St Anthony S Modifiers Made Easy

HCFA is intensifying its investigation of he inappropriate use of modifiers in Medicare billing. Incorrect usage of CPT and HCPCS Level II modifiers can cost you money, or now, get you in trouble...Are you sure you're using them correctly?

This combination textbook and workbook, explains each phase of the medical claim cycle, from the time the patient calls for an appointment until the financial transaction for the encounter is completed. Coverage includes types of insurance payers, basic coding and billing rules, and standard requirements for outpatient billing using the CMS-1500 claim form. It also emphasizes legal aspects related to each level of the medical claim cycle and the importance of the medical office employee, showing their responsibility for and impact on successful reimbursement. 3 separate chapters offer coverage of the basic concepts of medical coding. A comprehensive overview of the CMS-1500 claim form with step-by-step guidelines and illustrations thoroughly covers reimbursement issues and explains the billing process. Includes detailed information on various insurance payers and plans including Medicare, government medical plans, disability plans, private indemnity plans, and managed care. Stop & Review sections illustrate how the concepts presented in each chapter relate to real-life billing situations. Sidebars and Examples highlight key concepts and information related to the core text lesson. A companion CD-ROM contains sample patient and insurance information that readers can use to practice completing the accompanying CMS-1500 claim form, as well as a demonstration of Altapoint practice management software. Features completely updated information that reflects the many changes in the insurance industry. Contains a new chapter on UB-92 insurance billing for hospitals and outpatient facilities. Includes a new appendix, Quick Guide to HIPAA for the Physician's Office, to provide a basic overview of the important HIPAA-related information necessary on the job.

INSURANCE HANDBOOK FOR THE MEDICAL OFFICE is a key text for medical administrative assisting, medical front office programs, or those who wish to become insurance billing specialists, claims assistance professionals, or electronic claims processors for physicians' practices and hospital outpatient clinics. Those already practicing in this area will also find this text beneficial, as will health claims examiner programs. The goal of this extremely up-to-date text is to increase efficiency and streamline administrative procedures for the most exasperating aspect of the doctor's office routine: insurance billing. This text offers guidance for all aspects of submitting, tracing, appealing, and transmitting claims for today's full range of health plans. Important coverage of diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, Managed Care, and more is presented. Additionally, a free CD-ROM featuring the HCFA-1500 claim form is included with the book. The CD-ROM contains 10 scored patient case studies with related insurance information so that the student can practice completing the HCFA-1500 claim form in a fun, interactive format.

Understanding Health Insurance: A Guide to Professional Billing, 7th edition, utilizes a step-by-step approach to provide instruction about the completion of health insurance claims. The objectives of this edition are to 1) introduce information about major third party payers, 2) provide up-to-date information about federal health care regulations, 3) clarify coding guidelines and provide application exercises for each coding system, 4) introduce reimbursement issues, 5) emphasize the importance of coding for medical necessity, and 6) help users develop the skill to complete claims accurately.. Case studies and review exercises provide users with numerous opportunities to apply knowledge and develop skills in completing CMS-1500 claims accurately. The textbook CD-ROM and accompanying workbook provide additional exercises and practice in completing CMS-1500 claims electronically. Current information is provided on CPT-5 and ICD-10-CM coding systems. The appendices include information about processing the UB-92 (CMS-1450) and dental claims.