CourseSmart Reader

Patient Billing, 7th Edition

by Sanderson, Susan

Publisher: McGraw-Hill Higher Education

Publishing Date: 2009/01/16

eText ISBN-10

0-07-733073-0

eText ISBN-13

978-0-07-733073-6

Print ISBN-10

0-07-340202-8

Print ISBN-13

978-0-07-340202-4

Saleable Print ISBN-10

0-07-340202-8

Saleable Print ISBN-13

978-0-07-340202-4

Table of Contents

To the Student, ix

Your Career in Medical Billing, ix

About This Book, x

Computer Supplies and Equipment, xi

How Can I Succeed in This Class?, xiii

To the Instructor, xxi

Teaching and Learning Supplements, xxi

Acknowledgments, xxiii

Chapter 1. Introduction to Patient Billing, 1

What You Will Learn, 1

Overview of Medical Office Accounting, 2

Day-to-Day Activities, 3

Step 1 Preregister Patients, 3

Step 2 Establish Financial Responsibility, 4

Step 3 Check In Patients, 4

Step 4 Check Out Patients, 7

Step 5 Review Coding Compliance, 10

Step 6 Check Billing Compliance, 10

Step 7 Prepare and Transmit Claims, 10

Step 8 Monitor Payer Adjudication, 12

Step 9 Generate Patient Statements, 12

Step 10 Follow Up Payments and Collections, 12

Computerized Medical Office Databases, 16

Comparing a Computerized Billing System with a Manual Billing System, 18

Access to Information, 18

Search Capability, 18

Minimal Storage Space, 19

Electronic Claims Transmission, 19

Fewer Errors, 19

Claims Creation and Processing, 20

Fewer Steps to Record Data, 20

Chapter 1 Review, 23

Chapter 2. Using the Computer for Patient Billing, 27

What You Need to Know, 27

What You Will Learn, 27

Medisoft: A Computerized Patient Billing System, 28

Medisoft Menu Bar, 28

Getting Started with Medisoft, 34

Navigating the Medisoft Menus, 34

Changing the Medisoft Program Date, 35

Formats for Entering Dates, 36

Using Medisoft Help, 36

Exiting Medisoft, 38

Chapter 2 Review, 41

Chapter 3. Managing Data with a Computerized System, 43

What You Need to Know, 43

What You Will Learn, 43

Entering and Editing Data, 44

Editing Data, 44

Saving Data, 44

Deleting Data, 44

Patient Chart Numbers, 46

Searching in Medisoft, 48

Searching for Patients, 48

Searching for Other Data, 49

Adding New Codes, 50

Backing Up Data Files, 52

Viewing Backup Data Files, 54

Restoring the Backup File, 55

Chapter 3 Review, 57

Chapter 4. Entering Patient and Case Information, 61

What You Need to Know, 61

What You Will Learn, 61

How Patient Information is Organized, 62

Patient/Guarantor Information Requirements, 64

Case Information Requirements, 67

Entering Patient and Case Data, 76

Chapter 4 Review, 83

Chapter 5. Processing Transactions, 87

What You Need to Know, 87

What You Will Learn, 87

Handling Transactions, 88

Recording and Entering Procedure Charges, 88

Reviewing a Completed Encounter Form, 88

Entering a Procedure Charge, 90

Entering Payments, 97

Patient Payments, 98

Printing a Walkout Receipt, 98

Chapter 5 Review, 105

Chapter 6. Processing Claims and Creating Statements, 109

What You Need to Know, 109

What You Will Learn, 109

Claim Management, 110

Creating Claims, 110

Editing Claims, 113

Proofing Claims Using the List Only Option, 114

Transmitting Electronic Claims, 114

Printing Insurance Claim Forms, 117

Changing the Claim Status Manually, 119

Deleting Claims, 120

Insurance Payments, 120

Understanding the RA, 121

Entering Insurance Payments in Medisoft, 122

Adjustments, 127

Creating Patient Statements, 128

Statement Management Window, 128

Creating Patient Statements, 130

Printing Statements, 132

Chapter 6 Review, 135

Chapter 7. Producing Reports, 139

What You Need to Know, 139

What You Will Learn, 139

Medisoft Reports, 140

Day Sheets, 140

Crystal Reports Preview Window, 144

Analysis Reports, 145

Billing/Payment Status Report, 145

Practice Analysis Report, 145

Aging Reports, 147

Collection Reports, 149

Patient Collection Report, 149

Insurance Collection Reports, 150

Patient Ledgers, 151

Standard Patient Lists, 154

Custom Reports, 154

List Reports, 156

Designing Custom Reports and Bills, 157

Chapter 7 Review, 159

Family Care Center: A Patient Billing Simulation, 163

Office Procedures Manual, 163

Daily Tasks Before Patients Arrive, 163

Morning Tasks, 164

Afternoon Tasks, 164

Other Tasks During the Day, 164

Weekly Tasks, 164

Monday, November 1, 2010, 165

Tuesday, November 2, 2010, 167

Wednesday, November 3, 2010, 167

Thursday, November 4, 2010, 169

Friday, November 5, 2010, 170

Appendix: Office Hours, 173

What You Need to Know, 173

What You Will Learn, 173

Introduction to Office Hours, 173

Overview of the Office Hours Window, 173

Program Options, 174

Entering and Exiting Office Hours, 175

Entering Appointments, 175

Looking for a Future Date, 176

Searching for Available Appointment Time, 179

Entering Appointments for New Patients, 180

Changing or Deleting Appointments, 180

Previewing and Printing Schedules, 181

Source Documents, 183

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