Fordney's Medical Insurance and Billing

Linda M Smith is the author of Fordney's Medical Insurance, 16e and its accompanying workbook and online course. She has revised 3 editions of HIPAA Online. She has had over 40 years of experience in the healthcare industry as a business manager and is a Certified Professional Coder (CPC). She has also earned the credentials of E/M Specialist (CEMC) and is an approved Professional Medical Coding Curriculum Instructor (CPC-I) through the American Academy of Professional Coders (AAPC). Linda provides training privately to local organizations and is an instructor with various business and technical schools. She and her associates provide training in the areas of medical ethics, medical terminology, anatomy and physiology, and medical coding and billing. They provide continuing education workshops for the organizations mentioned above. Cheryl Fassett has worked in healthcare administration, billing, and coding for 34 years. She was a coding/billing specialist and account manager with Practicare Medical Management for five years and has been the practice manager for Riverside Associates in Anesthesia for the last 29 years. Her job tasks are varied and include auditing the coding, billing, and reimbursement for the practice, as well as payroll, scheduling, human resources, and working with the accounting department, legal team, and pension manager. In addition to this she has earned certifications from the AAPC in coding, billing, auditing, practice management, risk adjustment coding, clinical documentation, and instructing the AAPC coding curriculum. She was a contributor and subject matter expert for the Fordney Smith Medical Insurance and Billing 15th , 16th, and 17th editions. She has created and presented workshops and training to AAPC members, billing companies, and hospital staff on topics ranging from HIPAA compliance, revenue cycle and anesthesia coding to leadership, communication, cognitive biases and limiting beliefs.

• Unit 1 Career Role and Responsibilities1. Role of an Insurance Billing Specialist2. Privacy, Security, and HIPAA3. Compliance, Fraud, and AbuseUnit 2 Introduction to Health Insurance4. Basics of Health Insurance5. The Blue Plans, Private Insurance, and Managed Care Plans6. Medicare7. Medicaid and Other State Programs8. TRICARE and Veterans Health Care9. Workers’ Compensation, Automobile, and Liability Insurance10. Disability Income Insurance and Disability Benefit ProgramsUnit 3 Documentation and Coding for Professional Services11. Medical Documentation and the Electronic Health Record12. ICD-10-CM Coding13. CPT Coding14. HCPCS Level II CodingUnit 4 Claims Submission in the Medical Office15. The Paper Claim CMS 150016. The Electronic ClaimUnit 5 Revenue Cycle Management17. Receiving Payments and Insurance Problem-Solving18. Collection StrategiesUnit 6 Health Care Facility Billing19. Introduction to Health Care Facilities and Ambulatory Surgery Centers20. Billing for Health Care FacilitiesUnit 7 Employment21. Seeking a Job and Attaining Professional Advancement