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Overview
Here’s the complete overview of Medical Billing & Coding For Dummies PDF:
The definitive guide to starting a successful career in medical billing and coding
With the healthcare sector growing at breakneck speed―it’s currently the largest employment sector in the U.S. and expanding fast―medical billing and coding specialists are more essential than ever. These critical experts, also known as medical records and health information technicians, keep systems working smoothly by ensuring patient billing and insurance data are accurately and efficiently administered.
This updated edition provides everything you need to begin―and then excel in―your chosen career. From finding the right study course and the latest certification requirements to industry standard practices and insider tips for dealing with government agencies and insurance companies, Medical Billing & Coding For Dummies has you completely covered.
Features of Medical Billing & Coding For Dummies PDF
Here’s a quick overview of the essential features of this book:
- Find out about the flexible employment options available and how to qualify
- Understand the latest updates to the ICD-10
- Get familiar with ethical and legal issues
- Discover ways to stay competitive and get ahead
The prognosis is good―get this book today and set yourself up with the perfect prescription for a bright, secure, and financially healthy future!
Table of Contents
Below is the complete table of contents offered inside Medical Billing & Coding For Dummies PDF:
Introduction. 1
Part 1: Getting to Know Medical Billing and Coding. 5
Chapter 1: Dipping Your Toes into Medical Billing and Coding 7
Chapter 2: Exploring the Billing and Coding Professions 17
Chapter 3: Weighing Your Employment Options 31
Part 2: Boning Up on the Need-to-Knows of Your Profession. 43
Chapter 4: Compliance: Understanding the Rules. 45
Chapter 5: Not-So-Strange Bedfellows: Medical Terminology and Medical Necessity. 61
Chapter 6: Getting to Know the Payers. 85
Part 3: Becoming a Professional: Getting Certified. 103
Chapter 7: Your Basic Certification Options, Courtesy of the AAPC and AHIMA. 105
Chapter 8: The Path to Certification: Finding a Study Program. 119
Chapter 9: Signing Up and Preparing for the Certification Exam. 139
Chapter 10: Adding Street Cred: Specialty Certifications and Continuing Ed. 159
Part 4: Dealing and Succeeding with Nitty-Gritty On-the-Job Details. 171
Chapter 11: Processing a Run-of-the-Mill Claim: An Overview. 173
Chapter 12: Homing In on How to Prepare an Error-Free Claim. 191
Chapter 13: From Clearinghouse to Accounts Receivable to Money in the Pocket 209
Chapter 14: Handling Disputes and Appeals. 221
Chapter 15: Keeping Up with the Rest of the World. 241
Part 5: Working with Stakeholders. 249
Chapter 16: Dealing with Commercial Insurance Claims. 251
Chapter 17: Caring about Medicare and Medicaid. 263
Chapter 18: Coding Ethics: Being an Advocate for Your Employer 275
Part 6: The Part of Tens. 291
Chapter 19: Ten Common Billing and Coding Mistakes and How to Avoid Them 293
Chapter 20: Ten Acronyms to Burn into Your Brain. 299
Chapter 21: Ten (Plus One) Tips from Billing and Coding Pros. 305
Glossary. 311
Index. 319
Table of Contents
Introduction 1
About This Book. 1
Foolish Assumptions. 2
Icons Used in This Book. 2
Beyond the Book. 3
Where to Go from Here. 3
Part 1: Getting to Know Medical Billing and Coding. 5
Chapter 1: Dipping Your Toes into Medical Billing and Coding. 7
Coding versus Billing: They Really Are Two Jobs. 8
Following a Day in the Life of a Claim. 9
Keeping Abreast of What Every Biller/Coder Needs to Know. 10
Complying with federal and state regulations 10
Learning the lingo: Medical terminology. 11
Demonstrating medical necessity. 11
Deciding Which Job Is Right for You. 11
Examining your workplace options. 12
Thinking about your dream job. 12
Prepping for Your Career: Training Programs and Certifications 13
Previewing your certification options. 13
Going back to school. 14
Planning for the Future 15
Chapter 2: Exploring the Billing and Coding Professions. 17
Looking at the Medical Coding Job. 18
Verifying documentation. 18
Following up on unclear documentation. 21
Assigning diagnosis and procedure codes 21
Transforming visits into revenue 22
Determining whether medical coding suits you. 23
Breaking Down the Medical Biller’s Job. 23
Knowing the payers and keeping up on their idiosyncrasies. 24
Billing each payer correctly 25
Checking the claim over prior to submission. 27
Assessing whether medical billing is the right choice for you 27
Table of Contents
In Tandem: Working Together or Doing Both Jobs Yourself?. 28
Wearing both hats. 28
Deciding which job is for you. 29
Chapter 3: Weighing Your Employment Options. 31
Choosing Your Environment: Doctor’s Office, Hospital, and Others. 32
The doctor is in: Working in a physician’s office. 33
Hooking up with a hospital 33
Focusing on a billing or practice management company. 34
Processing claims for an insurance company. 35
Considering the best of the rest. 36
Getting your foot in the door. 36
Remote Access: Setting up Off-Site. 37
Working in your PJs. 37
The no-commute commute: Arranging a suitable workspace. 38
Looking at the downside of working remotely. 38
Reviewing Other Work Options: Freelancing, Temping, and More. 39
Heeding a Word of Advice for New Coders. 40
Part 2: Boning Up on the Need-to-knows Of Your Profession. 43
Chapter 4: Compliance: Understanding the Rules 45
You Rule! Meeting the Rule Makers. 46
The Centers for Medicare & Medicaid Services (CMS). 46
The Office of Inspector General (OIG) 47
The individual payer (insurance company). 47
Complying with HIPAA 48
Doing your part: Do’s and don’ts of compliance. 49
Uh-oh! Facing the consequences of non-compliance 53
Unbundling the Compliance Bundle 53
Looking at incidental procedures. 54
Identifying when separately reporting is okay 54
Recognizing when unbundling’s not okay. 55
Defining exclusivity. 55
Getting the Most out of the Dreaded Audit. 57
Distinguishing between internal and payer audits. 58
Guarding against an RAC audit. 58
Avoiding an audit: You can’t. 59
Protecting yourself from an audit. 59
Medical Billing & Coding For Dummies
Chapter 5: Not-So-Strange Bedfellows: Medical Terminology and Medical Necessity 61
Brushing Up on Basic Anatomy. 62
Getting familiar with body systems 62
Getting a handle on illness and disease. 64
Encountering injuries. 64
Say What? Deciphering Medical Terminology. 65
In the beginning: Knowing your prefixes. 65
Sussing out the suffixes. 67
Eureka! Putting them together 67
Understanding Medical Necessity. 69
Scrubbing In: Proving Medical Necessity for Surgical Procedures. 70
Checking out endoscopic procedures 70
Examining open surgical procedures. 73
Understanding incidentals and when procedures can be separately reported. 75
Using billing modifiers 75
Connecting with the World of Evaluation and Management Codes 76
Looking at what happens during the run-of-the-mill E&M visit. 77
Visiting the office. 78
Visiting the hospital. 80
Dealing with consultation visits. 82
Determining the level of billable service. 83
Chapter 6: Getting to Know the Payers 85
Wading through Commercial Insurance Payers. 86
Identifying the carriers. 87
Tuning in to networks. 89
Choosing third-party administrators 89
Medicare: Meeting the Chief Government Payer. 90
Examining Medicare, part by part. 91
Looking at Medicare supplement policies. 93
Coding and processing Medicare claims. 94
Working with Other Government Payers. 95
Patient Protection and Affordable Care Act (ACA) 95
Medicaid. 96
Tricare (Department of Defense) 98
CHAMPUS VA (Department of Veterans Affairs). 99
Office of Workers’ Compensation Programs (Department of Labor).
Medical Billing & Coding For Dummies PDF Free Download
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