Here is straight forward information for efficient billing and collecting.Collecting techniques for office staff Telephone collection scripts Collection letters & notices Verification of insurance Payment plan for past due accounts Choosing a collection agency Steps in processing an insurance claim Insurance claim follow-up Letter to slow paying insurance company Accounts receivable worksheet Insurance summary log Improving Medicaid claim submissions Analyzing A/R by source of revenue Tracking the effect of managed care plans Measuring performance of A/R management Checklist for assessing collection policies Patient communication on billing insurance

Collect money owed to your practice. Improve your revenue cycle by maximizing key processes for professional fee billing. Written by industry experts, this book is a step-by-step guide to billing and collection processes, performance outcomes and advanced billing practices. It includes case studies, tools, checklists, resources, policies and procedures to help you diagnose problems and develop plans to attain optimal financial performance.

When a doctor sees a patient, how does the doctor’s office get paid? If a claim for a service or procedure provided is denied, how does the doctor’s office get the patient’s insurance company to pay? Handling the Medical Claim: An 8-Step Guide on "How To" Correct and Resolve Claim Issues explains—from beginning to end—how to bill and collect on claims for services provided in a physician’s office. Focusing on the CMS-1500 claim form, the book explains how to prepare and file the form to submit charges to patients’ insurance companies. Written by a medical billing specialist experienced in handling medical claims and denials on both the provider and insurer sides of the business, this step-by-step guide begins by covering some basic good practice management skills. Next, it outlines each department’s specific duties based on the each department’s responsibilities for specific parts of the claim. In addition to learning how to submit and resolve claims that cannot be processed or are denied, readers will learn how to: Enter data in the doctor’s schedule, including appointment types Gather patient data from medical records Register patients, including patient information, guarantor, and policyholder and insurance information Input information about the appointment and diagnosis Use the different types of coding systems used for billing charges Understand the claim cycle, determine reimbursement, and apply payment Obtain patient and insurance information Appeal a denied claim and handle patient balances The book includes case examples and step-by-step guidance for resolving claim issues that could arise—including how to determine what part of the chapter you can find your answer and how to link your findings to the box number on the claim form to which the problem pertains. Highlighting opportunities for increasing revenue, it includes an overview of the revenue cycle and the importance of keeping cash flow moving. Packed with forms, charts, and illustrative examples, the text supplies the tools and understanding you’ll need to manage billing and collection in any physician’s office or clinical department.

This is a great Medical Billing and/or Collections Training Workbook/Journal for you or your staff that are learning how to successfully contact insurance carriers for statuses of medical claims. Whether you are working facility claims [UB04s] or professional/physician claims [CMS 1500], then this is a great tool to have on your desk as you are maneuvering through the red tape of claims follow-up. This Medical Collectors' Journal has the following; Training pages for 10 accounts Provider NPI/TAX ID fields Provider information fields Patient demographic fields Claims detail fields [such as claim number, dates of service, etc.] Places to jot down claim status notes Glossy cover and design 174 Pages 8.5" x 11" etc. Great for hospital business office staff, physician office staff, specialists, etc. Fantastic for Medical Billing and Coding students, teachers, trainers, etc. Save time and money by simply preparing accounts PRIOR to contacting various insurance carriers. NOTE: insurance reps know when you are prepared and are often more than willing to work through multiple accounts per phone call which saves healthcare providers time and money. Purchase multiple Claim Status Journals for each insurance carrier. Enjoy!

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

A complete guide to insurance billing and coding, Insurance Handbook for the Medical Office, 13th Edition covers all the plans that are most commonly encountered in clinics and physicians’ offices. Its emphasis on the role of the medical insurance specialist includes areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. Learning to fill in the claim form accurately is made easier by the use of icons for different types of payers, lists of key abbreviations, and numerous practice exercises. This edition provides the latest on hot topics such as ICD-10, healthcare reform, the new CMS-1500 form, and electronic claims. Trusted for more than 30 years, this proven reference from Marilyn Fordney prepares you to succeed as a medical insurance professional in any outpatient setting. Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist in filing clean claims, solving problems, and collecting overdue payments. Key terms and key abbreviations are defined and emphasized, reinforcing your understanding of new concepts and terminology. Detailed tables, boxes, and illustrations call out key points and main ideas. Unique! Color-coded icons clarify information, rules, and regulations for different payers. An Evolve companion website enhances learning with performance checklists, self-assessment quizzes, and the Student Software Challenge featuring cases for different payer types and an interactive CMS-1500 form to fill in. A workbook contains learning tips, practice exercises for key terms and abbreviations, review questions, study outlines, performance objectives, a chapter with practice tests, and critical thinking activities for hands-on experience with real-world cases. Available separately. Updated coverage of key health insurance topics includes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, electronic claims, ICD-10, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, Meaningful Use, and CPT 2013. Updated ICD-10 coding information prepares you for the October 2014 ICD-10 implementation date. Updated content on claim forms includes block-by-block explanations and examples for the new CMS-1500 Claim Form. Updated guidelines for the filing and submission of electronic claims include sample screenshots and prepare you for the future of the medical office.

A complete guide to insurance billing and coding, Insurance Handbook for the Medical Office, 13th Edition covers all the plans that are most commonly encountered in clinics and physicians' offices. Its emphasis on the role of the medical insurance specialist includes areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. Learning to fill in the claim form accurately is made easier by the use of icons for different types of payers, lists of key abbreviations, and numerous practice exercises. This edition provides the latest on hot topics such as ICD-10, healthcare reform, the new CMS-1500 form, and electronic claims. Trusted for more than 30 years, this proven reference from Marilyn Fordney prepares you to succeed as a medical insurance professional in any outpatient setting. Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist in filing clean claims, solving problems, and collecting overdue payments.Key terms and key abbreviations are defined and emphasized, reinforcing your understanding of new concepts and terminology.Detailed tables, boxes, and illustrations call out key points and main ideas.Unique! Color-coded icons clarify information, rules, and regulations for different payers.An Evolve companion website enhances learning with performance checklists, self-assessment quizzes, and the Student Software Challenge featuring cases for different payer types and an interactive CMS-1500 form to fill in.A workbook contains learning tips, practice exercises for key terms and abbreviations, review questions, study outlines, performance objectives, a chapter with practice tests, and critical thinking activities for hands-on experience with real-world cases. Available separately. Updated coverage of key health insurance topics includes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, electronic claims, ICD-10, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, Meaningful Use, and CPT 2013.Updated ICD-10 coding information prepares you for the October 2014 ICD-10 implementation date.Updated content on claim forms includes block-by-block explanations and examples for the new CMS-1500 Claim Form.Updated guidelines for the filing and submission of electronic claims include sample screenshots and prepare you for the future of the medical office.

Full of new, innovative tools, techniques, policies and procedures, and advanced practices that allow you to diagnose and treat your revenue cycle and ensure a financially healthy bottom line. The depth and magnitude of change in health care reimbursement means that your medical practice cannot rely on the same old billing methods. Anything less than optimal performance from your billing office reduces cash flow and costs you money. The authors present cutting edge strategies to meet today s reimbursement challenges and improve the profitability of your medical practice. The authors lay out real life business practices that can be adopted tomorrow in your medical practice, including how to: Decipher consumer-directed health plans; Conduct patient financial clearance; Segment patients in terms of financial risk; Staff to effectively conduct front-end and back-end billing; Capture increased revenue at the point of care; Understand real-time claims adjudication; Shrink your collections cycle; Position your practice for pay-for-performance; Work and prevent costly claim denials and rework; Code appropriately to ensure your fair share of differential payer reimbursement; Leverage multiple technologies; and Perform a cost/benefit analysis of your revenue cycle.

"Provide analytical tools and systematic review processes for the practice administrator to strengthen the practice's business operations"--Provided by publisher.