Workbook for Fordney’s Medical Insurance and Billing
- 16th Edition - December 13, 2021
- Author: Linda M. Smith
- Language: English
- Paperback ISBN: 9780323795364 9 7 8 - 0 - 3 2 3 - 7 9 5 3 6 - 4
- eBook ISBN: 9780323810784 9 7 8 - 0 - 3 2 3 - 8 1 0 7 8 - 4
Get hands-on practice in medical insurance billing and coding! Corresponding to the chapters in Fordney's Medical Insurance and Billing, 16th Edition, this workbook provides… Read more
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Get hands-on practice in medical insurance billing and coding! Corresponding to the chapters in Fordney's Medical Insurance and Billing, 16th Edition, this workbook provides realistic exercises that help you apply concepts and develop the critical thinking skills needed by insurance billing specialists. Review questions reinforce your understanding of your role and responsibilities, and assignments ask you to complete claim forms by extracting information from patient records and properly selecting procedural and diagnostic codes. Not only will you master the CMS-1500 and 837P claim forms, but you will understand each stage of an insurance claim.
- Cover image
- Table of Contents
- Contributor
- Instruction Guide to the Workbook
- Learning Objectives
- Instructions to the Student
- Key Terms and Key Abbreviations
- Note Taking
- Review Question Assignments
- Simulation Assignments
- Medical Terminology and Abbreviations
- Patient Records
- Financial Records
- Cms-1500 Claim Form
- Performance Evaluation Checklist
- Student Reference Notebook
- Reference Material
- Employee Insurance Procedural Manual
- Unit One: Career Roles and Responsibilities
- 1. Role of an Insurance Billing Specialist
- Key Abbreviations
- Performance Objectives
- Study Outline
- Assignment 1.1 Review Questions
- Criticalthinking
- Assignment 1.2 Critical Thinking
- Assignment 1.3 Visit Websites
- Assignment 1.4 Compose Email Messages
- 2. Privacy, Security, and HIPAA
- Assignment 2.1 Review Questions
- Assignment 2.2 Critical Thinking: Incidental Disclosure Versus Hipaa Violation
- Assignment 2.3 Visit Websites
- 3. Compliance, Fraud, and Abuse
- Assignment 3.1 Review Questions
- Assignment 3.2 Critical Thinking: Fraud Versus Abuse
- Assignment 3.3 Visit Websites
- Unit Two: Introduction to Health Insurance
- 4. Basics of Health Insurance
- Assignment 4.1 Review Questions
- Assignment 4.2 Critical Thinking: Administrative Sequence of Processing an Insurance Claim
- Assignment 4.3 Critical Thinking: Differences in Insurance Keyterms
- Assignment 4.4 Abstract Data from an Insurance Identification Card
- Assignment 4.5 Abstract Data from an Insurance Identificationcard
- Assignment 4.6 Abstract Data from an Insurance Identification card
- 5. The Blue Plans, Private Insurance, and Managed Care Plans
- Assignment 5.1 Review Questions
- Assignment 5.2 Obtain Authorization for a Consultation from a Managed Care Plan
- Assignment 5.3 Obtain Authorization for Physical Therapy from a Managed Care Plan
- Assignment 5.4 Obtain Authorization for Diagnostic Arthroscopy from a Managed Care Plan
- Assignment 5.5 Obtain Authorization for Consultation from a Managed Care Plan
- Assignment 5.6 Obtain Authorization for Diagnostic Body Scan from a Managed Care Plan
- 6. Medicare
- Assignment 6.1 Review Questions
- Assignment 6.2 Calculate Mathematical Problems
- Assignment 6.3 Complete a Medicare Advance Beneficiary Notice of Noncoverage
- 7. Medicaid and Other State Programs
- Assignment 7.1 Review Questions
- Assignment 7.2 Critical Thinking
- 8. TRICARE and Veterans’ Health Care
- Assignment 8.1 Review Questions
- Assignment 8.2 Critical Thinking
- 9. Workers’ Compensation
- Assignment 9.1 Review Questions
- Assignment 9.2 Complete a Doctor’s First Report of Occupational Injury or Illness Form for a Workers’ Compensation Case
- Assignment 9.3 Complete a Doctor’s First Report of Occupational Injury or Illness form for a Workers’ Compensation Case
- 10. Disability Income Insurance and Disability Benefits Programs
- Assignment 10.1 Review Questions
- Assignment 10.2 Complete a State Disability Insurance Form
- Assignment 10.3 Complete a State Disability Insurance Form
- Assignment 10.4 Complete a State Disability Insurance Form
- Assignment 10.5 Complete a State Disability Insurance Form
- Unit Three: Documentation and Coding for Professional Services
- 11. Medical Documentation and the Electronic Health Record
- Assignment 11.1 Review Questions
- Assignment 11.2 Critical Thinking: Solve an Office Problem
- Assignment 11.3 Abstract Subjective Observations and Objective Findings from Patient Records
- Assignment 11.4 Review of a Patient Record
- Assignment 11.5 Review an Operative Report
- Assignment 11.6 Review Radiology Record
- Assignment 11.7 Review Pathology/Laboratory Report
- Assignment 11.8 Review Physical Therapy Record
- 12. Diagnostic Coding
- Assignment 12.1 Review Questions
- Assignment 12.2 Locating Information in Icd-10-Cm, Volume 2
- Diagnostic Coding Assignments
- Assignment 12.3 Obtain General Diagnostic Codes for Conditions
- Assignment 12.4 Code Diagnoses from Medical Records
- Assignment 12.5 Code Diagnoses Using Z Codes
- Assignment 12.6 Code Neoplastic Diagnoses
- Assignment 12.7 Code Diagnoses for Patients With Diabetes
- Assignment 12.8 Code Diagnoses for Patients with Hypertension
- Assignment 12.9 Code Diagnoses for Injuries, Fractures, Burns, Late Effects, and Complications
- Assignment 12.10 Code Diagnoses for Pregnancy, Delivery, and Newborn Care
- Assignment 12.11 Code Diagnoses Using Table of Drugs and Chemicals
- 13. Procedural Coding
- Assignment 13.1 Review Questions
- Procedure Coding Assignments
- Assignment 13.2 Introduction to CPT and Coding Evaluation and Management Services
- Assignment 13.3 Code Anesthesia Problems
- Assignment 13.4 Code Surgical Problems
- Assignment 13.5 Code Problems for Radiology and Pathology
- Assignment 13.6 Procedure Code and Modifier Problems
- Assignment 13.7 Hcpcs/Modifier Code Match
- Assignment 13.8 Procedural Coding Case Scenarios
- Assignment 13.9 Case Scenario for Critical Thinking
- Assignment 13.10 Calculate Fees Based on Resource-Based Relative Value System
- Unit Four: Claims Submission in the Medical Office
- 14. The Paper Claim: CMS-1500
- Assignment 14.1 Review Questions
- Part III Multiple Choice
- Part IV True/False
- Assignment 14.2 Complete a Health Insurance Claim Form for a Private Case
- Assignment 14.3 Complete One Health Insurance Claim Form for a Private Case
- Assignment 14.4 Locate Errors on a Completed Health Insurance Claim Form
- Assignment 14.5 Complete a Claim Form for a Medicare/Medicaid Case
- Assignment 14.6 Complete a Claim Form for a Medicare Case
- Assignment 14.7 Complete a Claim Form for a Medicaid Case
- Assignment 14.8 Complete a Claim Form for a Medicaid Case
- Assignment 14.9 Complete a Claim Form for a Tricare Standard Case
- Assignment 14.10 Complete a Claim Form for a Tricare Extra Case
- Assignment 14.11 Complete a Claim Form for a Workers’ Compensation Case
- Assignment 14.12 Complete a Claim Form for a Workers’ Compensation Case
- 15. The Electronic Claim
- Key abbreviations
- Assignment 15.1 Review Questions
- Assignment 15.2 Input Data Into Element for Place of Service Codes for 837P Electronic Claims Submissions
- Assignment 15.3 Select the Correct Individual Relationship Code Number for 837P Electronic Claims Submission
- Assignment 15.4 Select the Correct Taxonomy Codes for Medical Specialists for 837P Electronic Claims Submission
- Unit Five: Revenue Cycle Management
- 16. Receiving Payments and Insurance Problem Solving
- Assignment 16.1 Review Questions
- Assignment 16.2 Using an Aging Report for Follow-Up
- Assignment 16.3 Post to a Financial Accounting Record (Ledger) from an Explanation of Benefits (Eob) Document
- Assignment 16.4 Locate Errors on a Returned Insurance Claim
- Assignment 16.5 Locate Errors on a Returned Insurance Claim
- Assignment 16.6 Locate Errors on a Returned Insurance Claim
- Assignment 16.7 File an Appeal
- 17. Collection Strategies
- Assignment 17.1 Review Questions
- Assignment 17.2 Select a Dun Message
- Assignment 17.3 Manually Post a Courtesy Adjustment
- Assignment 17.4 Manually Post a Patient’s Charges and Payment
- Assignment 17.5 Compose a Collection Letter
- Assignment 17.6 Accepting Credit Card Payments
- Assignment 17.7 Complete a Financial Agreement
- Unit Six: Health Care Facility Billing
- 18. Introduction to Health Care Facilities and Ambulatory Surgery Centers
- Assignment 18.1 Review Questions
- Critical Thinking Assignments
- Assignment 18.3 Calculating MS-DRG
- Assignment 18.4 APC Discounting
- Assignment 18.5 Critique of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI)
- 19. Billing for Health Care Facilities
- Assignment 19.1 Review Questions
- Part II Mix and Match
- Assignment 19.3 Assigning Character 3 for Root Operation (ICD-10-PCS)
- Assignment 19.4 Assigning ICD-10-PCS Codes
- Assignment 19.5 Completeing The UB-04
- Unit Seven: Employment
- 20. Seeking a Job and Attaining Professional Advancement
- Assignment 20.1 Review Questions
- Assignment 20.2 Job Searching and Job Skills
- Assignment 20.3 Complete a Worksheet and Type a Résumé
- Assignment 20.4 Complete a Cover Letter
- Assignment 20.5 Complete a Job Application Form
- Assignment 20.6 Prepare a Follow-Up Thank-You Letter
- Assignment 20.7 Visit Websites for Job Opportunities
- Assignment 20.8 Critical Thinking
- Test 1: Procedure (E/M and Medicine Sections) and Diagnostic Procedure Code Test
- Test 2: Procedure Code with Modifiers and Diagnostic Code Test
- Test 3: Procedure (Radiology and Pathology Sections) and Diagnostic Code Test
- Test 4: Complete a CMS-1500 Claim Form
- Test 5: Complete a CMS-1500 Claim Form
- Test 6: Complete a Claim form for a Medicare Case
- Test 7: Complete a claim form for a medicare/Medigap case
- Test 8: Complete a Claim form for a Medicaid Case
- Test 9: Complete a Claim form for a Tricare Case
- Test 10: Complete a Claim form for a Private Plan
- A. College Clinic Office Policies and Mock Fee Schedule
- College Clinic
- College Clinic Staff
- Abbreviations and Symbols
- Abbreviations
- Laboratory Abbreviations
- Mock Fee Schedule
- No. of pages : 376
- Language : English
- Edition : 16
- Published : December 13, 2021
- Imprint : Saunders
- Paperback ISBN : 9780323795364
- eBook ISBN : 9780323810784
Linda M. Smith
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COMMENTS
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ASSIGNMENT 19.1 REVIEW QUESTIONS Part I Fill in the Blank Review the objectives, key terms, glossary definitions of key terms, chapter information, and figures before completing the following review questions. is the term used when the second procedure is paid at 50% of 1. the APC rate. 2. In packaging, all of the supplies, medications and ...
ASSIGNMENT 19.1 REVIEW QUESTIONS Part I Fill in the Blank Review the objectives, key terms, glossary definitions of key terms, chapter information, and figures before completing the following review questions. 1. the APC rate. is the term used when the second procedure is paid at 50% of 2. In packaging, all of the supplies, medications and ...
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ASSIGNMENT 19.1 REVIEW QUESTIONS Part I Fill in the Blank Review the objectives, key terms, glossary definitions of key terms, chapter information, and figures before completing the following review questions. 1. is the term used when the second procedure is paid at 50% of the APC rate. 2. In packaging, all of the supplies, medications and ...
Assignment 19.1 Review Questions. Part II Mix and Match. Critical Thinking Assignments. Assignment 19.3 Assigning Character 3 for Root Operation (ICD-10-PCS) Assignment 19.4 Assigning ICD-10-PCS Codes. Assignment 19.5 Completeing The UB-04. Unit Seven: Employment. 20. Seeking a Job and Attaining Professional Advancement
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1.0. ASSIGNMENT 19.1 REVIEW QUESTIONS Part I Fill in the Blank Review the objectives, key terms, glossary definitions of key terms, chapter information, and figures before completing the following review questions. is the term used when the second procedure is paid at 50% of 1. the APC rate. 2. In packaging, all of the supplies, medications and ...
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