Recommended optional resources for taking the medical billing CMRS exam:
The CMRS Study Guide is optionally available through the AMBA in e-Book format that will assist you in taking the exam. The study materials are priced at $199 and are available through our online store. The Study Guide follows the exam layout listed above and covers about 80% of the questions on the exam.
Understanding Health Insurance: A Guide to Billing and Reimbursement (Paperback) by Jo Ann C. Rowell, Michelle A. Green Step by step directions explaining health insurance in a very detailed manner. Real examples that allow one to understand how insurance works easily. This manual is used by schools nationwide in medical billing training classes. Additionally, 5% of the answers to the AMBA CMRS exam can be found in this book. Also pictured is the Workbook and the Instructor's Manual. There are 150 sample questions from the CMRS exam in the workbook. The answers are in the Instructor's Manual
These coding books, HCPCS, CPT & ICD9, are necessary to take the AMBA CMRS Exam
Other books medical billing professionals may find helpful:
3-2-1 Code It! is your comprehensive learning solution for coding. This exciting new book combines ICD-9-CM, HCPCS level II and CPT coding concepts into one convenient learning package. This book presumes no prior knowledge of coding, and yet offers a level of detail suitable for both beginning and more experienced coders. Each coding chapter contains case studies to guide the user through the assignment of codes, and contains the most up-to-date information regarding coding guidelines and reimbursement issues. Also includes information on career opportunities for coders, the importance of joining professional organizations and obtaining credentials, the impact of working with other coding professionals, and how to develop opportunities for career advancement.
This combination textbook and workbook, explains each phase of the medical claim cycle, from the time the patient calls for an appointment until the financial transaction for the encounter is completed. Coverage includes types of insurance payers, basic coding and billing rules, and standard requirements for outpatient billing using the CMS-1500 claim form. It also emphasizes legal aspects related to each level of the medical claim cycle and the importance of the medical office employee, showing their responsibility for and impact on successful reimbursement.
With expert guidance and over 400 illustrations and graphics,
Hospital Billing and Coding: A Comprehensive Presentation covers
every facet of hospital insurance and billing, from check-in to
discharge. This one-of-a-kind, comprehensive approach prepares
students to meet the growing need for hospital billing and coding
professionals by transitioning students’ knowledge from the
physician/outpatient environment to the hospital environment.
Students will gain a solid understanding of the hospital regulatory
setting, including the structure and function of hospital
departments, patient accounts and data flow, the billing process,
coding, claim forms, reimbursement, HIPAA, and much more. * Includes
over 400 illustrations and graphics to bring important concepts to
life. * Skills and concepts presented in early chapters are utilized
throughout later chapters. * Test-your-knowledge exercises reinforce
lessons as students move forward in the text. * Review exercises at
the end of each chapter further reinforce essential information. *
Actual hospital cases offer students an opportunity to apply the
concepts used throughout the chapters to real-life scenarios. * A
department-by-department overview of hospital structure provides
detailed coverage of how hospitals really work. * Software exercises
drawn from relevant source documents — such as application of
registration; Charge Description Master (CDM); and Patient Invoice —
simulate a hospital billing and coding environment and provide an
alternative method of learning relevant procedures.
This comprehensive text is written by educators and experienced coders to help learners master the complexities of medical coding. The 12 modules address a variety of medical specialties including dermatology, cardiology, primary care, and orthopedics, and tackle the common coding problems encountered in the real world. Coding exercises provide practice for learners and enable them to test their knowledge.
Understanding Medical Coding contains instruction for both inpatient and outpatient coding, and links a connection to the billing/reimbursement/collections process. The book takes the user through all steps necessary to code a claim correctly, link the correct CPT and ICD-9-CM codes for reimbursement for various insurance carriers and government entities, explains adjustments and how and when to bill patients, and what to do if there is a denial or rejection. The book provides an overview of both CPT and ICD-9-CM coding, and also provides more code-specific information, concentrating on specialty coding and the levels of coding. Understanding the coding rationales increases knowledge and skill in one or more area, enhancing skills and performance for various facilities locations and departments.
This practical approach to training students for a career in medical coding begins with an introduction to Current Procedural Terminology (CPT), followed by in-depth explanations of the sections found in the CPT manual. Several chapters, organized to follow the CPT codes by body system, introduce various procedures and demonstrate how to code each one. Practice exercises following each step of information and at the end of each chapter reinforce important concepts and allow users to check their comprehension. Unit II covers the International Classification of Diseases, 9th Revision, Clinical Modification (ICD 9-CM), and Unit III offers information about third party reimbursement. Appendices provide the official ICD-9-CM guidelines for coding and reporting, answers to the in-text exercises, and the documentation guidelines for E/M services. Workbook available.
This workbook to accompany Step-by-Step Medical Coding contains three types of activities/exercises for each chapter. These include: theory, abbreviated patient service and diagnosis descriptions, and original reports. Theory questions are comprised of fill-in-the-blanks, multiple choice and true or false questions. The abbreviated patient service and diagnosis descriptions are line coding exercises. The original reports exercises give students the opportunity to gain a real-world experience by coding from original source documents that have been "washed" of all confidential information.
Great overview of billing and coding. Good for a beginner. This book is not designed for a provider who needs the appropriate codes for billing, rather, it is written for medical billing staff.
This handy resource clearly explains the principles and practices used by medical offices, hospitals, and health facilities to encode medical services in order to receive payment from government agencies and insurance companies.
Finally, a complete guide to the hospital coding and billing processes that includes both inpatient and outpatient coding as well as inpatient and outpatient billing! Understanding Hospital Coding and Billing offers a comprehensive look at the world of hospital/facility coding and billing in a work-text format. This learning solution will promote understanding of the entire facility process from patient intake through the entire billing process. Knowledge of the total process is imperative to successful comprehension of both coding and billing in the facility setting.
Manual providing health care collection and billing managers with a resource tool containing forms, checklist, policies, procedures, and guidelines. Addresses the concerns of health care billing and collections. Purchase of this manual does not include updates. Loose-leaf pages in a three-ring binder.
Don't forget about the modifier. Missing or incorrect usage of modifiers is the most common reason that claims are rejected by payors. Leave off a modifier, or put in the wrong one, and your claim may be denied or paid the wrong amount. Coding with Modifiers: A Guide to Correct CPT and HCPCS Level II Modifier Usage provides step-by-step guidance for the proper use of CPT and HCPCS modifiers. Also included are specific requirements for modifier usage in both professional service and hospital reporting.
This revision incorporates the important changes both in the Medisoft program and in the medical office environment. Computers in the Medical Office offers training and applications using full-featured, state-of-the-art software and current, realistic medical office cases while building transferable computerized medical billing and scheduling skills. Although it is correlated to Medisoft software, students who complete CIMO learn the appropriate terminology and skills necessary to use any patient billing software program with minimal additional training.
This is a comprehensive learning tool for processing insurance claim forms for inpatient and outpatient services for acute, subacute, long-term care, specialty and clinic facilities using the Uniform Bill 92 or UP-92 (HCFA-1450 form). (inpatient and outpatient billing, acute care billing, processing claim forms, HCFA-1450, uniform bill, Medicaid, Medicare, TRICARE, Blue Cross/Blue Shield) ALSO AVAILABLE - INSTRUCTOR SUPPLEMENTS CALL CUSTOMER SUPPORT TO ORDER Instructor's Guide ISBN: 0-8273-8224-3
Includes practical how-to information on office administration, financial management, medical law and ethics, managed care--virtually every topic related to running an efficient medical office.
This text uses a systems approach that clinicians may incorporate into their practice. /The included CD contains customizable forms, with checklist progress note forms for the 20 most common primary care diagnoses and checklists of 20 pirmary care tasks for HEDIS measurements.
Essentials of Physician Practice Management offers a practical reference for administrators and medical directors and provides a comprehensive text for those preparing for a career in medical administration, practice management, and health plan administration. Essentials of Physician Practice Management is filled with valuable insights into every aspect of medical practice management including operations, financial management, strategic planning, regulation and risk management, human resources, and community relations.
This must have resource gives physicians and office administrators the information they need to make informed decisions and set their practice on a sound fiscal foundation. In an easy-to-understand format - Simplifies financial analysis. Outlines steps to assure revenue maximization and expense management. Discusses financial safeguards and other internal control issues. Includes chapters on budgeting, ratios and benchmarking. Provides financial report samples, charts, checklists and a glossary of financial terminology. Offers practical responses to the fiscal realities of health care market demands.
The book is organized into three sections: Qualitative Aspects of Medical Practice, Quantitative Aspects of Medical Practice, and Contemporary Aspects of Medical Practice. Appendices include sample management service agreements, and information on medical unions and public perception of physician salaries. A particularly useful feature is a brief biosketch of each contributor, complete with contact information.
A proven and unique combination of learning principles and exercises, this widely respected book continues to get better! Medical Terminology for Health Professions, Fifth Edition, simplifies the process of learning hundreds of difficult, complex medical terms. The see and say pronunciation system makes pronouncing unfamiliar terms easy. Because word parts are such an important aspect of learning medical terminology, mastery of these building blocks is emphasized throughout the book. Organized by body system, chapters begin with an overview of the structures and functions of that system so you can relate these to specialty, pathology, diagnostic, and treatment procedures that follow.
An Entirely Different and Proven Approach to Make the E/M System Work for Physicians in the Patient Care Environment! Written by an expert who has practiced and taught the practical side and successful use of the E/M coding system since its inception, this book provides proven solutions to change E/M coding into an invaluable asset. Physicians, medical students, administrators, coding professionals, chart auditors, and others will discover this book to be a solid learning tool and guide to completing E/M documentation and coding correctly and in a timely fashion while enhancing patient care.
This book is a one-stop resource for HIPAA privacy and security advice that can immediately be applied to any organization's unique situation. It defines what HIPAA is, what it requires, and what can be done to achieve and maintain compliance. It describes the HIPAA Privacy and Security Rules and compliance tasks in easy-to-understand language, focusing not on technical jargon, but on what organizations need to do to meet requirements. Anyone preparing an organization for HIPAA laws will receive expert guidance on requirements and other commonly-discussed topics. The book enables organizations determine how HIPAA will impact them, regardless of whether they are a HIPAA Covered Entity.
The Credentialing Guide is a comprehensive resource for issues regarding credentialing in managed care plans. This publication will include a state-by-state overview of credentialing laws and medical board credentialing activities. It also contains analytic chapters that examine credentialing from the practitioner's perspective, the delegation of credentialing functions, the relationship between credentialing and quality improvement, and an analysis of what American courts have to say about credentialing in managed care organizations and hospitals.
The fourth edition of this popular textbook provides the basic information needed to learn critical concepts of managed care. Derived from the best-selling Managed Health Care Handbook, Fourth Edition, this text presents basic information on all the critical concepts of managed care; compares myths about managed care to actual facts; progresses from introductory material on the types of managed care organizations to negotiating and contracting, controlling utilization, and using data reports in medical management; illuminates the regulatory landscape, with careful attention to both federal and state law, as well as the legislative environment. Learning objectives open each chapter; useful tables and charts summarize key information at a glance; study questions encourage thoughtful analysis; includes a glossary of terms and common acronyms. Also includes Study Guide.
Are you getting tired of searching three or four different books for current information about Medicare? Now you can get all the important Medicare compliance information you need in a single, easy-to-use book at a very affordable price. The Medicare Compliance Manual 2006 contains over 900 pages packed with the information you need to maximize your Medicare reimbursement and protect yourself from audit liability. Answers your coverage questions with explanations and cross-references to the Medicare Carriers, Intermediary and Hospital manuals. Medicare E/M Documentation Guidelines, the most current version of HCFA evaluation and management documentation guidelines to help you protect your practice from audit liability.
Craft, implement and operate a solid, working compliance program with this nuts-and-bolts resource created by experienced compliance experts. From MGMA in collaboration with Powers, Pyle, Sutter and Verville, PC, the book will assist medical group practices of all sizes and ownership structures. Updated to incorporate the latest guidance from the Office of Inspector General (OIG), it addresses the seven key elements of a compliance plan as set forth in the OIG guidance. It then defines each element and provides detailed, practical guidelines for addressing compliance. Features more than a dozen sample documents, including a compliance officer job description and incident reporting form, as well as the complete text of the "2000 OIG Compliance Program Guidance for Individual and Small Physician Practices." 2000, 83 pp.
The HIPAA Compliance Handbook is intended for HIPAA coordinators, project managers, privacy officers, compliance professionals, health care record managers and others who have the responsibility for implementing the HIPAA Administrative Simplification title. It contains easy-to-understand explanations of the legal and regulatory provisions as well as sample HIPAA-related policies procedures, agreements, logs and reports. The 2006 Handbook, provides the following benefits: Contains a methodology for performing a HIPAA compliance assessment, identifying the gaps, evaluating risks, implementing changes and monitoring results Builds in-house understanding and expertise more quickly by shortening the HIPAA learning curb Saves time by avoiding blind alleys Allows readers to progress at their own pace.
The decision to implement Electronic Health Records (EHR) will allow your office to run like a well-oiled machine, freeing physicians and administrators from thinking about day to day operations. Regardless of where you are in the EHR process, this book is an invaluable asset. You may learn something new about the EHR you've already purchased. If you're in the EHR evaluation process, this book will be your guide. EHR Implementation is a valuable resource that helps you evaluate and map out your workflow so vendors can customize the software for you. Follow a logical and well-defined step by step selection process, supported by a well-defined implementation process. Designed to be a working document loaded with flow charts, graphs, checklists and clear implementation steps. Helps you research, select, negotiate and implement electronic health records in your medical practice.
Comprehensive textbook for the documentation course required in all Physical Therapy programs. Covers every aspect of documentation including reimbursement and billing, coding, legal issues, PT and PTA communication, as well as utilization review and quality assurance. Includes a bonus pocket book with sample documentation forms and checklists.
This manual is based on a seminar that took place in Houston, Texas. Insurance law is constantly changing and the practitioner must remain informed on the recent developments. By reading this manual you will gain knowledge from experts in insurance law that will facilitate your understanding of current issues in several extremely important areas.
This comprehensive sample business plan is provided in Adobe Acrobat format, and may be upgraded to a MS Word file. The plan is an extensive example that includes exhaustive 12-month and 3-year financial forecasts, in layouts that are required by banks, lenders, and investors. The sample business plan provides excellent insight into the day-to-day workings of the business. The sample can be used to quickly and easily develop a business plan that reflects your company's situation.
This is a thorough, careful examination of the ins and outs of self-representation in a civil lawsuit. The authors open with a lesson on the judicial system, thereafter providing a realistic look at what to consider when deciding whether or not to proceed "pro se." Once the reader decides to go it alone, this book gives him or her the necessary law, procedures, and strategies to prepare a case and get it to court. The how-to instruction is augmented by anecdotes and historical perspective, making the text as interesting as it is practical. Well-rounded appendixes provide forms, definitions, and sample arguments. From filing small-claims paperwork and using a law library to preparing a case and conducting a trial, readers will learn basic legal techniques to handle their own civil claims. Also included are sample legal forms, a concise dictionary of legal terms, anecdotes, and real-life case scenarios.
The Third Edition of this highly successful textbook addresses the issues associated with managed care and advances in computer technology that have occurred since the last edition. New legal issues arise when information is integrated and widely available in different electronic formats to a growing number of players in the health care delivery system. The legal issues surrounding technological advances in computer-based patient records, electronic links between patients and providers, telemedicine, community-wide information systems, and access to patient record information are addressed. The implications of new Federal regulation of the confidentiality of health care information, an overview and discussion of state and Federal regulation of managed care, provisions governing electronic payment claims contained in the Health Insurance Portability and Accountability Act and their impact on the transmission of other forms of health care information will all be features of the third edition of Medical Records and the Law.
This directory features a comprehensive introduction to health insurance, medical claims processing, detailed instructions for completion of all health insurance claim forms, an alphabetical listing of over 2,000 third party payers and regulatory agencies with the addresses, telephone numbers and FAX numbers, website urls, plus special pages to add your own listings for local carriers, unions, and employer plans plus everything you need for health insurance claim submission and follow-up. Contact information for over 2,000 third party payers. CMS1500 claim form instructions. UB92 claim form instructions. ADA claim form instructions
For more than 65 years, Taber's has provided students, nurses, and health professionals with the definitions and information they need to provide superior care for their patients, while remaining portable and easy-to-carry. KEY FEATURES INCLUDE 56,000 easy-to-understand definitions, 700 illustrations; more than 500 in full-color, Cyclopedic format, Pronunciations, Abbreviations, Etymologies, 100 most frequently prescribed drugs, Patient Care sections with clinically pertinent information, Tables that put important information at your fingertips, Disease entries that include symptoms, diagnosis and treatment
Dr. Evan S. Levine considers it his ethical responsibility to say what other doctors won't-that the health care industry has put profits ahead of healing patients. A practicing internist and cardiologist, he shows how to get the best medical care-and avoid the scams used to bilk patients and boost profits. He shows you where to look, what to ask and what to avoid in order to get the best medical care for you and your family.
Completely updated for its Third Edition, this practical reference is a comprehensive guide to the anesthetic and perioperative management of patients during all procedures performed by general and subspecialist surgeons. The book explains each procedure from both the surgeon's and the anesthesiologist's perspective, presents details on anesthetic technique, and guides the anesthesiologist and surgeon through the decisions that must be made before, during, and after surgery. Emphasis is on factors that impact the anesthesiologist, including patient positioning, duration of surgery, and complications. The Third Edition covers 40 new and variant surgical procedures. New chapters include office-based surgery and invasive procedures in anesthesia.
Starting and Managing Your Own Physical Therapy Practice (Paperback) Private physical therapy practice information, referring practitioners, credentialed provider, payer mix, mechanical traction, personal health information, staff therapist, appointment cards and billing are all things explained in this book.
Completely revised and updated and written by experts in hospice and home care, this is the seminal resource for home health and hospice care administrators. It is an excellent, comprehensive reference that covers subjects such as management issues, certification standards, financial issues and tips on how to be a successful administrator.
Although it may seem like everyone has a website these days, this in not 100 percent true. Small companies with and without websites struggle with 2 main design issues: What should be on my website and how do I organize and build a website that will be effective for my business? This book provides answers to these questions and specifically addresses the fact that although a website is not for every company, it can be a cost-effective tool for small companies who do not have a big marketing budget or large distribution networks. This book will help small companies sculpt their content and build navigation systems that meet their specific needs and maximize the site?s potential.
"…cuts through the nonsense, providing a clear, simple and concise explanation of how websites reach top positions in search engines ..." (PC Advisor, September 2006). You have a cool Web site, and a really great product, service, or cause you want people to know about. But visitors aren’t beating down your cyber-door. What happened? The answer, most likely, is that you haven’t made your site irresistible to search engines. Search engines have a great deal of control over the volume of traffic a Web site gets, because they put your site in front of people searching for your product or service. If you know the secrets of wooing the search engines, you can gain greater visibility for your site, advance your position in the rankings, avoid techniques that cause search engines to bump your site to the end of the list plus learn so much more!
Interested in promoting your business and/or Web site, but dont have the big budget for traditional advertising? This new book will show you how to build, promote, and make money off of your Web site or brick and mortar store using the Internet, with minimal costs. Let us arm you with the knowledge you need to make your business a success! Learn how to generate more traffic for your site or store with hundreds of Internet marketing methods, including many free and low-cost promotions. This new book presents a comprehensive, hands-on, step-by-step guide for increasing Web site traffic and traditional store traffic by using hundreds of proven tips, tools, and techniques. Learn how to target more customers to your business and optimize your Web site from a marketing perspective. You will learn to target your campaign, use keywords, generate free advertising, search-engine strategies, learn the inside secrets of e-mail marketing, how to build Web communities, co-branding, auto-responders, Google advertising, banner advertising, eBay storefronts, Web-design information, search-engine registration, directories, and real-world examples of what strategies are succeeding and what strategies are failing.
Some people believe salesmen are born, not made. Sjodin, a public speaking and sales techniques consultant, insists anyone can become an effective seller by polishing his speaking skills and learning to sell himself and his ideas to business partners, investors, employers and supervisors. "Everybody sells something," she notes. Sjodin's book is based on the idea that presentations are typically torpedoed by nine common mistakes: "winging it" instead of being prepared, being overly informative instead of persuasive, misusing allotted time, providing inadequate support, failing to close the deal, being boring, relying too heavily on visual aids, using distracting gestures or body language and wearing inappropriate clothing. The author provides practical tips for achieving her recommendations and anecdotes to illustrate her points. New to this revised edition are sections about "elevator pitches" (how to close a deal if you're on an elevator with the one person "who could make your dreams a reality") and tales from Sjodin's workshops. While the book entertains, much of it skims the surface and fails to go beyond the realm of common sense ("Expensive clothes aren't essential. What's important is that your clothes look clean, pressed, and coordinated in color and style."), providing tidbits that might be useful to people new to the business world, but it's hard to see what experienced professionals would get out this book. Still, for readers fresh out of business school needing a pep talk and a reminder that it's okay to deviate from the PowerPoint script, this book is worth a look.
We published this book because many pharmaceutical sales professionals have expressed the need for more in-depth selling skills, when dealing with specialist physicians. The book covers all of the different types of specialists, selling to foreign doctors, handling objections and questions, use of clinical data, bridging techniques and group selling presentations. There is emphasis on psychological selling, with segments on observation skills, personality styles, and body language. Effective sales call planning is one of the major objectives of the book. In essence what we have done is combine traditional selling skills with psychological selling to maximize the effectiveness of sales call planning and execution. There are worksheets and planning documents in all key sections to assist with sales call planning.
Here in a short, compact and concise format is the basics of how to persuade more people more effectively, more ethically, and more often. Ziglar draws from his fundamental selling experiences and shows that while the fundamentals of selling may remain constant, sales people must continue learning, living, and looking: learning from the past without living there; living in the present by seizing each vital moment of every single day; and looking to the future with hope, optimism, and education. His tips will not only keep your clients happy and add to your income, but will also teach you ideas and principles that will, most importantly, add to the quality of your life. Content drawn from Ziglar on Selling.
Life is not fair. Selling is not fair either. Look around and you will see that the salesperson with the best product doesn't always win the sale. It's because every salesperson out there claims to have the best service, the highest quality, and the best deal. As a result, customers are quick to commoditize these similiar-sounding claims of greatness, and they instead gravitate toward products, companies, and salespersons who can differentiate themselves in some way. Fortunately, you don't need a huge advantage. Most sales are won or lost by very small margins. That means you simply need an edge--a differentiable advantage that will set you apart from everyone else. That's what you will find in this book--100 chapters, each designed to give salespeople a one-percent advantage over their competitors. After all, it only takes 1% to have a competitive edge in sales.
"For good measure, he throws in 60 fast ideas to raise fees and/or increase profits." (MD Daily Record, 3/28/02) "...any consultant starting out will find this book useful." (Business Information Alert, Volume 15, Number 2)
"Alan Weiss is the most successful consultant I know. When he speaks, I listen. You should too." — George Morrisey, author, Jossey-Bass "Morrisey on Planning" series
"Alan Weiss long ago learned the real secret of consulting: It's about people, it's about relationships." — William L. Winter, Ph.D., president, The American Press Institute
The practical toolbox for readers of Million Dollar Consulting. This useful guide provides specific checklists, guidelines, templates, and actual examples for every step of the consulting process. It covers marketing, sales, meetings, implementation, follow-up, invoicing, practice management, insurance, equipment, subcontracting, and scores of other elements. Thousands of people have bought Weiss's Million Dollar Consulting and started their own consultancy. Now, this handy resource goes hand-in-hand to provide all the tools new consultants need to enact all the recommendations and ideas in Million Dollar Consulting.
The guru of the Guerrilla Marketing series, with over a million copies in print, teaches entrepreneurs how to market aggressively without spending one cent. Levinson, the authority on big-business marketing on a small-business budget, takes this concept one step further by offering scores of marketing ideas that are completely free. He proves that aggressive marketing doesn't have to be expensive if you use creative and unconventional means. * Hold a giveaway contest. You'll attract customers and acquire names for your mailing list. * Give free talks, consultations, and demonstrations. You'll establish yourself as an expert and publicize your business at the same time. * Post on websites, bulletin boards, and other online communities. They offer countless opportunities for spreading your business message. * Feed your clients. Sending cookies or offering free refreshments in your store can set you apart from the competition. Levinson offers dozens of other tips -- some straightforward, many surprising -- in a unique, indispensable guide that proves you don't have to pay top dollar to improve your bottom line.
This book is a virtual warehouse of marketing ideas, packed to the rafters with 1.500 great marketing tricks guaranteed to boost sales revenues, profits, and customer loyalty. No marketing stone is left unturned in this meaty volume. The essentials are covered in chapters on research, planning, competition, customer service, advertising, direct marketing, public relations, networking, prospecting, closing, creative selling, Web sites, trade shows and many other topics.