Fordney’s Medical Insurance 15th Edition PDF Free Download [Direct Link]

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In this article, we are sharing with our audience the genuine PDF download of Fordney’s Medical Insurance PDF using direct links which can be found at the end of this blog post. To ensure user safety and faster downloads, we have uploaded this .pdf file to our online cloud repository so that you can enjoy a hassle-free downloading experience.

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Overview

Here’s the complete overview of Fordney’s Medical Insurance 15th Edition PDF:

Get a solid foundation in insurance billing and coding! Trusted for more than 30 years, Fordney’s Medical Insurance equips you with the medical insurance skills you need to succeed in any of today’s outpatient settings. The 15th edition has been expanded to include inpatient insurance and billing and ambulatory surgical center billing. Updated coverage emphasizes the role of the medical insurance specialist in areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. As with previous editions, all the plans that are most commonly encountered in clinics and physicians’ offices are incorporated into the text, as well as icons for different types of payers, lists of key abbreviations, and numerous practice exercises that accurately guide you through the process of filling out claim forms. In addition, SimChart® for the Medical Office (SCMO) activities on the companion Evolve website give you the opportunity to practice using electronic medical records.

Features of Fordney’s Medical Insurance 15th Edition PDF

Here’s a quick overview of the essential features of this book:

  • UNIQUE! Interactive UB-04 Form filler on Evolve gives you additional practice with inpatient Electronic Health Records.
  • Separate chapter on HIPAA Compliance in Insurance Billing, as well as Compliance Alerts throughout highlights important HIPAA compliance issues to ensure you are compliant with the latest regulations.
  • Separate chapter on documentation in the medical office covers the principles and rationales of medical documentation.
  • Increased focus on electronic filing/claims submission prepares you for the industry-wide transition to electronic claims submission.
  • Emphasis on the business of running a medical office and the importance of the medical insurance specialist prepares you for your role in the workplace.
  • Detailed examples of potential situations throughout text signal you to be attentive to these types of occurrences.
  • Specialized icons throughout text alert you to the connections and special considerations related to specific topics that medical insurance specialists need to be aware of.
  • Procedures clearly outline in step-by-step format detail common responsibilities of the medical insurance specialist.
  • SimChart® for the Medical Office (SCMO) application activities on the companion Evolve website add additional functionality to the insurance module on the SCMO roadmap.
  • Key terms are defined and emphasized throughout the text to reinforce your understanding of new concepts and terminology.
  • NEW! Expanded coverage of inpatient insurance billing, including diagnosis and procedural coding provides you with the foundation and skills needed to work in the physician office, outpatient, and inpatient setting.
  • NEW! Expanded coverage of Ambulatory Surgical Center (ASC) billing chapter provides you with the foundation and skills needed to work in this outpatient setting.
  • NEW! Updated information on general compliance issues, HIPAA, Affordable Care Act and coding ensures that you have the knowledge needed to enter today’s ever-changing and highly regulated healthcare environment.

Table of Contents

Below is the complete table of contents offered inside Fordney’s Medical Insurance 15th Edition PDF:

  • Unit 1. Career Role and Responsibilities
  • 1. Role of an Insurance Billing Specialist
  • Key Abbreviations
  • Background of Insurance Claims, Coding, and Billing
  • Role of the Insurance Billing Specialist
  • Medical Etiquette
  • Professional Ethics
  • Scope of Practice and Liability
  • Future Challenges
  • Key Points
  • Student Assignment
  • 2. Privacy, Security, and HIPAA
  • Key Abbreviations
  • Health Insurance Portability and Accountability
  • Transaction and Code Set Regulations
  • National Identifiers
  • The Privacy Rule: Confidentiality and Protected Health Information
  • The Security Rule: Administrative, Technical, and Physical Safeguards
  • Health Information Technology for Economic and Clinical Health Act
  • Application to the Health Care Setting
  • Best Practices to Avoid Common Hipaa Violations
  • Key Points
  • Student Assignments
  • 3. Compliance, Fraud, and Abuse
  • Key Abbreviations
  • Compliance Defined
  • Fraud and Abuse Laws
  • Compliance Programs
  • OIG Compliance Program Guidelines
  • Compliance as a Career
  • What to Expect from the Health Care Organization
  • Key Points
  • Student Assignment
  • Unit 2. Introduction to Health Insurance
  • 4. Basics of Health Insurance
  • Key Abbreviations
  • History of Health Insurance in the United States
  • Health Care Reform
  • Legal Principles of Insurance
  • Health Care Organization–Patient Contracts and Financial Obligation
  • The Insurance Policy
  • Choice of Health Insurance
  • Types of Health Insurance Coverage
  • Exception
  • Handling and Processing Insurance Claims
  • Life Cycle of an Insurance Claim
  • Keeping up to Date
  • Key Points
  • Student Assignment
  • 5. The Blue Plans, Private Insurance, and Managed Care Plans
  • Key Abbreviations
  • Private Health Insurance
  • Managed Care
  • Managed Care Systems
  • Medical Review
  • Management of Plans
  • Plan Administration
  • Financial Management
  • Key Points
  • Student Assignment
  • 6. Medicare
  • Key Abbreviations
  • Background
  • Policies and Regulations
  • Additional Insurance Programs
  • Utilization and Quality Control
  • Program Fundamentals
  • Medicare Reimbursement
  • Claim Submission
  • After Claim Submission
  • Key Points
  • Student Assignment
  • 7. Medicaid and Other State Programs
  • Key Abbreviations
  • Medicaid
  • Medicaid Programs
  • Medicaid Eligibility
  • Medicaid Benefits
  • Medicaid Managed Care
  • Claim Procedures
  • After Claim Submission
  • Key Points
  • Student Assignment
  • 8. TRICARE and Veterans’ Health Care
  • Key Abbreviations
  • TRICARE
  • History of Tricare
  • Health Plans
  • Veterans Health Administration Program
  • Claims Procedure
  • After Claim Submission
  • Key Points
  • Student Assignment
  • 9. Workers’ Compensation
  • Key Abbreviations
  • History
  • Workers’ Compensation Laws and Insurance
  • Eligibility
  • Coverage
  • Types of State Compensation Benefits
  • Types of State Workers’ Compensation Claims
  • Fraud and Abuse
  • Legal Situations
  • Medical Reports
  • Reporting Requirements
  • Claim Submission
  • Key Points
  • Student Assignment
  • 10. Disability Income Insurance and Disability Benefit Programs
  • Key Abbreviations
  • Disability Claims
  • History
  • Disability Income Insurance
  • Federal Disability Programs
  • State Disability Insurance
  • Voluntary Disability Insurance
  • Claims Submission Guidelines
  • Conclusion
  • Key Points
  • Student Assignments
  • Unit 3. Documentation and Coding for Professional Services
  • 11. Medical Documentation and the Electronic Health Record
  • Key Abbreviations
  • The Documentation Process
  • Incentive Programs for Adoption of Electronic Health Records
  • General Principles of Health Record Documentation
  • Legible Documentation
  • Documentation Terminology
  • Abstracting from Health Records
  • Review and Audit of Health Records
  • Release and Retention of Health Records
  • Documentation Guidelines for Evaluation and Management Services
  • Key Points
  • Student Assignment
  • 12. Diagnostic Coding
  • Key Abbreviations
  • Diagnosis Coding Overview
  • International Classification of Diseases
  • Official Guidelines for ICD-10-CM
  • The Future of Diagnosis Coding
  • Key Points
  • Student Assignments
  • 13. Procedural Coding
  • Key Abbreviations
  • Understanding the Importance of Procedural Coding Skills
  • A Coding Specialist’s Tools
  • Healthcare Common Procedure Coding System
  • Current Procedural Terminology Content and Format
  • Code Modifiers
  • Correct Coding Edits and Practices
  • Methods of Payment
  • Key Points
  • Student Assignment
  • Unit 4. Claims Submission in the Medical office
  • 14. The Paper Claim CMS-1500
  • Key Abbreviations
  • The Paper Claim CMS-1500
  • Types of Submitted Claims
  • Abstracting from Medical Records
  • Health Insurance Claim Form (CMS-1500)
  • Common Reasons Why Claim Forms are Delayed or Rejected
  • Additional Claim Submission Errors
  • Claim Completion Guidelines
  • Instructions for Completing the Health Insurance Claim Form (CMS-1500)
  • Key Points
  • Student Assignment
  • 15. The Electronic Claim
  • Key Abbreviations
  • Electronic Data Interchange
  • Electronic Claims
  • Advantages of Electronic Claim Submission
  • Clearinghouses
  • Transaction and Code Sets Regulations: Streamlining Electronic Data Interchange
  • Electronic Standard HIPAA 837P
  • Claim Attachments Standards
  • Standard Unique Identifiers
  • Practice Management System
  • Building the Claim
  • Putting Hipaa Standard Transactions to Work
  • Methods of Sending Claims
  • Computer Claims Systems
  • Transmission Reports
  • Key Points
  • Student Assignment
  • Unit 5. The Claim Follow-Up and Payment Process
  • 16. Receiving Payments and Insurance Problem Solving
  • Key Abbreviations
  • Revenue Cycle Management
  • Response from a Submitted Claim
  • Claim Policy Guidelines
  • Explanation of Benefits
  • Affordable health insurance plans
  • Claim Management Techniques
  • Claim Inquiries
  • Problem Claims
  • Rebilling
  • Review and Appeal Process
  • Filing an Appeal
  • State Insurance Commissioner
  • Claim Denial Management
  • Key Points
  • Student Assignment
  • 17. Collection Strategies
  • Key Abbreviations
  • Collection Strategies
  • Accounts Receivable
  • Patient Education
  • Fees
  • Credit and Collection Laws
  • The Collection Process
  • Key Points
  • Student Assignment
  • Unit 6. Healthcare Facility Billing
  • 18. Ambulatory Surgery Center
  • Key Abbreviations
  • History of Ambulatory Surgery Centers
  • Types of Ambulatory Surgery Centers
  • Ambulatory Surgery Center Payment System
  • Payment for Ambulatory Surgery Center Services
  • Payment Rates
  • Medicare Setting Component Within Base Rate
  • Separately Payable Services
  • Hospital Outpatient Prospective Payment
  • Medical professional liability insurance
  • Differences Between ASC and Hospital Outpatient Department Reimbursement Models
  • Revenue Cycle Management
  • Reimbursement Process
  • Other Types of Reimbursement
  • Medicaid Overview
  • Medical Records for Reimbursement
  • Medical Coding and Billing Guidance
  • Claims Management and Health Care Claim Submission
  • Modifiers
  • Status (Payment) Indicators
  • National Correct Coding Initiative Edits
  • Other Payers
  • Local Coverage Determinations and National Coverage Determinations
  • Ambulatory Surgery Center Quality Reporting (ASCQR)
  • Consumer Assessment of Health Care Providers and Systems Outpatient and Ambulatory Surgery Survey
  • Student Assignment
  • 19. Hospital Outpatient and Inpatient Billing
  • Key Abbreviations
  • Revenue Cycle
  • Types of Reimbursement Methodologies
  • Medicare
  • Key Points
  • Student Assignment
  • Unit 7. Employment
  • 20. Seeking a Job and Attaining Professional Advancement
  • Key Abbreviations
  • Employment Opportunities
  • Professional Organizations
  • Best short term health insurance
  • Job Search
  • Self-Employment
  • Attaining Professional Advancement

Fordney’s Medical Insurance 15th Edition PDF Free Download

Alright, now in this part of the article, you will be able to access the free PDF download of Fordney’s Medical Insurance 15th Edition PDF using our direct links mentioned at the end of this article. We have uploaded a genuine PDF ebook copy of this book to our online file repository so that you can enjoy a blazing-fast and safe downloading experience.

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Fordney's Medical Insurance 15th Edition PDF

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