Coding generally requires a good background in medicine, but it doesn't entirely exclude
those who have little or no background. Coding is generally done by a variety of staff in
the provider's office, but most do not have the background in medical termin
Let's start with wounds, fractures, burns, and surgery (with some E&M codes thrown in
for good measure). Wounds are classified as Simple, Intermediate, or Complex. Simple
repair is for superficial wounds involving the epidermis or dermis or subcutaneous t
Certifying billers is now a common process. When you complete this course, you will
take a final examination and receive your certification. It will work for most offices that
require training (although the demand on certified billers increa
*the billing process can be really complicated, so it is very important to learn the
terminology for a better understanding.
MEDICAL TERMINOLOGY & BILLING WORDS
aducate- determination of a members payment or responsibility after
a medical claim is appli
Medical Billing I covered the history and costs of medical care, advances in technology,
office staff functions in a medical provider setting, and hospital billing functions. One
major point you learned is that insurance issues are not always
You have studied and learned the office staff functions in a medical provider setting from the
initial patient encounter to the final collection process.
This lesson deals with practice management issues. It will provide an overview of how
A maxim in the industry states that:
The longer accounts receivable remain outstanding, the greater the linear
decrease in the face value of those receivables.
The office staff providing billing services have a fiduciary responsib
How do medical providers establish what fees to charge?
As a matter of fact, most providers commencing medical private practice simply check
with their peers, find out what they charge and those borrowed charges became the base
for the new practitioner. P
From Then to Now
During the early 1900s, health care was largely free of special interests. But these special
interests have now firmly attached themselves to the health care delivery system.
The result is:
Exponentially escalating health care costs, and
LESSON ASSESMENT QUESTIONS WRONG
why is it imprtant to make sure the patient signs an assignment?
to make sure the provider get the insurance payment
why is chart documentation so important to the billing process?
it substantiates and documents the servic
In the Case of Medicare:
1. Assigned Claims
The physician who accepts assignment may bill Medicare
up to 20% of the Medicare allowed amount for the services rendered
after the deductible has been met. Medicare advises provi
patient has been excorted into an examining room for encounter with rovider. the info form has been
placed into a hard copy file folder and a chart numer has been assigned. the chart is then placed into a
hard copy file folder and a chart numbe
Lesson 3: Provider Structure and Protocols
This lesson focuses on the following topics:
Typical Organizational Chart
Staff and Responsibilities
Basic Practice Elements
Registering the Patient
1 PROVIDER OFFICE
one of mor
A Blended Family- exwife, dad, step dad, mom, step mom, ex husband, childern
matilda- exwife of ted with two childeren together.
red- married to mary. one child together (kevin) two childeren with matilda (laura and paul)
mary- married to ted. one child t
outpatient and inpatient services
once a patient has been referred to the hospital for care, two types of billing can take place;
- ER (walkins, patients needing immediate care)
- lab work (basic tests, blood work, urin and stool sampl