Key Features

  • 15 unique cases highlight CAAHEP and ABHES competencies with specific exercises relating to different payers, different billing situations, and common coding errors.
  • More than two hours of video clips include five videos for each case: one at check-in, three in the exam room, and one at checkout..
  • Realistic information resources include medical records for each case, an office policy manual, a fee schedule, a daysheet, and more.
  • A study guide (available in print and on the companion Evolve website):

      • Complements textbook content through lessons that correlate reading assignments with patients in the virtual practice.
      • Promotes active learning as you collect information from a variety of sources to make coding and billing decisions.
      • Encourages critical thinking as you discuss and troubleshoot the documentation of the medical records.
      • Contains common coding errors that you must spot and correct, as in real practice.
      • Augments knowledge of HIPAA by comparing the policy manual, the contents of each case's medical record, and what actually happens in the videos.
      • Makes lessons available online, allowing you to complete assignments and submit them electronically to your instructor.


Table of Contents

Getting Started

Quick Office Tour

Detailed Office Tour

Lesson 1: Role of an Insurance Billing Specialist

Lesson 2: HIPAA Compliance and Privacy in Insurance Billing

Lesson 3: Basics of Health Insurance

Lesson 4: Medical Documentation

Lesson 5: Diagnostic Coding

Lesson 6: Procedural Coding

Lesson 7: The Paper Claim CMS-1500

Lesson 8: Electronic Data Interchange: Transactions and Security

Lesson 9: Receiving Payments and Insurance Problem Solving

Lesson 10: Office and Insurance Collection Strategies

Lesson 11: The Blue Plans, Private Insurance, and Managed Care Plans

Lesson 12: Medicare

Lesson 13: Medicaid and Other State Programs

Lesson 14: TRICARE and CHAMPVA

Lesson 15: Workers' Compensation

Lesson 16: Disability Income Insurance and Disability Benefit Programs

Lesson 17: Hospital Billing

Lesson 18: Seeking a Job and Attaining Professional Advancement


Electronic ISBN: