Generate patient statements. Monitor payer adjudication

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Generate patient statements. Monitor payer adjudication"

Transcription

1 Preface Follow the Money! Medical insurance plays an important role in the financial well-being of every health care business. The regulatory environment of medical insurance is evolving faster than ever. Changes due to health care reform require medical office professionals to acquire and maintain an in-depth understanding of compliance, electronic health records, medical coding, and more. The fifth edition of Medical Insurance: An Integrated Claims Process Approach emphasizes the medical billing 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. Medical insurance specialists must be familiar with the rules and guidelines of each health plan in order to submit proper documentation. This ensures that offices receive maximum, appropriate reimbursement for services provided. Without an effective administrative staff, a medical office would have no cash flow! Here are some of the key skills covered for you and your students in Medical Insurance, 5e : Step 9 Step 8 Generate patient statements Step 10 Monitor payer adjudication Follow up payments and collections Prepare and transmit claims Step 7 Step 1 Preregister patients Check billing compliance Step 2 Medical Billing Cycle Step 6 Establish financial responsibility Review coding compliance Step 5 Check-in patients Check-out patients Step 3 Step 4 Procedural skills Communication skills Health information management skills Medical coding skills HIPAA/HITECH skills Learning administrative duties important in medical practices, as well as how to bill both payers and patients. Working with physicians, patients, payers, and others, using both written and oral communication. Using practice management programs and electronic health records technology to manage both patient records and the billing/collections process, to electronically transmit claims, and to conduct research. Understanding the ICD-9, ICD-10, CPT, and HCPCS codes and their importance to correctly reporting patients conditions on health insurance claims and encounter forms, as well as the role medical coding plays in the claims submission process. Applying the rules of HIPAA (Health Insurance Portability and Accountability Act) and HITECH (Health Information Technology for Economic and Clinical Health act) to ensure compliance, maximum reimbursement, and the electronic exchange of health information. xi

2 About the Cover In putting together our cover image, we wanted to represent the medical billing cycle, while highlighting the theme of follow the money. You can see the evolution from sketch to final cover in the images below. Here s How Your Colleagues Have Described Medical Insurance: For students to gain a better understanding of the material and gain the skills required to work in medical insurance, billing, and coding, they need to have a sound foundation of the nuances, guidelines, and requirements involved. This approach provides the students with the foundational blocks first, and then systematically builds on them. Cynthia Greiner Holmes, MAM The Valerius text is just right. It covers a difficult topic, but is laid out in such a way that if a person is learning the material for the first time, he or she can easily follow along. If an individual already knows some of the material, the chapters are laid out and labeled in such a way that he or she can easily, without confusion, continue on to the next topic without losing the way. Georgina Sampson, RHIA, Anoka Technical College This is the perfect textbook for teaching students the fundamentals of insurance, coding, billing/follow-up along with HIPAA compliance guidelines. Kimberly K. Rash, Gateway Community and Technical College This text is an excellent tool to prepare students to work in the physician practice. It gets straight to the point and provides students with all the information they need to get started. Nikita Carr, CPC, CMBS, Centura College A comprehensive text with thorough, yet easy to follow content not overwhelming for basic/introductory insurance, coding, and billing courses. Denise Kearney, CPC, Wayne Community College xii Preface

3 Organization of Medical Insurance, 5e Part Coverage 1: Working with Medical Insurance and Billing Covers Steps 1 through 4 of the medical billing cycle by introducing the major types of medical insurance, payers, and regulators, as well as the medical billing cycle. Also covers HIPAA Privacy, Security, and Electronic Healthcare Transactions/Code Sets rules. 2: Claim Coding Covers Steps 5 and 6 of the medical billing cycle, while building skills in correct coding procedures, use of coding references, and compliance with proper linkage guidelines. 3: Claims Covers Step 7 of the medical billing cycle by covering the general procedures for calculating reimbursement, how to bill compliantly, and preparing and transmitting claims. 4: Claim Follow-up and Payment Processing Covers Steps 8 through 10 of the medical billing cycle by providing descriptions of the major third-party private and governmentsponsored payers procedures and regulations, along with specific filing guidelines. Also explains how to handle payments from payers, follow up and appeal claims, file secondary claims, and correctly bill and collect from patients. This part includes two case studies chapters that provide exercises to reinforce knowledge of completing primary/secondary claims, processing payments from payers, and handling patients accounts. These case studies can be completed using Medisoft Advanced Version 16. 5: Hospital Services Provides necessary background in hospital billing, coding, and payment methods. Guide to Medisoft and Guide to Interactive Simulated CMS-1500 Form Provides information on how to work with Medisoft and the interactive CMS-1500 form. The text reads like a set of directions that are easy to follow and understand. The inclusion of many forms/documents and diagrams provide visual examples further emphasizing the topic. Ja n e W. D u m a s, CCM A, CPT, CET, CH I, R e ming to n College New to the Fifth Edition One of the first things you may notice, if you are familiar with earlier editions, is that the design of Medical Insurance has been updated and refreshed. Medical Insurance is now designed around the medical billing cycle, with each part of the book dedicated to a section of the cycle, followed by case studies to apply the skills needed in each section. The addition of end-of-chapter summaries allows for easier review. Key content changes include: Pedagogy Learning Outcomes are restated to reflect the revised version of Bloom s Taxonomy. Major chapter heads are structured to reflect the numbered Learning Outcomes. Thinking It Through questions have been added to assess each Learning Outcome. Preface xiii

4 End-of-chapter elements are now tagged with Learning Outcomes. New Chapter Summaries have been created in a tabular, step-by-step format with page references. Revised chapter structure lets students progress through the complete medical billing cycle, including the Primary Case Studies and the RA/ EOB/Secondary Case Studies. This new structure is reinforced by the design that ties the medical billing cycle clearly to the chapter. HIPAA-Related Updates 2011 ICD-9-CM and CPT/HCPCS codes are now included. HITECH rules are incorporated. Tips are now titled HIPAA/HITECH. Chapter by Chapter Chapter 1: New key terms certification, Patient Protection and Affordable Care Act (PPACA); updated Figure 1.1 reflects current employment statistics; chapter now emphasizes the importance of certification for career advancement Chapter 2: HITECH concepts added; new key terms American Recovery and Reinvestment Act, breach, breach notification, HITECH Chapter 3: New key terms cash flow, revenue cycle management, realtime benefit information; Internet-based insurance verification procedures added; new emphasis on real-time claim adjudication and time of service (TOS) collections Chapter 4: New key term ICD-10-CM; expanded introduction to ICD-10-CM with Thinking It Through to practice locating codes using the Internet-based code set Chapter 5: New key term resequenced; new topic of CPT resequenced codes Chapter 6: New key terms Certificate of Medical Necessity (CMN), never events, Pricing, Coding Analysis, and Coding (PDAC) contractor, Durable Medical Equipment Medicare Administrative Contractor (DME MAC); updated HPCPS contractor information Chapter 7: New key term Recovery Audit Contractor (RAC) Chapter 8: New billing tip on acceptable provider signatures Chapter 9: New key term medical home model; concept of medical home model introduced; new coverage of out-of-network billing and fees the FAIR Health Inc. out-of-network physician payment database Chapter 10: New discussion on voluntary use of ABN (replacing the NEMB); step-by-step instructions on filling out the ABN; discussion of nonpayment of CPT consultation codes under the Medicare Physician Fee Schedule; effect of the Health Reform Act (PPACA) on Medicare claims (now 12 months is the deadline by which providers may submit Medicare Claims) Chapter 11: New concept and key term Medicaid Integrity Program (MIP) Chapter 14: Update for Medicare Appeals Process and FERA rule Chapter 15: New key terms Red Flag rule, Equal Credit Opportunity Act (ECOA) Chapters 16 and 17: Updated for Medisoft Advanced Version 16 xiv Preface

5 Chapter 18: New coverage of hospital-acquired conditions (HACs) as they relate to never events; new never events modifiers; more information on MS-DRGs, new UB-04 claim exercises; updated coverage of the RAC program; explanation of ICD-10-PCS; new key terms hospital-acquired condition (HAC), major diagnostic category (MDC), hospital-issued notice of noncoverage (HINN), ICD-10-PCS To the Instructor McGraw-Hill knows how much effort it takes to prepare for a new course. Through focus groups, symposia, reviews, and conversations with instructors like you, we have gathered information about what materials you need in order to facilitate successful courses. We are committed to provide you with high-quality, accurate instructor support. Using Medisoft Advanced Version 16 with Medical Insurance Medical Insurance features Medisoft Advanced Version 16 patient accounting software with Chapters 16 and 17. McGraw-Hill has partnered with Medisoft from the very beginning, going back fifteen years to when the software was DOS-based! The support you receive when you are using a McGraw-Hill text with Medisoft is second to none. Your students will need the following: Minimum System Requirements Pentium III 500 MHz (minimum) or higher processor 500 MB available hard disk space 512 MB RAM 32-bit color display (minimum screen display of ) Windows XP Professional SP3 or higher 32-bit Windows Vista Business SP1 or higher 32-bit Windows 7 Ultimate External storage device, such as a USB flash drive, for storing backup copies of the working database Medisoft Advanced Version 16 patient billing software Student data file, available for download from the book s Online Learning Center, Instructor s Software: Medisoft Advanced Version 16 CD-ROM Instructors who use McGraw-Hill Medisoft-compatible titles in their courses receive a fully working version of Medisoft Advanced Version 16 software, which allows a school to place the live software on the laboratory or classroom machines. Only one copy is needed per campus location. Your McGraw-Hill sales representative will help you obtain Medisoft for your campus. Preface xv

6 Medisoft-Compatible Titles Available from McGraw-Hill: Sanderson, Computers in the Medical Office (CiMO), 7e , Sanderson, Case Studies for Use with Computers in the Medical Office, 6e X, Valerius/Bayes/Newby/Seggern, Medical Insurance: An Integrated Claims Process Approach, 5e , Valerius/Bayes/Newby/Seggern, Workbook for Use with Medical Insurance: An Integrated Claims Process Approach, 5e , Bayes/Crist/Becklin, Medical Office Procedures, 7e , xvi Preface

7 The McGraw-Hill Guide to Success for Medisoft Advanced Version 16 We want your transition to Medisoft Advanced Version 16 to be a snap! In The McGraw-Hill Guide to Success for Medisoft Advanced Version 16, the following topics are addressed: Software installation procedures for both the Instructor Version and the Student At-Home Version of Medisoft Student data files installation procedures Use of flash drives Backup and restore processes Frequently asked questions (FAQs) Instructor resources Technical support Ask your McGraw-Hill sales representative to send you a copy, or visit to review the materials online. Instructor Resources You can rely on the following materials to help you and your students work through the exercises in the book: Instructor Edition of the Online Learning Center at valerius5e. Your McGraw-Hill sales representative can provide you with access and show you how to go green with our online instructor support. Instructor s Manual with course overview; lesson plans; sample syllabi; transition guides; answer keys for end-of-chapter questions; and correlations to competencies from several organizations such as ABHES, CAAHEP, and CAHIIM. More details can be found in the IM and at the book s website, A PowerPoint slide presentation for each chapter, containing teaching notes correlated to Learning Outcomes. Each presentation seeks to reinforce key concepts and provide a visual for students. The slides are excellent for in-class lectures. Test bank and answer key for use in classroom assessment. The comprehensive test bank includes a variety of question types, with each question linked directly to its Learning Outcome, Bloom s Taxonomy, and difficulty level. Both a Word version and a computerized version (EZ Test) of the test bank are provided. Conversion Guide with a chapter-by-chapter breakdown of how the content has been revised between editions. The guide is helpful if you are currently using Medical Insurance and moving to the new edition, or if you are a first-time adopter. Instructor Asset Map to help you find the teaching material you need with a click of the mouse. These online chapter tables are organized by Learning Outcomes, and allow you to find instructor notes, PowerPoint slides, and even test bank suggestions with ease! The Asset Map is a completely integrated tool designed to help you plan and instruct your courses efficiently and comprehensively. It labels and organizes course material for use in a multitude of learning applications. Preface xvii

8 Connect Plus : McGraw-Hill Connect Plus is a revolutionary online assignment and assessment solution, providing instructors and students with tools and resources to maximize their success. Through Connect Plus, instructors enjoy simplified course setup and assignment creation. Robust, media-rich tools and activities, all tied to the textbook Learning Outcomes, ensure you ll create classes geared toward achievement. You ll have more time with your students and spend less time agonizing over course planning. McGraw-Hill LearnSmart for Medical Insurance, Billing, and Coding: LearnSmart diagnoses students skill levels to determine what they re good at and where they need help. Then, it delivers customized learning content based on their strengths and weakness. The result: Students get the help they need, right when they need it instead of getting stuck on lessons, or being continually frustrated with stalled progress. McGraw-Hill Higher Education and Blackboard have teamed up. What does this mean for you? 1. Your life, simplified. Now you and your students can access McGraw-Hill s Connect and Create right from within your Blackboard course all with one single sign-on. Say goodbye to the days of logging in to multiple applications. 2. Deep integration of content and tools. Not only do you get single sign-on with Connect and Create, you also get deep integration of McGraw-Hill content and content engines right in Blackboard. Whether you re choosing a book for your course or building Connect assignments, all the tools you need are right where you want them inside of Blackboard. 3. Seamless gradebooks. Are you tired of keeping multiple gradebooks and manually synchronizing grades into Blackboard? We thought so. When a student completes an integrated Connect assignment, the grade for that assignment automatically (and instantly) feeds your Blackboard grade center. 4. A solution for everyone. Whether your institution is already using Blackboard or you just want to try Blackboard on your own, we have a solution for you. McGraw-Hill and Blackboard can now offer you easy access to industry leading technology and content, whether your campus hosts it, or we do. Be sure to ask your local McGraw-Hill representative for details. Need Help? Contact the Digital Care Support Team Visit our Digital CARE Support website at Browse the FAQs (frequently asked questions) and product documentation, and/or contact a CARE support representative. The Digital CARE Support Team is available Sunday through Friday. xviii Preface

9 Beyond Medical Insurance: Opportunities for Your Students to Apply their Skills Workbook for Use with Medical Insurance: An Integrated Claims Process Approach, Fifth Edition ( , ) The Workbook for Use with Medical Insurance has excellent material for reinforcing the text content, applying concepts, and extending understanding. It combines the best features of a workbook and a study guide. Each workbook chapter enhances the text s strong pedagogy through: Assisted Outlining reinforce the chapter s key points Key Terms objective questions and crossword puzzles/word finds Critical Thinking questions that stimulate process understanding Guided Web Activities build skill in locating and then evaluating information on the Internet Applying Concepts reinforce and extend abstracting insurance information, calculating insurance math, and using insurance terms The workbook matches the text chapter-by-chapter. It reinforces, applies, and extends the text to enhance the learning process. Medical Coding Workbook for Physician Practices & Facilities Edition ( , ) The Medical Coding Workbook provides practice and instruction in coding and compliance skills. Since medical insurance specialists verify diagnosis and procedure codes and use them to report physicians services, a fundamental understanding of coding principles and guidelines is the baseline for correct claims. The coding workbook reinforces and enhances skill development by applying the coding principles introduced in Medical Insurance, 5e and extending knowledge through additional coding guidelines, examples, and compliance tips. It offers over 75 case studies that simulate more real-world application. Also included are inpatient scenarios for coding that require compliance with ICD-9-CM Official Guidelines for Coding and Reporting sequencing rules, as explained in Chapter 18 of the text. Preface xix

10 CodeitRightOnline : Your Online Coding Tool So that your students can gain experience with the use of an online coding tool, they will have access for a 14-day period to CodeitRightOnline, produced by Contexo Media, a division of Access Intelligence. Features These are the general features that are offered with a subscription: CodeitRightOnline Search The ability to find a CPT, HCPCS Level II, and ICD-9-CM code either using the Index or Tabular search sections, by code terminology, description, keyword, or code number to locate the correct code. Plus, the Single Search Feature allows you to locate all codes related to a particular term. Fully customizable Provides note capability, LCD customization, personalized searches and fee schedules, and specialty-specific code sets. Print Custom Coding Books Subscribers can create and print their own specialty-specific CPT, HCPCS, ICD-9-CM, and RVU books. Coding Crosswalks Essential coding links from CPT codes to ICD-9-CM to HCPCS Level II codes and to Anesthesia codes. Articles We have compiled articles from CMS, OIG, carriers, intermediaries, payers, and other government websites along with newsletter articles from AMA, AHA, Decision Health, Coding Institute, and others. Plus LCD/NCD codes for a local state carrier, Medicare s payment policy indicators, and, of course, CPT, HCPCS Level II, and ICD-9-CM codes with full descriptions and our Plain English Definitions. ICD-10-CM/PCS Code Sets Helps you prepare for 2013 mandatory implementation with ICD-10-CM/PCS full code sets and descriptions. NCCI Edits Validator Validates codes to help you remain in compliance with the correct coding guidelines established by the Centers for Medicare & Medicaid Services (CMS). Automatic Updates Ensures that CodeitRightOnline contains the most up-to-date, real-time information. Build-A-Code Allows students to build codes from the ground up, helping them understand how ICD-10 codes are constructed. Click-A-Dex Helps index searches for easy future reference. Comprehensive Medicare Resource Contains local coverage determination (LCD) and national coverage determination (NCD) information, contact information for comprehensive list of Medicare providers, and information on how to bill for procedures allowed by Medicare s Physician Quality Reporting Initiative (PQRI) program. ABC Codes and Descriptions Provide access to the alternative medicine codes you need to describe services, remedies, and/or supplies required during patient visits. xx Preface

11 Using the Online Coding Tool Go to CodeitRightOnline to complete the steps needed to begin. The following screen will appear: Click on the Free Trial tab at the top right-hand corner of the screen. On the page that appears, enter your name, address, school, phone, and address. Next, click on Use account contact information for your account administrator information, a one-time process that optimizes CodeitRight- Online for your particular location. Choose a username and password you will remember. Next, read the Terms and Conditions, including the AMA Agreement. After accepting these Terms and Conditions, click Continue. You will then receive an containing an activation link. Clicking on the link will activate your account. From that page, follow the Click here link to sign in with the account information you selected. This will take you to the CodeitRightOnline home page you re in! These actions set up your trial subscription. Now, to use the online coding tool to locate codes, click Search and select the appropriate code set. Next, choose the start point for your code search. For example, select ICD-9-CM Vol 1,2 and Vol 3 in the Show Results For box, enter the term fracture, and click Search. CodeitRightOnline will return a list of the various fracture entries for your selection. To see how it works, choose Fracture of Ribs, Closed and click the code number to review the Tabular List entry. Preface xxi

Preface. Medical Billing Cycle

Preface. Medical Billing Cycle Preface Step 9 Step 8 Generate patient statements Step 10 Monitor payer adjudication Follow up payments and collections Prepare and transmit claims Step 7 Follow the Money! Medical insurance plays an important

More information

Medical Coding Workbook for Physician Practices and Facilities: ICD-10 Edition

Medical Coding Workbook for Physician Practices and Facilities: ICD-10 Edition Expertise in working with the HIPAA-mandated code sets found in ICD-10-CM and CPT/HCPCS is the baseline for correct coding. The diagnosis and procedure codes that physician practices and hospitals report

More information

Overview. A Note from the Authors on Why They Wrote This Book PREFACE

Overview. A Note from the Authors on Why They Wrote This Book PREFACE PREFACE Overview Medical Coding Certification Exam Preparation is designed to aid in the review for the Certified Professional Coder (CPC) exam. However, much of the information included in this text will

More information

New to the Second Edition

New to the Second Edition p reface EHR Matters! Welcome to the second edition of Integrated Electronic Health Records: An Online Course and Worktext for Greenway Medical Technologies PrimeSUITE! Electronic Health Records implementation

More information

preface EHR HIM EHR Matters!

preface EHR HIM EHR Matters! preface EHR Matters! Welcome to Integrated Electronic Health Records: An Online Course and Worktext for Greenway Medical Technologies PrimeSUITE! Electronic Health Records implementation in the United

More information

MediRegs Coding Suite

MediRegs Coding Suite MediRegs Coding Suite Specialized health care solutions to accelerate coding compliance and ensure accurate and timely reimbursement MediRegs Coding Suite from Wolters Kluwer Law & Business is a web-based

More information

A. CPT Coding System B. CPT Categories, Subcategories, and Headings

A. CPT Coding System B. CPT Categories, Subcategories, and Headings OST 148 MEDICAL CODING, BILLING AND INSURANCE COURSE DESCRIPTION: Prerequisites: None Corequisites: None This course introduces CPT and ICD coding as they apply to medical insurance and billing. Emphasis

More information

Table of Contents 1: Welcome 2: Connect Plus

Table of Contents 1: Welcome 2: Connect Plus 1 McGraw Hill Guide to Success for the Greenway/Shanholtzer Integrated EHR Online Course 2 Table of Contents 1: Welcome 2: Connect Plus Functionality 3: Demo Mode 4: Practice Mode 5: Test Mode 6: Assessment

More information

ICD-10 Action Plan: Your 12-Step Transition Plan for ICD-10. Written by the AMA CPT Medical Informatics Department

ICD-10 Action Plan: Your 12-Step Transition Plan for ICD-10. Written by the AMA CPT Medical Informatics Department ICD-10 Action Plan: Your 12-Step Transition Plan for ICD-10 Written by the AMA CPT Medical Informatics Department P R A C T I C E T O O L S E P T E M B E R 2 0 1 2 This resource is for educational purposes

More information

MEDICAL BILLING & CODING PROGRAM

MEDICAL BILLING & CODING PROGRAM ELIM OUTREACH TRAINING CENTER 1820 Ridge Rd Suite 300-301 Homewood, IL 60430 Tel:708-922-9547-Fax: 708-922-9568 E-mail: elim1820@comcast.net Website: elimotc.com MEDICAL BILLING & CODING PROGRAM ELIM OUTREACH

More information

Lesson 1. Introduction to Computers in the Medical Office ASSIGNMENT 1: INSTALLING THE MEDISOFT SOFTWARE. Introduction. Loading the Software

Lesson 1. Introduction to Computers in the Medical Office ASSIGNMENT 1: INSTALLING THE MEDISOFT SOFTWARE. Introduction. Loading the Software Introduction to Computers in the Medical Office ASSIGNMENT 1: INSTALLING THE MEDISOFT SOFTWARE There s no corresponding textbook reading for this section. Introduction Medisoft is one of many practice

More information

Frequently Asked Questions (FAQs)

Frequently Asked Questions (FAQs) OVERVIEW 1. What is an ICD Code? The International Classification of Diseases (ICD) code set is used primarily to report medical diagnosis and inpatient procedures. ICD codes are mandated by the Centers

More information

CMIS. Insurance Specialist (CMIS) Certified Medical CMIS. Class size is limited to 25 to maximize learning experience.

CMIS. Insurance Specialist (CMIS) Certified Medical CMIS. Class size is limited to 25 to maximize learning experience. CMIS Certified Medical Insurance Specialist (CMIS) Class size is limited to 25 to maximize learning experience. CMIS Understand payer models and rules for accurate claim filing and reimbursement. Improving

More information

Local Coverage Article: Venipuncture Necessitating Physician s Skill for Specimen Collection Supplemental Instructions Article (A50852)

Local Coverage Article: Venipuncture Necessitating Physician s Skill for Specimen Collection Supplemental Instructions Article (A50852) Local Coverage Article: Venipuncture Necessitating Physician s Skill for Specimen Collection Supplemental Instructions Article (A50852) Contractor Information Contractor Name CGS Administrators, LLC Article

More information

Improved Revenue Cycle Management. Cathrina Caldwell, CPC, CPC-H Director, Sales Product Consulting

Improved Revenue Cycle Management. Cathrina Caldwell, CPC, CPC-H Director, Sales Product Consulting Improved Revenue Cycle Management Cathrina Caldwell, CPC, CPC-H Director, Sales Product Consulting Optum Businesses (Formerly Known as Ingenix) One of the largest health information, technology and consulting

More information

Professional Review Guide for the CCS-P Examination 2009 Edition

Professional Review Guide for the CCS-P Examination 2009 Edition Professional Review Guide for the CCS-P Examination 2009 Edition Patricia J. Schnering, RHIA, CCS Toni Cade, MBA, RHIA, CCS, FAHIMA Lisa Delhomme, MHA, RHIA Irene L. E. Mueller, EdD, RHIA PRG Publishing,

More information

Preparing for ICD-10 WellStar Medical Group Toolkit

Preparing for ICD-10 WellStar Medical Group Toolkit Preparing for ICD-10 WellStar Medical Group Toolkit Preparing for ICD-10 On Oct. 1, 2015, WellStar will transition from ICD-9 to ICD-10 coding for all medical diagnoses and hospital procedures Systemwide.

More information

Contexo Media is the Best Value in Coding Education

Contexo Media is the Best Value in Coding Education We have found that the Contexo Books are the best choice for us not only price-wise but mainly because of the illustrations, descriptions and the layout of the books. The Contexo ICD-9 books have full

More information

What is your level of coding experience?

What is your level of coding experience? The TrustHCS Academy is dedicated to growing new coders to enter the field of medical records coding while also increasing the ICD-10 skills of seasoned coding professionals. A unique combination of on-line

More information

Online Claim Entry UB-04. Presented by: Xerox State Healthcare, LLC Provider Relations

Online Claim Entry UB-04. Presented by: Xerox State Healthcare, LLC Provider Relations Online Claim Entry UB-04 Presented by: Xerox State Healthcare, LLC Provider Relations Resources When online use: Ask Service Representative HIPAA.Desk.NM@xerox.com NMPRSupport@xerox.com Call Center 505-246-0710

More information

ICD-10 Coding for Audiology

ICD-10 Coding for Audiology ICD-10 Coding for Audiology Mary Sue Fino-Szumski, Ph.D., M.B.A. Vanderbilt University School of Medicine Vanderbilt Bill Wilkerson Center Department of Hearing and Speech Sciences Disclosure Financial

More information

How to select a practice management system

How to select a practice management system How to select a practice management system New challenges and opportunities are impacting your practice today The physician practice environment is changing dramatically. The transition to ICD-10-CM and

More information

A Learning Path to Understanding Biology

A Learning Path to Understanding Biology A Learning Path to Understanding Biology Understanding Biology and its online assets have been carefully thought out and crafted to help you, the student, work efficiently and effectively through the material

More information

HIPAA: AN OVERVIEW September 2013

HIPAA: AN OVERVIEW September 2013 HIPAA: AN OVERVIEW September 2013 Introduction The Health Insurance Portability and Accountability Act of 1996, known as HIPAA, was enacted on August 21, 1996. The overall goal was to simplify and streamline

More information

COURSE INFORMATION FORM

COURSE INFORMATION FORM DATE SUBMITTED 4/4/14 CATALOG NO. HIM 214 DATE DICC APPROVED 02/2015 DATE LAST REVIEWED 11/4/13 DISCIPLINE COURSE TITLE COURSE INFORMATION FORM Health Information Management Healthcare Reimbursement Methodologies

More information

Medical Billing and Coding Specialist Total Program Cost with Prerequisite Courses: $4,184 315 Total Program Hours with elective

Medical Billing and Coding Specialist Total Program Cost with Prerequisite Courses: $4,184 315 Total Program Hours with elective Medical Billing and Coding Specialist Total Program Cost with Prerequisite Courses: $4,184 315 Total Program Hours with elective Medical Billing and Coding Specialists are responsible for translating and

More information

Welcome to. Countdown to ICD-10: TOP 10 THINGS TO DO TO PREPARE FOR ICD-10

Welcome to. Countdown to ICD-10: TOP 10 THINGS TO DO TO PREPARE FOR ICD-10 Welcome to Countdown to ICD-10: TOP 10 THINGS TO DO TO PREPARE FOR ICD-10 Topics for Discussion ICD-10 Overview Countdown to ICD-10 Top 10 Things to Do to Prepare for ICD- 10 Get to Know ICD-10 Know Your

More information

Course Catalog. Libman Education Inc. offers the following training and education opportunities for HIM professionals:

Course Catalog. Libman Education Inc. offers the following training and education opportunities for HIM professionals: Libman Education Inc. offers the following training and education opportunities for HIM professionals: ANATOMY & PHYSIOLOGY/MEDICAL TERMINOLOGY Anatomy & Physiology Skills Assessment Knowledge of anatomy

More information

ICD -10 TRANSITION AS IT RELATES TO VISION. Presented by: MARCH Vision Care, 2013

ICD -10 TRANSITION AS IT RELATES TO VISION. Presented by: MARCH Vision Care, 2013 ICD -10 TRANSITION AS IT RELATES TO VISION Presented by: MARCH Vision Care, 2013 INTRODUCTION During the summer of 2008, the Department of Health and Human Services (HHS) initiated the implementation process

More information

National Correct Coding Initiative Policy Manual for Medicare Services Revision Date: January 1, 2014

National Correct Coding Initiative Policy Manual for Medicare Services Revision Date: January 1, 2014 National Correct Coding Initiative Policy Manual for Medicare Services Revision Date: January 1, 2014 Current Procedural Terminology 2013 American Medical Association. All Rights Reserved. Current Procedural

More information

Molina Healthcare Post ICD 10 FAQ

Molina Healthcare Post ICD 10 FAQ Molina Healthcare Post ICD 10 FAQ On March 31, 2014, the Senate voted to approve a bill to delay the implementation of ICD-10-CM/ PCS by at least one year. President Obama signed the bill into law on April

More information

WEEK CHAPTER OBJECTIVES ASSIGNMENTS & TESTS 19-20 6A medical necessity as it ICD-9-CM Coding. relates to reporting diagnosis codes on claims.

WEEK CHAPTER OBJECTIVES ASSIGNMENTS & TESTS 19-20 6A medical necessity as it ICD-9-CM Coding. relates to reporting diagnosis codes on claims. HEALTH INSURANCE & CODING Textbook: Understanding Health Insurance: A Guide to Billing and Reimbursement 11 th edition Website Activities: StudyWARE Online Practice Software linked to the book. SimClam:

More information

Below are some frequently asked questions that may assist your practice.

Below are some frequently asked questions that may assist your practice. Dear Providers: With the recent announcement in the delay for the implementation for ICD-10-CM/PCS we wanted to provide an update on Blue Cross and Blue Shield of Vermont s (BCBSVT) implementation. We

More information

Meaningful Use, ICD-10 and HIPAA 5010 Overview, talking points and FAQs

Meaningful Use, ICD-10 and HIPAA 5010 Overview, talking points and FAQs Meaningful Use, ICD-10 and HIPAA 5010 Overview, talking points and FAQs Providence Health & Services is committed to using technology and evidence-based practices to deliver the highest quality care in

More information

The following online training module will provide a general overview of the Vanderbilt University Medical Center s (VUMC) technical revenue cycle.

The following online training module will provide a general overview of the Vanderbilt University Medical Center s (VUMC) technical revenue cycle. The following online training module will provide a general overview of the Vanderbilt University Medical Center s (VUMC) technical revenue cycle. This Revenue Cycle Overview training will establish a

More information

Preface. Your Career in Medical Insurance, Billing, and Reimbursement

Preface. Your Career in Medical Insurance, Billing, and Reimbursement Welcome to the sixth edition of From Patient to Payment. This text/ workbook is designed for introductory medical insurance courses. Its practical, focused approach provides students with the basics of

More information

MEDICAL BILLING & CODING PROGRAM

MEDICAL BILLING & CODING PROGRAM ELIM OUTREACH TRAINING CENTER 1820 Ridge Rd Suite 300-301 Homewood, IL 60430 Tel:708-922-9547-Fax: 708-922-9568 E-mail: elim1820@comcast.net Website: elimotc.com MEDICAL BILLING & CODING PROGRAM ELIM OUTREACH

More information

Practice management system criteria checklist

Practice management system criteria checklist Practice management system criteria checklist The American Medical Association (AMA) and Medical Group Management Association (MGMA) have created the following checklist as a starting point for assessing

More information

Final. National Health Care Billing Audit Guidelines. as amended by. The American Association of Medical Audit Specialists (AAMAS)

Final. National Health Care Billing Audit Guidelines. as amended by. The American Association of Medical Audit Specialists (AAMAS) Final National Health Care Billing Audit Guidelines as amended by The American Association of Medical Audit Specialists (AAMAS) May 1, 2009 Preface Billing audits serve as a check and balance to help ensure

More information

Medical Practice Management Software EzMedPro http://www.dsoftsystems.com. User Manual For

Medical Practice Management Software EzMedPro http://www.dsoftsystems.com. User Manual For User Manual For Table of Contents INSTALLATION... 4 Windows Install... 4 EzMedPro Setup... 8 Environment Setup... 10 Setup Mode:... 10 Network Setup... 11 Standalone Mode... 12 Environment Setup... 13

More information

Development and Implementation of the Reimbursement Strategy. Patty Curoe Telgener, RN, MBA VP of Reimbursement Services Emerson Consultants, Inc.

Development and Implementation of the Reimbursement Strategy. Patty Curoe Telgener, RN, MBA VP of Reimbursement Services Emerson Consultants, Inc. Development and Implementation of the Reimbursement Strategy Patty Curoe Telgener, RN, MBA VP of Reimbursement Services Emerson Consultants, Inc. 1 Emerson Consultants, Inc. is a full service Consulting

More information

Countdown to ICD-10. August 27, 2015

Countdown to ICD-10. August 27, 2015 Countdown to ICD-10 August 27, 2015 Disclaimers This presentation was current at the time it was published or uploaded onto the web. Medicare policy changes frequently so links to the source documents

More information

Chapter 1. Health Insurance Specialist Career

Chapter 1. Health Insurance Specialist Career Chapter 1 Health Insurance Specialist Career INTRODUCTION Health insurance practice follow rules of the health insurance policy. The office staff or the insurance specialist work hard to send bills on

More information

1. ICD-10-CM, SKILLED NURSING FACILITIES, AND LAB SERVICES

1. ICD-10-CM, SKILLED NURSING FACILITIES, AND LAB SERVICES 1. ICD-10-CM, SKILLED NURSING FACILITIES, AND LAB SERVICES 1.1 ICD-10-CM, SKILLED NURSING FACILITIES, AND LAB SERVICES Welcome to the ICD-10-CM, Skilled Nursing Facilities, and Lab Services training. Please

More information

MEDICAL BILLING AND CODING CERTIFICATE

MEDICAL BILLING AND CODING CERTIFICATE Sonoran Desert Institute School of Arts and Sciences Academy of Medical Professions 8767 E. Via De Ventura, Suite 126 Scottsdale AZ 85258-3376 Phone: (480) 314-2102 or Toll Free 1-800-336-8939 Fax: (480)

More information

ICD-10 Compliance Date

ICD-10 Compliance Date ICD-10 Implementation Frequently Asked Questions Updated September 2015 ICD-10 Compliance Date The U.S. Department of Health and Human Services (HHS) issued a rule on July 31, 2014 finalizing October 1,

More information

FAQs on Billing for Health and Behavior Services

FAQs on Billing for Health and Behavior Services FAQs on Billing for Health and Behavior Services by Government Relations Staff January 29, 2009 Practicing psychologists are eligible to bill for applicable services and receive reimbursement from Medicare

More information

PELLISSIPPI STATE COMMUNITY COLLEGE MASTER SYLLABUS INSURANCE BILLING & CODING OST 2945

PELLISSIPPI STATE COMMUNITY COLLEGE MASTER SYLLABUS INSURANCE BILLING & CODING OST 2945 PELLISSIPPI STATE COMMUNITY COLLEGE MASTER SYLLABUS INSURANCE BILLING & CODING OST 2945 Class Hours: 3.0 Credit Hours: 3.0 Laboratory Hours: 0.0 Revised: Spring 2010 Catalog Course Description: A continuation

More information

Improved revenue cycle management for Epic. Cathrina Caldwell, CPC, CPC-H Director, Sales Product Consulting

Improved revenue cycle management for Epic. Cathrina Caldwell, CPC, CPC-H Director, Sales Product Consulting Improved revenue cycle management for Epic Cathrina Caldwell, CPC, CPC-H Director, Sales Product Consulting Agenda OptumInsight Overview Traditional physician claim workflow A better way Claims Manager

More information

SPRING/SUMMER 2016 ONLINE CLASSES

SPRING/SUMMER 2016 ONLINE CLASSES 1 SPRING/SUMMER 2016 ONLINE CLASSES What to Expect with these Online Courses All classes meet online. Just turn on your computer, Go to Internet, Enter Online classroom. Instructor available to give you

More information

Medical Office Billing

Medical Office Billing Medical Office Billing A Self-Study Training Manual Sarah J. Holt, PhD, FACMPE Medical Group Management Association 104 Inverness Terrace East Englewood, CO 80112-5306 877.275.6462 mgma.com Introduction

More information

COM Compliance Policy No. 3

COM Compliance Policy No. 3 COM Compliance Policy No. 3 THE UNIVERSITY OF ILLINOIS AT CHICAGO NO.: 3 UIC College of Medicine DATE: 8/5/10 Chicago, Illinois PAGE: 1of 7 UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE CODING AND DOCUMENTATION

More information

Elmira Business Institute Medical Billing (MED 130) Elmira Business Institute Student Syllabus: Medical Billing (MED 130) Semester: Spring 2014

Elmira Business Institute Medical Billing (MED 130) Elmira Business Institute Student Syllabus: Medical Billing (MED 130) Semester: Spring 2014 Instructor Information: Instructor: Office Location: Telephone: Email: Office and Tutoring Hours: Elmira Business Institute Student Syllabus: Medical Billing (MED 130) Semester: Spring 2014 Course Identification:

More information

ActivHealthCare EDI User Guide

ActivHealthCare EDI User Guide ActivHealthCare EDI User Guide Table of Contents Page Enrollment 2 Preparing Your Management Software 3 Claims Submission for AHC Network Affiliates 4 Online Entry Tool 7 Claims Follow-Up 8 Frequently

More information

Addressing the Revenue Disruption Associated with the Transition to ICD-10. October 29, 2012 www.medimobile.com

Addressing the Revenue Disruption Associated with the Transition to ICD-10. October 29, 2012 www.medimobile.com Addressing the Revenue Disruption Associated with the Transition to ICD-10 October 29, 2012 www.medimobile.com Table of Contents Executive Summary................... 3 Introduction.........................

More information

and the Mechanics of MICHAEL K. HARRINGTON, MSHA, RHIA, CHP Faculty Department of Health Administration St. Joseph's College of Maine Standish, Maine

and the Mechanics of MICHAEL K. HARRINGTON, MSHA, RHIA, CHP Faculty Department of Health Administration St. Joseph's College of Maine Standish, Maine HEALTH CARE FINANCE and the Mechanics of Insurance and Reimbursement MICHAEL K. HARRINGTON, MSHA, RHIA, CHP Faculty Department of Health Administration St. Joseph's College of Maine Standish, Maine Ä-

More information

Management Report Services. Staff Training and Education Services

Management Report Services. Staff Training and Education Services Management Report Services Your management team will receive reports that are clear, well defined and serve as a tool for increased performance. These include a brief description emphasizing how the information

More information

To define and explain different learning styles and learning strategies.

To define and explain different learning styles and learning strategies. Medical Billing and Coding Program Overview The Medical Billing and Coding program prepares students for entry-level employment as a medical billing and/or coding clerk. It discusses the fundamentals of

More information

Transitioning from ICD-9-CM to ICD-10-CM. Tidewater Physicians Multispecialty Group Williamsburg, VA

Transitioning from ICD-9-CM to ICD-10-CM. Tidewater Physicians Multispecialty Group Williamsburg, VA Transitioning from ICD-9-CM to ICD-10-CM Tidewater Physicians Multispecialty Group Williamsburg, VA February 22, 2014 Our Agenda Some guidelines for this morning s presentation Our Transformational Point

More information

ICD-10 Frequently Asked Questions

ICD-10 Frequently Asked Questions ICD-10 Frequently Asked Questions ICD-10 General Overview... 3 What is ICD-10?... 3 Why are we adopting ICD-10?... 3 What are the benefits of the ICD code expansion?... 3 What does ICD-10 compliance mean?...

More information

Education & Training Plan Medical Billing & Coding with Medical Administration Online includes National Certification and Clinical Externship

Education & Training Plan Medical Billing & Coding with Medical Administration Online includes National Certification and Clinical Externship Education & Training Plan Medical Billing & Coding with Medical Administration Online includes National Certification and Clinical Externship MyCAA Information Course Code: TJC-MBCMA12 Program Duration:

More information

Medisoft Version The Confident Choice for Compliant Practice Management

Medisoft Version The Confident Choice for Compliant Practice Management Medisoft Version The Confident Choice for Compliant Practice Management Medisoft Version 18 a proven, trusted and affordable practice management solution designed to simplify and streamline the way you

More information

No refunds can be issued after the start date published in your Financial Award document.

No refunds can be issued after the start date published in your Financial Award document. Testing Services and Programs 1200 N. DuPont Highway Dover, DE 19901 http://www.desu.edu/academics/university-testing-services-and-programs Contact: Amystique Harris-Church 302.857.6143 achurch@desu.edu

More information

Software Installation and Creating a New Company

Software Installation and Creating a New Company Chapter 1 Software Installation and Creating a New Company OBJECTIVES 1. System Requirements. 2. Download QuickBooks 2014. 3. Install Software from CD. 4. Starting QuickBooks. 5. Creating a New Company.

More information

Certificate Course in Electronic Medical Records Administration

Certificate Course in Electronic Medical Records Administration Course Name Certificate Course in Electronic Medical Records Administration Contact Hours: 45 Course Description This course is approved by the Association for Healthcare Documentation Integrity (AHDI)

More information

CodeItRightOnline Product Overview Table of Contents

CodeItRightOnline Product Overview Table of Contents CodeItRightOnline Product Overview Table of Contents Introducing CodeItRightOnline...2 General Information...2 Code Sets...3 ICD-9-CM vol 1/2...4 ICD-10-CM...13 CPT Codes...15 HCPCS...22 ICD-9-CM vol 3...23

More information

ICD-10 User Guide July 2015

ICD-10 User Guide July 2015 ICD-10 User Guide July 2015 Contents Introduction... 3 Set up the Crosswalk parameter... 3 Set up the ICD-10 compliance date for an insurance carrier... 4 Add the employer insurance... 6 New ICD Search

More information

Be Prepared or Be Prey

Be Prepared or Be Prey Be Prepared or Be Prey By Evan M. Gwilliam MBA, DC, CPC, CPC-I, CCPC, CPMA, NCICS, CCCPC, MCS-P SUMMARY Compliance is not a dirty word; it s the opposite. It makes an office cleaner, and it s now mandatory

More information

A Guide to Education and Training for ICD-10 Implementation

A Guide to Education and Training for ICD-10 Implementation A Guide to Education and Training for ICD-10 Implementation Table of Contents Chapter One: Phases of implementation Chapter Two: Timelines for implementation Chapter Three: Part One: Part Two: Part Three:

More information

To the Instructor... vii. Lesson Planning and Answers to Review Questions. Introduction to Health Information Management

To the Instructor... vii. Lesson Planning and Answers to Review Questions. Introduction to Health Information Management Contents To the Instructor... vii Lesson Planning and Answers to Review Questions PART 1 Introduction to Health Information Management CHAPTER 1 Health Care Delivery Systems...3 CHAPTER 2 The Health Information

More information

Frequently Asked Questions about ICD-10-CM/PCS

Frequently Asked Questions about ICD-10-CM/PCS Frequently Asked Questions about ICD-10-CM/PCS Q: What is ICD-10-CM/PCS? A: ICD-10-CM (International Classification of Diseases -10 th Version-Clinical Modification) is designed for classifying and reporting

More information

ICD 10: Final Steps for Successful Implementation

ICD 10: Final Steps for Successful Implementation ICD 10: Final Steps for Successful Implementation Gayle R. Lee, JD Matt Elrod, PT, DPT, MEd, NCS Presenters Gayle Lee, JD, has more than 15 years of experience working on health care issues impacting the

More information

CLAIM FORM REQUIREMENTS

CLAIM FORM REQUIREMENTS CLAIM FORM REQUIREMENTS When billing for services, please pay attention to the following points: Submit claims on a current CMS 1500 or UB04 form. Please include the following information: 1. Patient s

More information

Medical Coding and Billing Specialist Course Description

Medical Coding and Billing Specialist Course Description Medical Coding and Billing Specialist Course Description EDUCATIONAL OBJECTIVES American School of Technology s Medical Coding and Billing Specialist program is an academic program that prepares graduates

More information

5/2/2014. Beginning Biller / Coder 101 Thursday, May 8 1:00 p.m. to 2:30 p.m. Disclaimer. Stay in touch through Facebook Please note

5/2/2014. Beginning Biller / Coder 101 Thursday, May 8 1:00 p.m. to 2:30 p.m. Disclaimer. Stay in touch through Facebook Please note Disclaimer Beginning Biller / Coder 101 Thursday, May 8 1:00 p.m. to 2:30 p.m. Presented by: Judy B Breuker, CPC, CPMA, CCS P, CDIP, CHC, CHCA, CEMC, AHIMA Approved ICD 10 CM/PCS Trainer The class is intended

More information

Glossary of Terms. Account Number/Client Code. Adjudication ANSI. Assignment of Benefits

Glossary of Terms. Account Number/Client Code. Adjudication ANSI. Assignment of Benefits Account Number/Client Code Adjudication ANSI Assignment of Benefits Billing Provider/Pay-to-Provider Billing Service Business Associate Agreement Clean Claim Clearinghouse CLIA Number (Clinical Laboratory

More information

Coding and Payment Guide for Anesthesia Services

Coding and Payment Guide for Anesthesia Services Coding and Payment Guide for Anesthesia Services An essential coding, billing, and payment resource for anesthesiology and pain management 2006 4th edition Contents Introduction...............................

More information

No refunds can be issued after the start date published in your Financial Award document.

No refunds can be issued after the start date published in your Financial Award document. Testing Services and Programs 1200 N. DuPont Highway Dover, DE 19901 http://www.desu.edu/academics/university-testing-services-and-programs Contact: Amystique Harris-Church 302.857.6143 achurch@desu.edu

More information

Office Managers Association at Presbyterian Hospital of Plano

Office Managers Association at Presbyterian Hospital of Plano Office Managers Association at Presbyterian Hospital of Plano Update your charge slips annually Team approach Pain management example Grace period discontinued! New CPT, HCPCS and ICD-9 codes Changed definitions

More information

TYLER JUNIOR COLLEGE School of Continuing Studies 1530 SSW Loop 323 Tyler, TX 75701 1.800.298.5226 www.tjc.edu/continuingstudies/mycaa

TYLER JUNIOR COLLEGE School of Continuing Studies 1530 SSW Loop 323 Tyler, TX 75701 1.800.298.5226 www.tjc.edu/continuingstudies/mycaa TYLER JUNIOR COLLEGE School of Continuing Studies 1530 SSW Loop 323 Tyler, TX 75701 1.800.298.5226 www.tjc.edu/continuingstudies/mycaa Education & Training Plan Medical Billing & Coding Student Full Name:

More information

DIAGNOSTIC CODING FOR

DIAGNOSTIC CODING FOR Book sampler: These are sample pages of the book containing front and back cover, table of contents, what is ICD, top coding questions & answers, how to use the guide, sample ICD-0-CM scenario Charles

More information

ASA Medical Services Company Brochure

ASA Medical Services Company Brochure ASA Medical Services Company Brochure ASA Medical Billing Services 588 56 th Street 2 nd Floor West New York, NJ 07093-1236 Office: (201)-770-1103 Fax : (201)-770-1104 www.asamedicalbilling.com Why Use

More information

HIT 210. Basic CPT Procedural Coding. Syllabus

HIT 210. Basic CPT Procedural Coding. Syllabus HIT 210 Basic CPT Procedural Coding Syllabus Instructor Jeanie Heck, BBA, CCS, CPC, FCS, PCS Email address Use Course Email (Internal Moodle email) Course Introduction This is a beginning level course

More information

CODING. Neighborhood Health Plan 1 Provider Payment Guidelines

CODING. Neighborhood Health Plan 1 Provider Payment Guidelines CODING Policy The terms of this policy set forth the guidelines for reporting the provision of care rendered by NHP participating providers, including but not limited to use of standard diagnosis and procedure

More information

Revenue Cycle Management Services. QTAT Team: Integrity, Honesty, Efficiency and Communication Skills

Revenue Cycle Management Services. QTAT Team: Integrity, Honesty, Efficiency and Communication Skills Revenue Cycle Management Services QTAT Team: Integrity, Honesty, Efficiency and Communication Skills R C M S Medical Coding Medical Billing Account Receivables QTAT BPO Solutions Inc is a business process

More information

Status Active. Assistant Surgeons. This policy addresses reimbursement for assistant surgical procedures during the same operative session.

Status Active. Assistant Surgeons. This policy addresses reimbursement for assistant surgical procedures during the same operative session. Status Active Reimbursement Policy Section: Surgery/Interventional Procedure Policy Number: RP - Surgery/Interventional Procedure - 001 Assistant Surgeons Effective Date: June 1, 2015 Assistant Surgeons

More information

Introduction to ICD-10: A Guide for Providers. Centers for Medicare & Medicaid Services

Introduction to ICD-10: A Guide for Providers. Centers for Medicare & Medicaid Services Introduction to ICD-10: A Guide for Providers Centers for Medicare & Medicaid Services 1 Table of Contents Compliance Date: October 1, 2014» What is ICD-10?» Why ICD-10 matters» Why transition to ICD-10»

More information

FREQUENTLY ASKED QUESTIONS

FREQUENTLY ASKED QUESTIONS FREQUENTLY ASKED QUESTIONS The American Academy of Dental Sleep Medicine provides support for its members in matters relating to insurance reimbursement for oral appliance therapy. The following section

More information

CLAIMS Section 5. Overview. Clean Claim. Prompt Payment. Timely Claims Submission. Claim Submission Format

CLAIMS Section 5. Overview. Clean Claim. Prompt Payment. Timely Claims Submission. Claim Submission Format Overview The Claims department partners with the Provider Relations, Health Services and Customer Service departments to assist providers with any claims-related questions. The focus of the Claims department

More information

Revenue Cycle Academy. E-Learning

Revenue Cycle Academy. E-Learning Revenue Cycle Academy E-Learning CONTENTS Revenue Cycle Fundamentals 3 Courseware Index 4 Certifications Patient Access... 6 Documentation & Charge Capture... 7 Billing & Collections... 8 Strategic Revenue

More information

SNOMED CT... 42 Patient Diagnosis... 44 Map inoperative codes to the operative codes with the crosswalk parameter off... 49 Map inoperative codes to

SNOMED CT... 42 Patient Diagnosis... 44 Map inoperative codes to the operative codes with the crosswalk parameter off... 49 Map inoperative codes to IMS 08242015 Build September 2015 Contents ICD-10 User Guide for EMR... 1 Introduction... 5 Parameters... 5 Set up the Crosswalk parameter... 5 Set the ICD-10 compliance date... 6 Set the default ICD search

More information

Practice medicine not management

Practice medicine not management Practice medicine not management Maximize your collections Reduce your time to payment Significantly improve your cashflow Spend more time with your patients Physicians Group Management One of the biggest

More information

EDI Claims Link for Windows Version 3.5. User s Manual. December 2011. EDI Claims Link for Windows User Manual

EDI Claims Link for Windows Version 3.5. User s Manual. December 2011. EDI Claims Link for Windows User Manual EDI Claims Link for Windows Version 3.5 User s Manual December 2011-1 - TABLE OF CONTENTS Overview EDI Claims Link for Windows Application 4 About the EDI Claims Link for Windows Application 6 How to log

More information

This information is current as of the training dates.

This information is current as of the training dates. Welcome to this training on Billing Basics for Washington State Local Health Jurisdictions. This training will help you understand basic principles and processes needed for billing private insurance. This

More information

HIT 255 MEDICAL BILLING AND REIMBURSEMENT METHODOLOGIES Spring Semester 2012

HIT 255 MEDICAL BILLING AND REIMBURSEMENT METHODOLOGIES Spring Semester 2012 HIT 255 MEDICAL BILLING AND REIMBURSEMENT METHODOLOGIES Spring Semester 2012 Instructor Mary Jo Jenkins, MPH, RHIA Email address Instructor Office Hours Contact Information mjenkins@pipeline.sbcc.edu but

More information

HEALTH INFORMATION MANAGEMENT CODER I/II

HEALTH INFORMATION MANAGEMENT CODER I/II Monterey County I 50T02 II 50T03 HEALTH INFORMATION MANAGEMENT CODER I/II DEFINITION Under general supervision, reviews, interprets, codes and abstracts medical records information according to standard

More information

What You Need to Know for the Upcoming Transition to ICD-10. Written by the AMA CPT Medical Informatics Department

What You Need to Know for the Upcoming Transition to ICD-10. Written by the AMA CPT Medical Informatics Department What You Need to Know for the Upcoming Transition to ICD-10 Written by the AMA CPT Medical Informatics Department W H I T E P A P E R J U N E 2 0 1 2 This white paper is for educational purposes only and

More information

FREQUENTLY ASKED QUESTIONS ABOUT ICD-10-CM

FREQUENTLY ASKED QUESTIONS ABOUT ICD-10-CM FREQUENTLY ASKED QUESTIONS ABOUT ICD-10-CM Version 10 - May 2014 Disclaimer: At this time, a new effective date for ICD-10-CM has not been established. Please check with CMS for any additional information.

More information

Preface TO THE STUDENT

Preface TO THE STUDENT Welcome to The Complete Procedure Coding Book! This book is part of a three-book series that instructs students on how to become proficient in medical coding a health care field that continues to be in

More information

10/14/2015. Common Issues in Practice Management. Industry Trends. Rebecca Lynn Hanif, CPC,CPCO,CCS, CMUA AHIMA Approved ICD-10-CM/PCS Trainer

10/14/2015. Common Issues in Practice Management. Industry Trends. Rebecca Lynn Hanif, CPC,CPCO,CCS, CMUA AHIMA Approved ICD-10-CM/PCS Trainer Common Issues in Practice Management Rebecca Lynn Hanif, CPC,CPCO,CCS, CMUA AHIMA Approved ICD-10-CM/PCS Trainer cpmresults.com Industry Trends cpmresults.com Patient Responsibility Patients are now responsible

More information