Valerius, Joanne,

Medical insurance : a revenue cycle process approach / Joanne D. Valerius, RHIA, MPH, Oregon Health & Science University, Nenna L. Bayes, AAS, BBA, M.Ed., CPC, Ashland Community and Technical College, Retired, Cynthia Newby, CPC, CPC-P, Amy L. Blochowiak, MBA, ACS, AIAA, AIRC, ARA, FLHC, FLMI, HCSA, HIA, HIPAA, MHP, PCS, SILA-F, Northeast Wisconsin Technical College. - Ninth edition. - xviii, 537 pages : illustrations ; 28 cm.

Includes bibliographical references and indexes.

Part 1. WORKING WITH MEDICAL INSURANCE AND BILLING -- 1. Introduction to the Revenue Cycle -- 2. Electronic Health Records, HIPAA, and HITECH: Sharing and Protecting Patients’ Health Information -- 3. Patient Encounters and Billing Information -- Part 2. CLAIM CODING -- 4. Diagnostic Coding: ICD-10-CM -- 5. Procedural Coding: CPT and HCPCS -- 6. Visit Charges and Compliant Billing -- Part 3. CLAIMS -- 7. Healthcare Claim Preparation and Transmission -- 8. Private Payers/ACA Plans -- 9. Medicare -- 10. Medicaid -- 11. TRICARE and CHAMPVA -- 12. Workers’ Compensation and Disability/Automotive Insurance -- Part 4. CLAIM FOLLOW-UP AND PAYMENT PROCESSING -- 13. Payments (RAs), Appeals, and Secondary Claims -- 14. Patient Billing and Collections -- 15. Primary Case Studies -- 16. RA/Secondary Case Studies -- Part 5. HOSPITAL SERVICES -- 17. Hospital Billing and Reimbursement.

"Follow the Money! Medical insurance plays an important role in the financial well-being of every healthcare business. The regulatory environment of medical insurance is now evolving faster than ever. Changes due to healthcare reform require medical office professionals to acquire and maintain an in-depth understanding of compliance, electronic health records, medical coding, and more. The eighth edition of Medical Insurance: A Revenue Cycle Process Approach emphasizes the revenue cycle 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"--

9781265166717 1265166714 9781266269578 1266269576

2022036996


Health insurance.
Health insurance claims--United States.
Health insurance--United States.

HG9383 / .V45 2024

368.38/2