Guide to Health Claims Examining : An Honors Certification Textbook
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Lieferung aus: Vereinigte Staaten von Amerika, Usually ships in 1-2 business days.
Von Händler/Antiquariat, YellowHammerBooks.
Health claims examining and medical billing are two of the fastest-growing employment opportunities in the United States today. Insurance companies, medical offices, hospitals and other health care providers are in great need of trained personnel to create and process claims. With the aid of this text, a student  can learn the skills necessary to become a successful health claims examiner. The material has been designed to be comprehensive, yet user-friendly. The text follows a logical learning format by beginning with a broad base of information and then, step by step, following the course of a health claims from billing to examining. Paperback, Ausgabe: 2, Label: Prentice Hall, Prentice Hall, Produktgruppe: Book, Publiziert: 2006-10-21, Studio: Prentice Hall, Verkaufsrang: 418755.

Lieferung aus: Vereinigte Staaten von Amerika, Usually ships in 1-2 business days.
Von Händler/Antiquariat, worldreaders.
Health claims examining and medical billing are two of the fastest-growing employment opportunities in the United States today. Insurance companies, medical offices, hospitals and other health care providers are in great need of trained personnel to create and process claims. With the aid of this text, a student  can learn the skills necessary to become a successful health claims examiner. The material has been designed to be comprehensive, yet user-friendly. The text follows a logical learning format by beginning with a broad base of information and then, step by step, following the course of a health claims from billing to examining. Paperback, Ausgabe: 2, Label: Prentice Hall, Prentice Hall, Produktgruppe: Book, Publiziert: 2006-10-21, Studio: Prentice Hall, Verkaufsrang: 418755.

Lieferung aus: Vereinigte Staaten von Amerika, Usually ships in 1-2 business days.
Von Händler/Antiquariat, books-go-round.
Health claims examining and medical billing are two of the fastest-growing employment opportunities in the United States today. Insurance companies, medical offices, hospitals and other health care providers are in great need of trained personnel to create and process claims. With the aid of this text, a student  can learn the skills necessary to become a successful health claims examiner. The material has been designed to be comprehensive, yet user-friendly. The text follows a logical learning format by beginning with a broad base of information and then, step by step, following the course of a health claims from billing to examining. Paperback, Ausgabe: 2, Label: Prentice Hall, Prentice Hall, Produktgruppe: Book, Publiziert: 2006-10-21, Studio: Prentice Hall, Verkaufsrang: 418755.

Lieferung aus: Vereinigte Staaten von Amerika, Versandkostenfrei.
Von Händler/Antiquariat, Book Deals [60506629], Lewiston, NY, U.S.A.
Brand New, Unread Copy in Perfect Condition. A+ Customer Service! Summary: (NOTE: Each chapter contains Summary, Assignments, Questions for Review, and Honors for Certification.)1.Introduction to Insurance.The Rising Cost of Health Care.Employee Benefits.Types of Insurance.Type of Health Benefit Plans.Departments in an Insurance Company.Claims Examiner's Responsibilities.The Department of Insurance.2. Legal Issues.Disclaimers.Privacy Guidelines.Fraud.HIPAA and Fraud and Abuse.Investigation.Checkpoints for Spotting Provider Fraud and Insurance Abuse.Embezzlement.Legal Damages.Maintenance of Records.Subpoenas.Exercises.3. Billing Forms.CMS-1500 Form.UB-92.Exercises.Appendix 3-1 Hospital Revenue Codes.4. Resource Manuals.ICD-9.CPT/RVS.HCPCS.Physicians Desk Reference (PDR).Medical Dictionary.Merck Manual.Red Book and Blue Book.Exercises.5. Contracts.Contract Validity.Group Contracts.Contract Provisions.Contract Benefits.Exclusions.Exercises.6. Eligibility.Employee Eligibility.Dependent Eligibility.Employee Effective Date of Coverage.Dependent Effective Date of Coverage.Open Enrollment.Termination of Coverage.Continuation of Coverage.HIPAA.Exercises.7. Usual, Customary, and Reasonable.Resource-Based Relative Value Study.Calculating UCR.Fee Schedules.Exercises.8. Benefit Structures.Benefit Definitions.Benefit Calculations.Calculating Deductible.Basic Benefits.Common Basic Benefits.Basic Major Medical Benefits.Comprehensive Major Medical Benefits.Computing Stoploss.Exercises.9. Cost-Containment Programs.Preadmission Testing.Pre-certification of Inpatient Admissions.Utilization Review.Second Surgical Opinion Consultations.Managed Care.Medical Case Management.Appendix 9-1 Potential Medical Case.Management Claims.10. General Plan Provisions.Acts of Third Parties.Completion of the Right of Reimbursement.Claims Ledger Sheet.Subrogation.Pre-existing Conditions.Mandates.Mental Health Parity Act.Exercises.Appendix 10-1 Possible Pre-existing Conditions.11. Claims Administration.Maintenance of Claim Files.Claim File Documentation.Claim Investigation.Referrals.Pended Claims.Claim Processing.Good Claim Practices.Payment Worksheet.Processing the Claim.Quick Reference Formulas.Prescription Drug Claims.12. Effective Communication.Verbal Communication.Letter Writing.Letter Structure.Terminology.Content.Proofreading.Claimant.Physician.Other Contacts.Communication of Details.Conclusions and Alternatives.Notice of Availability.Right of Review/ERISA.Adjustments.Exercise.13. Physician's Services.CPT Coding.Maintenance Therapy.Modifiers.Exercises.14. X-ray and Laboratory.Services.Radiology (X-ray).Pathology (Lab).General Guidelines.Component Charges.Exercises.15. Surgery.Surgical Procedures.Surgery and the CPT.General Guidelines.Maternity Expenses.Cosmetic Surgery.Obesity Surgery.Co-Surgeons.Assistant Surgeons.Exercises.

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