Healthcare Documentation Program Introduction to the Healthcare Industry & Medical Terminology Course 1 0105801LB01B-34 Healthcare Documentation Program Course One Lesson 1—The World of Health Care Lesson 2—Medical Insurance 101 Lesson 3—Private Insurance and Managed Care Lesson 4—Medicaid, CHIP and Medicare Lesson 5—Military Insurance, Workers’ Compensation and COBRA Lesson 6—Introduction to Medical Terminology Lesson 7—Dividing and Combining Medical Terms Lesson 8—Medical Abbreviations, Symbols and Special Terms Lesson 9—Ethics and Legal Issues Lesson 10—Medical Records Healthcare Documentation Program All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from Weston Enterprises, Inc. Copyright © 2013-2014, Weston Enterprises, Inc. 0105801LB01B-34 Acknowledgments Editorial Staff Director of Education: Janet Perry, B.A. Instructional Design Supervisor: Kimberly Fields, M.A. Associate Editor: Brenda Blomberg, B.A., CPC Associate Editor: Stephanie MacLeod, M.S. Design/Layout Design Supervisor: Connie Hunsader Graphic Designer: D. Brent Hauseman Graphic Designer: Sandy Petersen FOR MORE INFORMATION CONTACT: At-Home Professions Fort Collins, CO 80525 www.at-homeprofessions.edu II 0105801LB01B-34 Table of Contents Table of Contents Lesson 1: The World of Health Care Step 1: Learning Objectives for Lesson 1...................................................................................................................... 1 Step 2: Lesson Preview .................................................................................................................................................... 1 Step 3: Set Goals............................................................................................................................................................... 2 Step 4: Time Management .............................................................................................................................................. 3 Set a Schedule and Stick to It .......................................................................................................................... 4 Step 5: Stay Motivated ..................................................................................................................................................... 6 Step 6: Teamwork in the Healthcare Profession .......................................................................................................... 6 Physicians .......................................................................................................................................................... 7 Nurses ................................................................................................................................................................. 7 Nurse’s and Physician Assistants .................................................................................................................... 8 Emergency Personnel ....................................................................................................................................... 8 Support Staff ...................................................................................................................................................... 8 Step 7: Healthcare Professionals .................................................................................................................................... 9 Medical Transcriptionist/Editor ..................................................................................................................... 9 Medical Coding Specialist ............................................................................................................................. 10 Medical Billing Specialist ............................................................................................................................... 10 Step 8: Responsibilities ................................................................................................................................................. 11 Step 9: Practice Exercise 1-1 ......................................................................................................................................... 12 Step 10: Review Practice Exercise 1-1 ......................................................................................................................... 13 Step 11: Personal Qualities ........................................................................................................................................... 13 Professionalism ............................................................................................................................................... 13 Presentation ..................................................................................................................................................... 14 Adaptability ..................................................................................................................................................... 14 Step 12: Character Traits............................................................................................................................................... 14 Curiosity and Drive ........................................................................................................................................ 14 Warmth and Confidence ............................................................................................................................... 14 Organizational and Professional Skills ........................................................................................................ 14 Step 13: Practice Exercise 1-2 ...................................................................................................................................... 15 Step 14: Review Practice Exercise 1-2 ......................................................................................................................... 15 Step 15: Lesson Summary ............................................................................................................................................. 15 Endnotes .......................................................................................................................................................... 15 0105801LB01B-34 III Healthcare Documentation Program Lesson 2: Medical Insurance 101 Step 1: Learning Objectives for Lesson 2...................................................................................................................... 1 Step 2: Lesson Preview .................................................................................................................................................... 1 Step 3: Insurance Terminology ...................................................................................................................................... 2 Allowable Charge .............................................................................................................................................. 3 Deductible ......................................................................................................................................................... 3 Copayment ........................................................................................................................................................ 3 Explanation of Benefits .................................................................................................................................... 4 Step 4: Preauthorization ................................................................................................................................................. 6 Visitation Limits ............................................................................................................................................... 6 Step 5: Practice Exercise 2-1 ........................................................................................................................................... 6 Step 6: Review Practice Exercise 2-1 ............................................................................................................................. 7 Step 7: Tools of the Trade ............................................................................................................................................... 7 CMS-1500 .......................................................................................................................................................... 8 UB-04 ................................................................................................................................................................. 9 Coding Resources ........................................................................................................................................... 10 Step 8: Life Cycle of a Medical Bill .............................................................................................................................. 11 Processing the Bill .......................................................................................................................................... 12 Step 9: Accurate and Thorough ..................................................................................................................................