA).