From the Publisher
Trusted by medical insurance specialists for more than 30 years, Insurance Handbook for the Medical Office helps you excel at all aspects of insurance billing for a full range of today's health care plans. This edition helps you keep pace with industry changes, featuring the latest information on HIPAA regulations, diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, and more. The accompanying Student Workbook with CD-ROM (sold separately) lets you practice "real world" billing with patient simulations using Altapoint and the Student Software Challenge.
- Procedural (CPT and HCPCS) and diagnostic (ICD-9-CM) coding and documentation are emphasized, since they are the keystones to obtaining maximum reimbursement.
- Key terms are bolded at first mention, explained within the context of the discussion, and defined in the glossary.
- Separate chapters on Electronic Data Interchange and HIPAA Compliance and Privacy in Insurance Billing provide essential knowledge of electronic claims filing, informing you of submission guidelines used in the majority of medical offices today.
- Icons clearly identify each insurance payer with a specific color and graphic, making specific information easy to locate.
- Compliance features located at appropriate points throughout most chapters offer tips to ensure compliance with correct billing and coding practice, particularly HIPAA and OIG.
- A separate chapter on documentation in the medical office describes how proper documentation can prevent penalties and refund requests, and help you prove compliance in the case of an audit or review.
- Detailed examples and samples of completed insuranceforms show you how to apply knowledge in the real world.
- Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist's role in filing clean claims, solving problems that do occur, and collecting overdue payments.
- Service to Patient feature throughout the chapters focuses on ways to provide quality service to the patient as well as your co-workers.
- All content has been reviewed by industry experts and meticulously updated to reflect recent changes in insurance claim filing.
- In addition to the list of key terms at the beginning of each chapter, a separate list of key abbreviations clarifies common terms identified in the field primarily by their abbreviations.
- Key points at the end of each chapter briefly summarize important chapter content to help you better understand the subject matter.
LouAnn Schraffenberger
This is a textbook to be used in a course to teach health insurance processing and claims management. This is the fifth edition of the text. According to the author, the revised text's purpose is to increase efficiency and streamline administrative procedures for insurance billing. The book is primarily designed for the student who plans to seek employment in a physician's office or clinic or with an independent billing business and needs a good understanding of the reimbursement process. The book may be used in formal education programs within a community or technical college. It may also be used for a certificate program or continuing education course. It may also be used by an individual on the job or for independent study. The author who wrote the first edition 20 years ago is a former instructor at Ventura (CA) College. There are a total of 16 chapters covering the broad topics of claims processing, healthcare payers, inpatient and outpatient billing, and employment as a health insurance specialist. This is a classic text for health insurance/billing specialists programs. With the text, the publishers offer a student workbook, an instructor's manual, software, and a computerized test bank. This provides the teacher and the student with a complete package of valuable information.
Doody Review Services
Reviewer:LouAnn Schraffenberger, MBA, RHIA, CCS, CCS-P (Univ of Illinois at Chicago School of Biomed & Health Info Mgmt)
Description:This is the sixth edition of a well-known textbook for medical office insurance processing.
Purpose:The goal is to increase efficiency and streamline procedures for physician office insurance billing. The book has been used as a text for insurance billing courses in community, vocational, or commercial training institutions. The editor's primary goal is to increase the knowledge base and professionalism of the insurance billing specialist.
Audience:The audience includes administrative medical specialists, such as the insurance billing specialist, clinical coding specialist, or reimbursement specialist. The book could be used for programs related to medical billing, medical assisting, or clinical coding. The editor is a former college instructor and she uses a wide variety of educators and practitioners as contributing authors.
Features:The book is composed of five units: career roles, the claims process, healthcare payers, inpatient and outpatient billing, and employment. Each of the 18 chapters contains objectives, key terms, and student assignments. The appendixes have a comprehensive list of references, including other books, periodicals, newsletters, software, and audio- and videotapes.
Assessment:The book is part of a complete instructional package. There is an accompanying workbook for students, software for completing insurance claim forms, an instructor's manual, and a computerized test bank of over 1,000 questions and answers. The author has put together acomprehensive instructional program. Every billing/insurance certificate program should examine this book as a required text. It would also be an essential reference for physician billing offices. Several new chapters have been added to this edition, such as a chapter on career and professionalism. The list of references needs some updating in regard to names and addresses of professional organizations and certifying bodies.
Rating
3 Stars from Doody
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