Glencoe Medical Insurance
Glencoe Medical Insurance provides focused coverage of the knowledge and skills necessary for successful medical insurance processing, including in-depth coverage of medical insurance, the claims process, HCFA 1500, and UB-92. It covers all types of medical insurance including Blue Cross, Blue Shield, HMOs, PPOs, Medicare, Medicaid, and other plans. Managed care is integrated throughout the text, including discussion of contract law as it relates to managed care. There is an emphasis on practice management and patient finance. Optional exploratory computer activities use MediSoft for Windows Advanced. The focus in the text is on electronic claims filing but paper claims are covered as well. Unique to this text is an entire chapter emphasizing how crucial correct coding is to reimbursement and compliance with federal regulations.
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Introduction to Claims Processing
The Legal Environment
21 other sections not shown
allowed charge Alphabetic Index amount Anesthesia Arthroscopy audit benefits CHAMPVA CHAPTER REVIEW claim form Click clinical coder CODING GUIDELINES coinsurance Compliance Guideline condition contract copayment covered CPT codes deductible diagnosis codes dialog box digit disease documentation electronic claims employer encounter form entered entry established patient examination example federal form locator fraud and abuse HCFA HCPCS Health Information Health Insurance health plan HIPAA hospital identification number identify inpatient insurance carrier insurance claims insurance plan INSURED'S main term managed care plans Medicaid medical insurance specialist medical necessity medical practices Medicare Medigap MediSoft modifiers neoplasm organization outpatient patient information patient medical record payment performed physician PHYSICIAN CODING GUIDELINES practice's preauthorization Problem Focused procedure codes professional provider provider's received referred reimbursement release specific statement surgery surgical Tabular List third-party payers tion Transaction treatment TRICARE usually