Medical Insurance Made Easy - Pageburst Digital Book (Retail Access Card) book cover

Medical Insurance Made Easy - Pageburst Digital Book (Retail Access Card)

Understanding the Claim Cycle

This is a Pageburst digital textbook; This combination textbook and workbook, explains each phase of the medical claim cycle, from the time the patient calls for an appointment until the financial transaction for the encounter is completed. Coverage includes types of insurance payers, basic coding and billing rules, and standard requirements for outpatient billing using the CMS-1500 claim form. It also emphasizes legal aspects related to each level of the medical claim cycle and the importance of the medical office employee, showing their responsibility for and impact on successful reimbursement.

Book, 560 Pages

Published: December 2005

Imprint: Saunders

ISBN: 978-1-4557-3428-3


  • 1. Learning to Speak the Language
    2. You’re Part of a Team
    3. How the Medical Claim Cycle Works
    4. CMS-1500 Claim Form
    5. Basic Principles for Diagnosis Coding
    6. Basic Principles for Evaluation and Management (E/M) Services
    7. Basic Principles of Procedure Coding
    8. Private Indemnity and Managed Care Medical Plans
    9. Other Plans with Medical Coverage and Disability Plans
    10. Medicare
    11. Other Government Medical Plans
    12. Hospital/Facility Rules
    13. Reimbursement Success
    14. Developing Critical Thinking Skills: Analyzing Problems and Making Decisions
    Appendix A Lake Eola Family Practice Associates
    Appendix B 1997 Examination Tables
    Appendix C Department of Insurance Guide
    Appendix D Quick Guide to HIPAA for the Physician’s Office


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