Abstract

A comprehensive, approachable guide to hospital insurance billing and coding, Understanding Hospital Billing and Coding, 3rd Edition covers everything hospital billers need to know, from patient admission to accounts receivable management and HIPAA. It builds on your knowledge so that you can make a successful transition from the physician/outpatient environment to the hospital setting. Written by coding expert Debra P. Ferenc, this book covers the hospital regulatory setting, the structure and functions of hospital departments, patient accounts and data flow, the billing process, coding, claim forms, reimbursement, accounts receivable management, HIPAA requirements, and much more.

• Over 300 illustrations and graphics bring important concepts to life.
• Practice hospital cases let you apply concepts to real-life scenarios.
• A department-by-department overview of hospital structure shows how hospitals really work.
• Detailed chapter objectives highlight what you are expected to learn.
• Key terms, acronyms, and abbreviations with definitions are included in each chapter.
• Concept Review boxes reinforce key concepts.
• Test Your Knowledge exercises reinforce lessons as you progress through the material.Comprehensive presentation of the UB-04 includes section-by-section explanations and a comparison between the CMS-1500 and UB-04.
• Detailed explanations of HIPAA, hospital coding, and various payer systems prepare you to enter the field of hospital billing and coding.
• Chapter summaries review key concepts.
• Review exercises in each chapter reinforce your understanding and improve your retention of important concepts.
• Exercises on the companion Evolve website simulate a hospital billing and coding environment and provide another method of learning procedures by drawing from source documents.

• Updated Claim Forms chapter covers the UB-04 claim form.
• Updated information covers diagnosis and procedural coding, with guidelines and applications.
• Updated claim forms and names are used throughout.