The 21st century environment of rising cost and decreased payments in healthcare is a reality. Without the efforts of an expert insurance staff, physicians may face financial jeopardy. Medical Office Billing provides a comprehensive guide to the role of medical office billing staff.
Why this training manual?
This workbook provides an introduction for new medical office insurance staff and serves as a reference for existing insurance staff members and practice managers.
Medical Office Billing explains the fundamentals of how to work effectively as a member of the medical office insurance staff.
By working through this book, individuals will:
- Understand why an insurance claim is filed
- Gain a framework for thinking about the major types of health insurance
- Understand what constitutes fraud and abuse and how to avoid each
- Comprehend the elements of medical coding and how to read – and explain – an EOB (Explanation of Benefits)
- And much more!
Each lesson ends with glossary, exercises, and scenarios to help you solidify your understanding and knowledge. As an added bonus, the book includes a CD with pre-tests as well as the post-tests that appear at the end of each lesson.
Published by MGMA, 2011, 322 pp., ISBN 978-1-56829-388-2
See author Sarah Holt explain how this book will help your medical insurance staff understand what they need to know to become more effective in the billing department
Sarah J. Holt, PhD, FACMPE
Holt is the administrator of several healthcare organizations of various types—she does practice management for Cape Girardeau Surgical Clinic, Inc. & Breast Care Center as well as Cape Medical Billing Corp a physicians’ billing company. Additionally, she is the administrator of Cape Girardeau Doctors’ Park, an 80-acre complex of 35 medical buildings where a full range of medical services are offered.
Holt has a PhD in policy analysis with a healthcare emphasis from St. Louis University, an M.A. in counseling from Southeast MO State University, and an undergraduate degree in education. She has done extensive research on how medical office insurance staff members make decisions relating to insurance reimbursement and how complexity influences organizations.
She teaches health policy and healthcare reimbursement at the graduate level at Southeast MO State University and speaks on healthcare management topics to audiences of physicians, management and staff. Holt has led Cape Girardeau Surgical Clinic, Inc. to be recognized as a Better Performer numerous times. She is the author of the book, Get the Money in the Door: Physician Billing Basics and the upcoming release Medical Office Billing: A Self-Study Training Manual.
Holt has for many years been is an active participant of the American College of Medical Practice Executives (ACMPE) and in Medical Group Management Association (MGMA) at local, state, and national levels. She is a Fellow in the ACMPE and is a past chair of the ACMPE Board of Directors.
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'This is a great book for someone who wants to know EVERYTHING about medical office billing! It has great resources, definitions, and explanations logically organized in a workbook format. Each [lesson] has excellent tests to make sure the reader has grasped the details and can apply them to real life billing scenarios. I would highly recommend this book for anyone interested in honing their skills in medical office billing.' —Nancy R. Babbitt, FACMPE, Babbitt and Associates, Consultant/Speaker/Author
'Medical Office Billing: A Self-Study Training Manual provides an excellent resource to train billing staff in navigating the complicated gauntlet of claims processing in an increasingly complex and confusing regulatory and contractual environment. Sarah J. Holt, PhD, FACMPE, shares her insight and experience into the billing and collections process by taking each component of the revenue cycle and explaining it in a clear and concise manner. By showing how each step works and interrelates to the other aspects of this critical function, Medical Office Billing provides a firm foundation of knowledge for the staff responsible for this activity. This book is an excellent primary resource [for] training the billing and insurance staff [members] to become top performers in obtaining the proper financial remuneration for the services rendered by the practice.' —Alan J. Beason, MS, FACMPE, CEO/Administrator, Cardiovascular Consultants, LLP