Chapter 12 Diagnostic Coding Chapter outline I. Introduction to International Classification of Diseases Coding System A. Three Major Coding Structures II. History of International Classification of Diseases Coding A. Uses of Coded Data III. Two…
Chapter 10 Military Carriers Chapter outline I. Military Health Programs II. TRICARE A. Military Health System B. TRICARE Management Activity (TMA) C. TRICARE Regional Contractors D. Who Is Eligible for TRICARE? E. Who Is Not Eligible for…
Chapter 9 Conquering Medicare’s Challenges Chapter outline I. Medicare Program A. Medicare Program Structure 1. Medicare Part A 2. Medicare Part B B. Enrollment C. Premiums and Cost-Sharing Requirements D. Medicare Part C (Medicare Advantage Plans) 1. Healthcare…
Chapter 13 Procedural, Evaluation and Management, and HCPCS Coding Chapter outline I. Overview of Current Procedural Terminology (CPT) Coding A. Purpose of CPT B. Development of CPT II. Three Levels of Procedural Coding III. CPT…
Chapter 18 Hospital Billing and the UB-04 Chapter outline I. Hospital Versus Physician Office Billing and Coding II. Modern Hospital and Health Systems A. Emerging Issues III. Common Healthcare Facilities A. Acute Care Facilities B. Critical…
Chapter 8 Understanding Medicaid Chapter outline I. What is Medicaid? II. Evolution of Medicaid A. Temporary Assistance for Needy Families (TANF) B. Supplemental Security Income (SSI) 1. Eligibility 2. Eligibility Expansion C. Medicaid and Healthcare Reform III. Structure…
Chapter 14 The Patient Chapter outline I. Patient Expectations A. Professional Office Setting B. Relevant Paperwork and Questions C. Honoring Appointment Times D. Patient Load E. Getting Comfortable with the Healthcare Provider F. Privacy and Confidentiality G. Financial…
Chapter 2 Tools of the Trade A Career as a Health (Medical) Insurance Professional Chapter outline I. Your Future as a Health Insurance Professional A. Required Skills and Interests 1. Education 2. Preparation II. Job…
Chapter 11 Miscellaneous Carriers Workers’ Compensation and Disability Insurance Chapter outline I. Workers’ Compensation A. History B. Federal Legislation and Workers’ Compensation C. Eligibility 1. Exemptions 2. Benefits 3. Denial of Benefits and Appeals 4. Time Limits D. Workers’…
Chapter 17 Reimbursement Procedures Getting Paid Chapter outline I. Understanding Reimbursement Systems A. Types of Reimbursement 1. Fee-for-Service 2. Discounted Fee-for-Service 3. Prospective Payment System 4. Relative Value Units 5. Managed Care Organizations 6. Capitation II. Medicare and Reimbursement…
