From Patient to Payment: Insurance Procedures for the Medical Office is a practical, focused overview of medical Insurance and billing. Students will experience a structured, hands-on, and practical approach In each chapter-a must for anyone who works with both paper and electronic claims and the medical billing process. The latest HIPAA forms and regulations, medical coding, and electronic claims are incorporated clearly within a focused program. Students will equip themselves with the basics of preparing correct health care claims through the brief introduction to Medisoft Patient Billing software V14, which can be used to complete claims.
• New reimbursement concepts such as the Physician Quality Reporting Initiative (PQRI) that provides financial incentives for successfully reporting the designated set of quality measures.
• New reimbursement concepts including Real-Time Claims Adjudication (RTCA) capability offered to providers by major health plans that allows providers to query the plan for the amount patients will owe and then ask patients for payment of their portion of planned visit bills at the time of service.
• New ICD-9-CM and CPT/HCPCS codes for physicians' offices and for hospitals, including the concept of "never events'-hospital acquired conditions that are not paid by federal/state insurances.
• Online Learning Center (OLC) provides chapter-specific applications, relevant links, quizzes, and more,
• Updated Chapter 16 on using Medisoft Advanced software Version 14.
• New Interactive Simulated CMS-1500 Form available from the OLC: the simulated form can be used with Adobe Reader to create and print CMS-1500 claim forms and provides an easy-to-use alternative to filling in claim forms by hand.