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Full Description
Medical Reimbursementthrough the ins and outs of medical billing. An understanding of medical insurance and related terms is essential to the medical billing process. Healthcare is very expensive for a variety of reasons and, to remain profitable, medical providers must manage their "business" with the help of qualified employees who understand insurance benefits and the responsibility of reimbursement. Simply having medical insurance coverage does not necessarily mean that insurance will pay for all, or even part, of healthcare expenses. Some individuals by their own choice or by unforeseen circumstances, do not have insurance and are considered to be self-insured (or self-pay patients) and are, therefore, responsible for the entire cost of their own healthcare expenses.
Contents
Introduction to Medical Billing/strong>Types of PayersThe Medical RecordPatient Ecounters Coding ReviewEncounter Sheet AssignmentEncounter SheetPre-Authorization AssignmentPatient Information SheetPatient Encounter SheetPre-Authorization FormPre-Certification AssignmentPre-Certification FormProfessional FeesFee Schedule Development AssignmentPrivate PayersThe Claim FormNUCC Field Specific InstructionsSecondary PayersCompletion of Claims AssignmentsPatient Information and Encounter SheetsPrimary Explanation of Benefits for Secondary ClaimGovernment Payers and Workers' Compensation MedicareMedicaidWorkers' CompensationCompletion of Medicare and Workers' Compensation Claims AssignmentsPatient Information and Encounter FormManagement of Practice Finances Posting Charges AssignmentPatient Account LedgersReimbursement for Healthcare ServicesPosting Insurance PaymentsInsurance Math GuidelinesInsurance Math Flow ChartPosting Payments AssignmentDay SheetAccount Balances and Guarantor Responsibility Patient Statement AssignmentPatient StatementsDelinquient Accounts, Collections, and Refunds Nonsufficient Funds PaymentsRefundsPosting Refunds and Delinquent Transactions AssignmentPatient Accounts LedgersBanking Services Accounts ReceivableAccounts PayableAccounts Payable and Banking AssignmentBlank ChecksDeposit SlipReconciliation Bank Reconciliation AssignmentDay Sheet AssignmentPhysicians Healthcare ServicesDay Sheet AssignmentDay Sheet Proofs AssignmentPractice Expenses Petty CashPetty Cash Fund AssignmentReplenishing Petty Cash AssignmentPayrollPayroll ProcessingPayroll AssignmentPayroll Records
