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Medical
Allied Health Services
Medical Coding & Billing
Dealing and Succeeding with Nitty-Gritty On-the-Job Details
Dealing and Succeeding with Nitty-Gritty On-the-Job Details
Curriculum
5 Sections
22 Lessons
10 Weeks
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Chapter 11: Processing a Run-of-the-Mill Claim: An Overview
5
1.1
Dreaming of the Perfect Billing Scenario
1.2
Delving into the Details: Contract Specifics
1.3
Covering Your Bases: Referrals and Preauthorization
1.4
Tracking Your Claim from Submission to Payment
1.5
Fighting for Proper Payment: Filing an Appeal with the Payer
Chapter 12: Homing In on How to Prepare an Error-Free Claim
4
2.1
Assigning CPT Codes
2.2
Applying Modifiers Correctly
2.3
Looking for Money Left on the Table
2.4
Checking and Double-Checking Your Documentation
Chapter 13: From Clearinghouse to Accounts Receivable to Money in the Pocket
4
3.1
Spending Time in the Clearinghouse
3.2
Facing Factors Affecting Reimbursement Amounts
3.3
Payment or Denial: Being in the Hands of the Payer
3.4
Breaking Down the Remittance Advice
Chapter 14: Handling Disputes and Appeals
6
4.1
Dealing with Disputes Involving Contract and Non-Contracted Payers
4.2
Knowing When to File an Appeal: General Guidelines
4.3
The Art of the Appeal: Understanding the Basics before You Begin
4.4
Going through an Appeal, Step by Step
4.5
Appealing Medicare Processing
4.6
Appealing a Workers’ Comp Claim
Chapter 15: Keeping Up with the Rest of the World
3
5.1
WHO’s on First: Providing Data to the World Health Organization
5.2
Charting Your Course with ICD
5.3
Moving beyond ICD-10
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