Insurance Handbook for the Medical Office - 14th Edition - ISBN: 9780323316255, 9780323316286

Insurance Handbook for the Medical Office

14th Edition

Authors: Marilyn Fordney
Paperback ISBN: 9780323316255
eBook ISBN: 9780323316286
eBook ISBN: 9780323316323
Imprint: Saunders
Published Date: 4th February 2016
Page Count: 656

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Stay up on the latest in insurance billing and coding with Marilyn Fordney’s Insurance Handbook for the Medical Office, 14th Edition. Trusted for more than 30 years, this market-leading handbook equips you to succeed as medical insurance specialist in any of today’s outpatient settings. 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 assist you in accurately filling out claim forms. This new edition also features expanded coverage of ICD-10, electronic medical records, electronic claims submission, and the HIPAA 5010 — keeping you one step ahead of the latest practices and protocols of the profession.

Key Features

  • Key terms are defined and emphasized throughout the text to reinforce understanding of new concepts and terminology.
  • Separate chapter on HIPAA Compliance in Insurance Billing, as well as Compliance Alerts throughout the text highlights important HIPAA compliance issues to ensure readers are compliant with the latest regulations.
  • Emphasis on the business of running a medical office and the importance of the medical insurance specialist details the importance of the medical insurance specialist in the business of the medical office.
  • Increased focus on electronic filing/claims submission prepares readers for the industry-wide transition to electronic claims submission.
  • Separate chapter on documentation in the medical office covers the principles of medical documentation and the rationales for it. 
  • Service to Patient features in most chapters offer examples of good customer service. 
  • User resources on the Evolve companion website feature performance checklists, self-assessment quizzes, the Student Software Challenge (with cases on different payer types and an interactive CMS-1500 (02-12) form to fill in).

Table of Contents

Unit One: Career Roles and Responsibilities
1. Role of an Insurance Billing Specialist
2. HIPAA Compliance in Insurance Billing

Unit Two: The Claims Process
3. Basics of Health Insurance
4. Medical Documentation
5. Diagnostic Coding
6. Procedural Coding
7. The Paper Claim: CMS-1500 (02-12)
8. The Electronic Claim
9. Receiving Payments and Insurance Problem Solving
10. Office and Insurance Collection Strategies

Unit Three: Health Care Payers
11. The Blue Plans, Private Insurance and Managed Care Plans
12. Medicare
13. Medicaid and Other State Programs
15. Worker’s Compensation
16. Disability Income Insurance and Disability Benefit Insurance

Unit Four: Inpatient and Outpatient Billing
17. Hospital Billing

Unit Five: Employment
18. Seeking a Job and Attaining Professional Advancement


No. of pages:
© Saunders 2017
Paperback ISBN:
eBook ISBN:
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About the Author

Marilyn Fordney

Affiliations and Expertise

Formerly, Instructor of Medical Insurance, Medical Terminology, Medical Machine Transcription, and Medical Office Procedures, Ventura College, Ventura, CA