Student Workbook for Comprehensive Health Insurance: Billing, Coding, and Reimbursement, 3rd edition

Published by Pearson (July 12, 2017) © 2018

  • Deborah Vines
  • Ann Braceland
  • Elizabeth Rollins
  • Susan Miller
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SECTION I: A CAREER IN HEALTH CARE

1. Introduction to Professional Billing and Coding Careers

SECTION II: THE RELATIONSHIP BETWEEN THE PATIENT, PROVIDER, AND CARRIER

2. Understanding Managed Care: Insurance Plans

3. Understanding Managed Care: Medical Contracts and Ethics

4. Introduction to the Health Insurance Portability and Accountability Act (HIPAA)

SECTION III: MEDICAL CODING

5. ICD-10-CM Medical Coding

6. Introduction to CPT and Place of Service Coding

7. Coding Procedures and Services

8. HCPCS and Coding Compliance

9. Auditing

SECTION IV: MEDICAL CLAIMS

10. Physician Medical Billing

11. Hospital Medical Billing

SECTION V: GOVERNMENT MEDICAL BILLING

12. Medicare Medical Billing

13. Medicaid Medical Billing

14. TRICARE Medical Billing

SECTION VI: ACCOUNTS RECEIVABLE

15. Explanation of Benefits and Payment Adjudication

16. Refunds, Follow-Up, and Appeals

SECTION VII: INJURED EMPLOYEE MEDICAL CLAIM

17. Workers' Compensation

Appendix A: Completing the CMS-1500 Form for Physician Outpatient Billing 

Appendix B:  Completing the CMS-1500 Form for Physician Outpatient Billing Plus Determining the Correct Diagnostic and Procedure Codes 

Appendix C: Completing the UB-04 Form for Hospital Billing 

Appendix D: Medical Forms 

Appendix E: Acronyms and Abbreviations 

Appendix F: Medical Terminology Word Parts 

Appendix G: Helpful Websites 

Glossary 

Index 

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