Medical Billing 101


Book Description

Learn the basics of physican-based medical billing with MEDICAL BILLING 101, 2E. Clear and practical guidelines introduce you to the job responsibilities and basic processes in the medical billing world. Case studies and software tools like SimClaimTM CMS-1500 software offer you practice on actual forms to build confidence and understanding of the reimbursement process. This easy-to-use guide starts you off on the right path as you begin your journey to becoming a medical billing professional. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.




Medical Billing & Coding For Dummies


Book Description

The definitive guide to starting a successful career in medical billing and coding With the healthcare sector growing at breakneck speed—it’s currently the largest employment sector in the U.S. and expanding fast—medical billing and coding specialists are more essential than ever. These critical experts, also known as medical records and health information technicians, keep systems working smoothly by ensuring patient billing and insurance data are accurately and efficiently administered. This updated edition provides everything you need to begin—and then excel in—your chosen career. From finding the right study course and the latest certification requirements to industry standard practices and insider tips for dealing with government agencies and insurance companies, Medical Billing & Coding For Dummies has you completely covered. Find out about the flexible employment options available and how to qualify Understand the latest updates to the ICD-10 Get familiar with ethical and legal issues Discover ways to stay competitive and get ahead The prognosis is good—get this book today and set yourself up with the perfect prescription for a bright, secure, and financially healthy future!




Understanding Hospital Billing and Coding


Book Description

- Updated Claim Forms chapter covers the UB-04 claim form. - Updated information covers diagnosis and procedural coding, with guidelines and applications. - Updated claim forms and names are used throughout.




ICD-10-CM Official Guidelines for Coding and Reporting - FY 2021 (October 1, 2020 - September 30, 2021)


Book Description

These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. The instructions and conventions of the classification take precedence over guidelines. These guidelines are based on the coding and sequencing instructions in the Tabular List and Alphabetic Index of ICD-10-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. These guidelines have been developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The importance of consistent, complete documentation in the medical record cannot be overemphasized. Without such documentation accurate coding cannot be achieved. The entire record should be reviewed to determine the specific reason for the encounter and the conditions treated.




Introduction to Mental Health Billing


Book Description

Revised in 2016! Complete guide to billing mental health insurance claims to insurance companies including new ICD10 codes and information on PQRS. Chapters include medication management, Medicare, Medicaid, Nursing home visits, psychological testing, using modifiers, EAP visits, denials, appeals and more.




The Price We Pay


Book Description

New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.




Model Rules of Professional Conduct


Book Description

The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.




The How-to Guide to Home Health Billing


Book Description

Make sure home health billing staff is well trained Home health care billing is a complicated task. Make sure that you are receiving all the payment you've earned, with accurate, compliant, and competent billing practices. The How-to Guide for Home Health Billing is your comprehensive guide to the many complex elements involved., helping you to provide the best training possible to billing staff and those who impact billing. You'll increase competence and confidence about billing requirements and practices. This book will help you: * Provide effective training for all billing staff, whether new to billing, or new to the home care system; along with tips for other agency staff such as therapists and nurses, who impact the billing process, on collaborating to ensure billing accuracy. * Focus on red flag areas and understand the complicated relationship between billing and coding/OASIS assessments. * The guide will give you the practical "nuts and bolts" education and information you need by taking difficult concepts and explaining them in an easy to understand way. * This step-by-step guide to billing not only covers Medicare, but also Medicaid and commercial insurance billing.




Never Pay the First Bill


Book Description

From award-winning ProPublica reporter Marshall Allen, a primer for anyone who wants to fight the predatory health care system--and win. Every year, millions of Americans are overcharged and underserved while the health care industry makes record profits. We know something is wrong, but the layers of bureaucracy designed to discourage complaints make pushing back seem impossible. At least, this is what the health care power players want you to think. Never Pay the First Bill is the guerilla guide to health care the American people and employers need. Drawing on 15 years of investigating the health care industry, reporter Marshall Allen shows how companies and individuals have managed to force medical providers to play fair, and shows how you can, too. He reveals the industry's pressure points and how companies and individuals have fought overbilling, price gouging, insurance denials, and more to get the care they deserve. Laying out a practical plan for protecting yourself against the system's predatory practices, Allen offers the inspiration you need and tried-and-true strategies such as: Analyze and contest your medical bills, so you don't pay more than you should Obtain the billing codes for a procedure in advance Write in an appropriate treatment clause before signing financial documents Get your way by suing in small claims court Few politicians and CEOs have been willing to stand up to the medical industry. It is up to the American people to equip ourselves to fight back for the sake of our families--and everyone else.