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- NEW! Expanded coverage of inpatient insurance billing, including diagnosis and procedural coding provides you with the foundation and skills needed to work in the physician office, outpatient, and inpatient setting.- NEW! Expanded coverage of Ambulatory Surgical Center (ASC) billing chapter provides you with the foundation and skills needed to work in this outpatient setting.- NEW! Updated information on general compliance issues, HIPAA, Affordable Care Act and coding ensures that you have the knowledge needed to enter today's ever-changing and highly regulated healthcare environment.
Linda Smith is the author of Fordney's Medical Insurance, 15e and its accompanying workbook. She has authored both the 3rd and 4th editions of HIPAA Online. Linda Smith has had over 40 years of experience in the healthcare industry as a business manager. Linda is a "Certified Professional Coder- (CPC). She has also earned the credentials of "E/M Specialist" (CEMC) and is an approved "Professional Medical Coding Curriculum Instructor" (CPC-I) through the American Academy of Professional Coders (AAPC).
Unit One: Career Role and Responsibilities 1. Role of an Insurance Billing Specialist 2. Privacy, Security and HIPAA 3. Compliance, Fraud and AbuseUnit Two: Introduction to the Revenue Cycle Process 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 Veterans' Health Care 9. Workers' Compensation 10. Disability Income Insurance and Disability Benefit Programs Unit Three: Documentation and Coding 11. Medical Documentation and the Electronic Health Record 12. Diagnostic Coding 13. Procedural CodingUnit Four: Claims Submission in The Medical Office 14. The Paper Claim CMS-1500 15. The Electronic ClaimUnit Five: The Claim Follow Up and Payment Process 16. Receiving Payments and Insurance Problem Solving 17. Office and Insurance Collection StrategiesUnit Six: Healthcare Facility Billing 18. Ambulatory Surgical Center 19. Hospital Outpatient and Inpatient Billing Unit Seven: Employment 20. Seeking a Job and Attaining Professional Advancement
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