Medical Insurance: A Revenue Cycle Process Approach

Medical Insurance: A Revenue Cycle Process Approach emphasizes the revenue cycle-ten steps that clearly identify all the components needed to successfully manage the medical insurance claims process. The cycle shows how administrative medical professionals "follow the money."

Part 1 WORKING WITH MEDICAL INSURANCE AND BILLING
Chapter 1 Introduction to the Revenue Cycle
Chapter 2 Electronic Health Records, HIPAA, and HITECH: Sharing and Protecting Patients' Health Information
Chapter 3 Patient Encounters and Billing Information


Part 2 CLAIM CODING
Chapter 4 Diagnostic Coding: ICD-10-CM
Chapter 5 Procedural Coding: CPT and HCPCS
Chapter 6 Visit Charges and Compliant Billing


Part 3 CLAIMS
Chapter 7 Healthcare Claim Preparation and Transmission
Chapter 8 Private Payers/ACA Plans
Chapter 9 Medicare
Chapter 10 Medicaid
Chapter 11 TRICARE and CHAMPVA
Chapter 12 Workers' Compensation and Disability/Automotive Insurance


Part 4 CLAIM FOLLOW-UP AND PAYMENT PROCESSING
Chapter 13 Payments (RAs), Appeals, and Secondary Claims
Chapter 14 Patient Billing and Collections
Chapter 15 Primary Case Studies
Chapter 16 RA/Secondary Case Studies


Part 5 HOSPITAL SERVICES
Chapter 17 Hospital Billing and Reimbursement