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.
- Self-study exercises
- reinforce your understanding with matching, true/false, multiple-choice, mix and match, and fill-in-the-blank questions, as well as critical thinking assignments.
- Key terms and abbreviations at the beginning of each chapter provide a quick reference to the health insurance terminology you need to know.
- Study outlines focus your review by listing the key points for each chapter.
- Performance objectives make learning easier by highlighting what you need to accomplish in each chapter.
- Critical Thinking assignments are based on short, real-world vignettes, preparing you to work in a real medical office and allowing you to apply theory learned from the textbook.
- Updated mock fee schedules present the latest information available, for use in completing forms and activities.
- Expanded coverage of inpatient insurance billing includes ICD-10 coding and CMS coding, ensuring that you are prepared to work in healthcare facility settings as well as the physician's office and outpatient settings.
- Updated information on general compliance issues, HIPAA, the Affordable Care Act, and coding reflects changes to the Fordney's Medical Insurance and Billing, 16th Edition text.
- Ambulatory Surgery Center chapter provides the foundation and skills needed for billing in this outpatient setting.
- NEW! Additional procedures
- provide more practice, helping you remember the material.
| Instruction Guide to the Workbook |
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Unit 1 Career Roles and Responsibilities |
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1 Role of an Insurance Billing Specialist |
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1 | (10) |
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2 Privacy, Security, and HIPAA |
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11 | (12) |
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3 Compliance, Fraud, and Abuse |
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23 | (8) |
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Unit 2 Introduction to Health Insurance |
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4 Basics of Health Insurance |
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31 | (12) |
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5 The Blue Plans, Private Insurance, and Managed Care Plans |
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43 | (16) |
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59 | (12) |
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7 Medicaid and Other State Programs |
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71 | (6) |
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8 TRICARE and Veterans' Health Care |
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77 | (6) |
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83 | (14) |
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10 Disability Income Insurance and Disability Benefits Programs |
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97 | (22) |
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Unit 3 Documentation and Coding for Professional Services |
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11 Medical Documentation and the Electronic Health Record |
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119 | (22) |
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141 | (18) |
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159 | (24) |
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Unit 4 Claims Submission in the Medical Office |
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14 The Paper Claim: CMS-1500 |
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183 | (28) |
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211 | (12) |
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Unit 5 Revenue Cycle Management |
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16 Receiving Payments and Insurance Problem Solving |
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223 | (18) |
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241 | (22) |
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Unit 6 Health Care Facility Billing |
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18 Introduction to Health Care Facilities and Ambulatory Surgery Centers |
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263 | (12) |
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19 Billing for Health Care Facilities |
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275 | (12) |
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20 Seeking a Job and Attaining Professional Advancement |
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287 | (16) |
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| Tests |
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303 | (32) |
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| Appendix College Clinic Office Policies and Mock Fee Schedule |
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335 | |
Linda M Smith is the author of Fordney's Medical Insurance, 16e and its accompanying workbook and online course. She has revised 3 editions of HIPAA Online. She has had over 40 years of experience in the healthcare industry as a business manager and is a Certified Professional Coder (CPC). She has also earned the credentials of E/M Specialist (CEMC) and is an approved Professional Medical Coding Curriculum Instructor (CPC-I) through the American Academy of Professional Coders (AAPC). Linda provides training privately to local organizations and is an instructor with various business and technical schools. She and her associates provide training in the areas of medical ethics, medical terminology, anatomy and physiology, and medical coding and billing. They provide continuing education workshops for the organizations mentioned above.
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