Preface

Acknowledgments

Part 1 WORKING WITH MEDICAL INSURANCE AND BILLING

Chapter 1 Introduction to the Medical Billing Cycle

Chapter 2 HIPAA, HITECH, and Medical Records

Chapter 3 Patient Encounters and Billing Information

Part 2 CLAIM CODING

Chapter 4 Diagnostic Coding: Introduction to ICD-9-CM and ICD-10-CM

Chapter 5 Procedural Coding: Introduction to CPT

Chapter 6 Procedural Coding: Introduction to HCPCS

Chapter 7 Visit Charges and Compliant Billing

Part 3 CLAIMS

Chapter 8 Health Care Claim Preparation and Transmission

Chapter 9 Private Payers/Blue Cross and Blue Shield

Chapter 10 Medicare

Chapter 11 Medicaid

Chapter 12 TRICARE and CHAMPVA

Chapter 13 Workers’ Compensation and Disability

Part 4 CLAIM FOLLOW-UP AND PAYMENT PROCESSING

Chapter 14 Payments (RAs/EOBs), Appeals, and Secondary Claims

Chapter 15 Patient Billing and Collections

Chapter 16 Primary Case Studies

Chapter 17 RA/EOB/Secondary Case Studies

Part 5 HOSPITAL SERVICES

Chapter 18 Hospital Billing and Reimbursement

Appendix A Guide to Medisoft

Appendix B Guide to the Interactive Simulated CMS-1500 Form

Appendix C Medical Specialties and Taxonomy Codes

Appendix D Place of Service Codes

Appendix E Professional Websites

Appendix F Forms

Abbreviations

Glossary

Index