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The Medical Office

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Facilities Management

What is FM – Definition of Facility Management
Facility management is a profession that encompasses multiple disciplines to ensure functionality of the built environment by integrating people, place, process and technology.

HIPAA: Health Insurance Portability and Accountability Act
AMA offers information for physicians about the HIPAA – Health Insurance Portability and Accountability Act of August 1996 as part of their physician resources program.

Fast Facts for Covered Entities

Americans with Disabilities Act

Facts About the Americans with Disabilities Act

Access To Medical Care For Individuals With Mobility Disabilities

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Office Equipment

How to Use a Fax Machine

Is a FAX document HIPAA-Secure?
Sending ePHI over regular insecure FAX is not recommended for HIPAA compliance; better solutions are available these days.

Does the HIPAA Privacy Rule permit a doctor, laboratory, or other health care provider to share patient health information for treatment purposes by fax, e-mail, or over the phone?

HIPAA Fax Cover Sheet

Fax Transmittal Procedures [EXAMPLE]

Using a Copier [VIDEO]

Understanding HIPAA: including print and copy machines in your business’s compliance plan
As one managed health care plan recently learned, overlooking copy and print machines when implementing HIPAA privacy and security measures is a costly mistake.

Multi-line Phone System Tutorial [VIDEO]

How Office Phone Systems Work
Equipping your business with a phone system rather than a multitude of single-line phones can improve office communication and increase productivity.

Is Your Business Phone System HIPAA Compliant?
A secure business phone system protects your office from penalties and criminal prosecution. Read on to see if your business phone system is HIPAA compliant.

Health Problems Caused by Computer Work

Ten Steps to HIPAA Security Compliance
The article will explain the new HIPAA security regulations and how family practices can comply with them.

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Facilities Management

Managing Your Postage Meter [VIDEO]
Managing Your Postage Meter [Video]

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Office Equipment

Introduction to medical equipment inventory management

Buying vs. Leasing Expensive Technology

Medical equipment: Should practices buy or lease?
One decision often facing medical practice owners is whether to buy or lease equipment. Here are a few points to consider before making your decision.

Training for equipment maintenance and repair

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Starting a practice 5-6 months out: Office design and supplies

Medical supplies and equipment for primary health care

What Is the Difference Between Supplies & Inventory?

Procedures for Ordering Office Supplies

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Office Management

Solutions for Managing Your Practice
AMA offers physician practice management solutions and tools as part of their online physician resource center that includes educational resources as well as health information technology (Health IT).

Basic Management Concepts for Medical Front Office Personnel
Patients get their first impression of your medical practice at the front office, so the success of your business depends on staffing your front lines with competent, efficient employees.

Effective Staff Management

Best Medical Practice Management Software
Find and compare Medical Practice Management software. Free, interactive tool to quickly narrow your choices and contact multiple vendors.

Medical practice checklists and forms
Forms, checklists and spreadsheets useful for starting up and managing a medical practice.

Practice Management Resources | Patient Care & Office Forms
Office Forms for Running Your Practice including chart forms, screenings and vaccinations, office signs and more.

How to Plan a Successful Meeting
You have the most leverage on a meeting’s success before a single person walks into the room. The more you manage the conditions under which people meet, the less you will need to manage their meeting behavior.

Planning and Structuring Effective Meetings
Meetings can serve many different purposes but in order for a meeting to be effective it needs careful planning and structure.

Making Travel Arrangements

How to Do Travel Arrangements

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Policy and Procedures Manuals

Policy Library | Medical Office Policy and Procedure Manuals

How to Develop a Policy Manual

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Community Resources

American Association for Marriage and Family Therapy (AAMFT)

American Counseling Association
American Counseling Association promoting counselors through work in advocacy, research and professional standards. Online education, resources, CE, ethics, publications, careers, conferences

NAADAC | The Association for Addiction Professionals
NAADAC, the Association for Addiction Professionals, represents the professional interests of more than 85,000 addiction counselors, educators and other addiction-focused health care professionals in the United States, Canada and abroad. NAADAC’s members are addiction counselors, educators and other addiction-focused health care professionals, who specialize in addiction prevention, treatment, recovery support and education.

National Society of Genetic Counselors

American Association of Retired Persons (AARP)
AARP is a membership organization leading positive social change and delivering value to people age 50 and over through information, advocacy and service.

Easter Seals
Nonprofit, community-based health agency dedicated to helping children and adults with disabilities attain greater independence.

March of Dimes
The March of Dimes funds lifesaving research and programs and works to end premature birth, birth defects and infant mortality. Every baby deserves a healthy start.

Society For The Blind
We empower individuals who are blind or have low vision to live productively and independently by building confidence through training, tools and mentorship

American Heart Association

American Cancer Society
Dedicated to helping persons who face cancer. Supports research, patient services, early detection, treatment and education. Contact us anytime day or night 1-800-227-234.

Homeless Assistance/U.S. Department of Housing and Urban Development (HUD)

Home – Child Welfare Information Gateway

The National Domestic Violence Hotline

U.S. Hunger Relief Charity | Feeding America
1 in 6 people struggles with hunger in the US. Feeding America is a nationwide network of food banks fighting hunger. Learn about our work & get involved.

Hospice Care

Assisted Living Facilities
Is assisted living right for you? Find tips for choosing the right facility and making the transition easier.

Meals on Wheels America
Meals on Wheels operates in virtually every community in America to address senior hunger and isolation.

The Association of Air Medical Services (AAMS)

The American Ambulance Association
To promote health care policies that ensure excellence in the ambulance services industry and provide research, education and communications programs to enable its members to effectively address the needs of the communities they serve.

The Community Transportation Association of America

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Computers in the Medical Office

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Functions of the Computer

Four Equipment Functions

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Components of the Computer

Components of a Computer System

Computer Components

Components of a Computer

Basic Hardware Unit-Input Unit,Memory auxillary,CPU,Output Units,Memory_auxillary,CPU,Output_Units

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Basics of Computer Use

Computer Basics Tutorial

Basic Computer Skills

Introduction to Network Security

Breaking Into the Basics of Network Security
Network security can be as simple as adhering to a set of rules; technology alone can’t thwart hack attacks and other security breaches.

Effective internet research [SLIDESHOW]

10 tips for smarter, more efficient Internet searching
These days, everyone is expected to be up to speed on Internet search techniques. But there are still a few tricks that some users — and even savvy searchers — may not be aware of.

Methods Of Effective Internet Research

What is Word Processing (word processor)?
Word processing is a term that means using a computer to create, edit, and print documents. Word processors are the most common types of applications.

What is word processor?
Computer dictionary definition for what word processor means including related links, information, and terms.

What is Spreadsheet?
A table of values arranged in rows and columns. Each value can have a predefined relationship to the other values.

What is spreadsheet?
A spreadsheet is both a sheet of paper designed to capture and show data in rows and columns and also, using the original meaning as a metaphor, a computer application program that captures, displays, and manipulates data arranged in rows and columns.

What is Database Management System (DBMS)?
A database management system (DBMS) is a collection of programs that enables you to store, modify, and extract information from a database.

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Computer Systems in Medical Practice Management

Best Medical Practice Management Software | 2015 Reviews of the Most Popular Systems
Find and compare Medical Practice Management software. Free, interactive tool to quickly narrow your choices and contact multiple vendors.

Medical practice management software

How to install a software program.
Information and help on how to install a software program, game, or utility on your computer.

Patient Identification

10 Tips for Effective Appointment Scheduling

Best Medical Scheduling Software | 2015 Reviews of the Most Popular Systems
Find and compare Medical Scheduling software. Free, interactive tool to quickly narrow your choices and contact multiple vendors.

Claims Processing
Getting your medical claims out of the door and paid as soon as possible is every health care provider’s primary goal as far as finance is concerned. The faster the claim goes out, the faster the money comes in. Make sure your office is equipped with the necessary software to save time and money.

What is backup?

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Medical Office Communication

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Greeting Patients

Making Your Practice’s First Impression a Positive One

7 Ways to Make Your Patients Smile
Amid the stresses of running a medical practice, it’s sometimes hard to find the time to keep your patients happy. But keeping your patients smiling is good for your wallet and your psyche.

Greet Patients So They’ll Want To Meet You! [VIDEO]
Don’t take greeting patients for granted. A proper greeting welcomes your patients into your practice and makes them glad to meet you.

Chapter 1: Greet the patient warmly and politely [VIDEO]

The HIPAA Privacy Rule: Patients’ Rights

The HIPAA Privacy Rule: Three Key Forms
The author provides samples of three forms useful in implementing HIPAA privacy regulations — the Notice of Privacy Policy, a patient authorization form, and a patient consent form that is not strictly required by HIPAA but may be useful.

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Managing the Telephone

Improving Telephone Management in Your Practice
The author describes how practices can evaluate whether their phone system is adequate for meeting demand and explains some process and equipment changes that might help improve performance.

How Does Your Practice Sound on the Phone?
Consultants offer tips on dealing with patient-initiated calls, including advice about scheduling appointments and managing requests for prescription refills.

Preventing Communication Errors in Telephone Medicine

Is your telephone hurting your practice? Phone do’s and don’ts
The first contact most patients have with your practice is by telephone. Here’s how to make that initial conversation work for you.

Improving Your Inflection on the Phone – For Dummies

Your Telephone Speaking Voice
Professional speaker and presentation skills expert Lenny Laskowki talks about telephone speaking tips.

Office Skills – Telephone Etiquette and Telephone Tips

8 Telephone Etiquette Tips – International Business Protocol and Social Etiquette

How to Deal With a Rude Person Over the Phone

Time Zone
Time zone and current times for all of the United States including information about daylight savings time and utc/gmt.

Improving Patient Care: Getting a Grip on Your Phone Calls – Family Practice Management
The author offers tips for reducing unnecessary phone calls to your office while improving patient care and service.

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Scheduling Appointments

Why Appointment Scheduling Is Important In the Medical Office
Find out why appointment scheduling is essential in your medical office. Save money on staff costs, reduce patient no shows, and much more with online scheduling.

Free Appointment Scheduler For Medical and Healthcare

Reducing Delays and Waiting Times With Open-Office Scheduling
This article will outline the process one clinic used to implement open-access scheduling, which frees up time on physicians’ schedules each day to allow for same-day appointments.

8 Tips for Effective Medical Office Appointment Scheduling
Create a more efficient and effective appointment scheduling process for your medical office with these 8 tips.

10 Tips for Effective Appointment Scheduling

Scheduling Appointments and Maintaining the Physician’s Schedule (Common Abbreviations) [SLIDESHOW]

Strategies for Better Patient Flow and Cycle Time
The article describes strategies that family practices have successfully used to move patients through their practice more efficiently, thereby improving patient satisfaction and practice productivity.

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Handling Mail

Mail Handling [SLIDESHOW] [SLIDESHOW]_ppt_presentation

How to Incoming Mail Handling Procedure

USPS – Classes of Mail

What Are Efficient Ways of Handling Corporate Outgoing Mail?

Folding a Letter [VIDEO]
How to fold and insert a business letter into an envelope properly. Remember, first impressions are lasting!

How to Fold and Insert a Letter Into an Envelope: 6 Steps

State Abbreviations
State Abbreviations for the US States and more.

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Managing Written Correspondence

Managing Correspondence and Mail

How to Improve Written Communication

How to Proofread


Basic Business Letters
This resource covers the parts of the basic business letter and provides three sample business letters.

Preparing your manuscript

Writing A Medical Case Report

Clinical Practice Guidelines : Writing a good medical report

Case Report Writing Template

Example Postoperative Report

The art of writing a good consultation letter to another physician

How To Write A Consultation Report That Will Make The Referring Physician Sit-up And Take Notice

Consultation Report Templates

Radiology Written Report Guideline

What is medical transcription (MT)? – Definition from
Medical transcription (MT) is the manual processing of voice reports dictated by physicians and other healthcare professionals into text format.

5 Must Know Medical Transcription Tips [VIDEO]

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Medical Records and Chart Documentation

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Purpose and Contents of Medical Records

What is the Primary Purpose of a Medical Record? [VIDEO]

Medical Record Content and Format

Continuity of Care, Definition of

Choosing an Electronic Health Records System

Practice Management Resources | Patient Care & Office Forms
Office Forms for Running Your Practice including chart forms, screenings and vaccinations, office signs and more.

Medical Office Forms

Your Medical Records

Right to Access Medical Records

Medical Record Retention and Media Format for Medical Records

Guidelines For Progress Notes

Medical Record Progress Notes [TEMPLATE]

What is problem list?
In health IT, a problem list is a designated section of a patient’s medical chart that details the most important medical information. The information, which is meant to be a succinct overview that can be absorbed at a glance, includes diagnoses such as asthma and hypertension, family history and past tests and procedures.

Problem list problems with electronic medical records

Make Action Plans

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Charting in the Patient’s Record

Guidelines for Charting Medical Records

Exam Documentation: Charting Within the Guidelines
The article, the second in a three-part series, details the section of Medicare’s E/M documentation guidelines pertaining to exams and explains how to comply and practice efficiently with them.

Making Changes in Charts?

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Selecting a Filing System

Standard Filing Systems

Types of Filing System

Different Ways to File Documents in a Filing Cabinet

Why Don’t More Hospitals Use Electronic Health Records?

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Filing Methods

Methods of filing: alphabetical. Numerical, geographical, chronological and subject wise

How to set up an effective filing system – filing methods
The importance of record keeping and filing systems cannot be too highly stressed. A well-planned system contributes significantly to efficiency of operation as well as to a company’s image.

Electronic File Cabinet – Organizing Medical Records [VIDEO]

Electronic Medical Record EMR Lessons in Setting up an EMR Clinic [SLIDESHOW] [SLIDESHOW]_ppt_presentation

18 Filing Rules For Proper Alphabetizing

Filing Systems

County Records Management Manual

Analysis of Staight Numeric Filing

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Tickler File

Tickler File

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Review of Basic Filing Procedures

Introduction Medical records management systems [SLIDESHOW]
Medical Records Management Module 1. Introduction Medical records management systems are only as good as the ease of retrieval of the data in the files.

Retention of Medical Records

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Financial Management

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Accounting Principles

Accounting Principles | Explanation

Basic Accounting Principles

Generally Accepted Accounting Principles
Accountants use generally accepted accounting principles (GAAP) to guide them in recording and reporting financial information.

assets definition

liabilities definition

equity definition

Accounting Equation | Explanation

T Accounts

T-Accounts | Ledger Accounts | Example
Once journal entries are made in the general journal or subsidiary journals, they must be posted and transferred to the T-accounts or ledger accounts. This is the second step in the accounting cycle.

Assets | Types of Assets | Classifications | Explanation | Examples
Asset is a resource controlled by the entity as a result of past events and from which future economic benefits are expected to flow to the entity (IASB Framework). Assets may be classified into Current and Non-Current. Main types of assets include Non-Current Assets such as buildings, plant and machinery, vehicles and Current Assets such as inventory, cash and receivables.

Petty Cash Accounting

Cash Voucher

Accounts Receivable (AR) Definition
Money owed by customers (individuals or corporations) to another entity in exchange for goods or services that have been delivered or used, but not yet paid for.

What is accounts receivable aging? – Questions & Answers

Classifying Liabilities
Learn more about classifying liabilities. Two typical classification types for liabilities are current and long-term.

Liabilities | Types | Classifications | Explanation | Examples
Liability is a present obligation of the enterprise arising from past events. Liabilities may be classified into Current and Non-Current. Types of liabilities include for example bank loans, trade payables and debentures.

4 Types of Financial Statements | Explanation | Examples | Templates
Financial Statements are written reports that quantify the financial strength, performance and liquidity of a company. The four main types of financial statements are Statement of Financial Position, Income Statement, Cash Flow Statement and Statement of Changes in Equity. Download free blank excel template of business financial statements.

Understanding Financial Statements
The financial statements shown on the next several pages are for a sole proprietorship, which is a business owned by an individual.

The Income Statement

Statement of Owners Equity

Beginners’ Guide to Financial Statement

Balance Sheet Definition
A financial statement that summarizes a company’s assets, liabilities and shareholders’ equity at a specific point in time. These three balance sheet segments give investors an idea as to what the company owns and owes, as well as the amount invested by the shareholders.

Balance sheet and income statement relationship | Three core financial statements [VIDEO]

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Bookkeeping Procedures

Basic Bookkeeping for Your Small Business

Understanding Basic Bookkeeping and Working With an Accountant

Accounting for the Medical Office


Accounting for Cash Transactions
Keeping track of your cash, payables and records can be an organizational nightmare. Find out the most efficient ways to keep all the money and the records in line and updated appropriately.

Encounter Forms

Bookkeeping, Taxes and Computers

Patient Ledger Card

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Banking Procedures

Banking Procedures and Control of Cash

The Risks of Accepting Checks

Accepting Checks

Steps of Writing a Business Check

Nine Check Writing Tips

Step-by-Step Process for Making a Bank Deposit and Writing a Deposit Slip
This post gives detailed instructions for opening mail, sorting mail, and making a bank deposit in the correct way for a medical practice.

Three money policies to rethink at your medical practice
Using current technology brings efficiency, reduces some of the control risks related to cash and checks, and helps keep the patient responsibility portion of your accounts receivable in check. Consider these three functions in your practice.

What is a reconciliation statement? – Questions & Answers

Bank Reconciliation | Explanation

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Billing and Collections

Improve your medical practice’s billing and collection processes with advice from practice management experts. Improve your medical practice’s billing and collection processes with advice from practice management experts.

Billing and Collections [ARTICLE COLLECTION]

Introduction to the Medical Billing Process

Billing Cycle Definition
The interval of time during which bills are prepared for goods and services that a company has sold.

Write Off Definition

How to Handle a Returned Check

Medical Office – Patient Collections – Medical Office Revenue Cycle
Maintaining excellent customer service while still offering excellent customer can be a challenge. Learn the do’s and don’ts of patient collections practices.

Why Every Practice Needs a Payment Policy
The author, a practice administrator, identifies reasons practices find it difficult to ask patients to pay at the time services are rendered and provides detailed instructions for improving collection rates.

How to make payment plans work for patients
Should you offer financing of your medical services to your patients? Keep in mind that medical bills are reportedly the number one reason for personal bankruptcies in the United States.

5 Best Practices for Using Payment Plans to Ensure Patient Payments

Hiring a Collection Agency
How to get your business’s delinquent bills paid with a collection agency

How The Debt Collection Agency Business Works
Understanding how the debt collection business works will give you a better chance of coming out ahead if you ever have to tangle with a collection agent.

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Payroll Processing

Payroll Taxes, Costs & Benefits Paid by Employers

What is FICA?

How to Calculate Federal Withholding Tax Using the Percentage Tables

Compliance Assistance – Wages and the Fair Labor Standards Act (FLSA)
US Department of Labor: The Wage and Hour mission is to promote and achieve compliance with labor standards to protect and enhance the welfare of the Nation’s workforce.

Questions and Answers for the Additional Medicare Tax

The Basics of the Medicare Tax
In the year 2015 Medicare taxes remain at 2.9% on all wages and self-employed income. The additional Medicare tax also remains in effect for 2015.

Federal Income Tax Definition
A tax levied by the United States Internal Revenue Service (IRS) on the annual earnings of individuals, corporations, trusts and other legal entities. Federal income taxes are applied on all forms of earnings that make up a taxpayer’s taxable income, such as employment earnings or capital gains.

What is the IRS Form 941?
You must file IRS Form 941 if you operate a business and have employees working for you.

What is a W-2 Form?
A W-2 tax form shows the amount of taxes withheld from your paycheck for the year and is used to file your federal and state taxes. Here are the basics.

What is a W-4 Form?
Used by your employer to determine the amount of taxes to withhold from your paycheck, the W-4 Form can help you out at tax time. Here are the details.

Publication 15 (2015), (Circular E), Employer’s Tax Guide

What is the difference between wages and salary?

Medicare Wages Definition
An employee’s earnings that are subject to a U.S. payroll tax known as the Medicare tax. Similar to the other U.S. payroll tax – Social Security – the Medicare tax is used to fund the government’s Medicare program, which provides subsidized healthcare and hospital insurance benefits to retirees and the disabled.

Publication 560 (2014), Retirement Plans for Small Business

Federal Unemployment Tax

Workers’ Compensation Insurance – Small Business Encyclopedia
Insurance that covers medical and rehabilitation costs and lost
wages for employees injured at work; required by law in all states

Gross Income Definition

Payroll Register – Definition
A payroll register is the record for a pay period that lists employee hours worked, gross pay, net pay, deductions, and payroll date.

Payroll Register in Excel [SLIDESHOW]

Completing a Payroll Register and Employee Earnings Record [VIDEO]

Employee Earnings Report
An employee earnings report is a record that details an employee’s payroll history. These reports often have columns totaling how many employee hours were worked, their net pay, gross pay, deductions from payroll, and other year-to-date payroll information.

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Medical Coding

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Diagnostic Coding

Diagnostic Coding

Diagnosis Coding: Why It Is So Important
Claims are paid based on the CPT code submitted to the payer. The diagnosis code supports medical necessity and tells the payer why the service was performed.

ICD-9 FAQ—Practice-Management/ICD-9-FAQ/

ICD – ICD-9-CM – International Classification of Diseases, Ninth Revision, Clinical Modification


ICD-9-CM Diagnosis and Procedure Codes: Abbreviated and Full Code Titles

Physician Fee Schedule

Diagnosis and Procedure Coding Resources

ICD-9 Conventions & Symbols [FLASHCARDS]
Vocabulary words for symbols, abbreviations, punctuation, and notations. Includes studying games and tools such as flashcards.

Official ICD-9-CM Coding Conventions

Foundations of ICD-9-CM

ICD-10-CM Coding Convention

What Does a Medical Abstractor Do? (with pictures)

How to Select the Right ICD-10 Code in Three Easy Steps
Identifying the correct ICD-10 code might seem a bit like finding a needle in a haystack, but in this post, we break it all down into three easy steps.

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Procedural Coding

What is Current Procedural Terminology (CPT)?
Current Procedural Terminology (CPT) is a code set that is used to report medical procedures and services to entities such as physicians, health insurance companies and accreditation organizations.

CPT – Current Procedural Terminology

CPT Code: What it is & why it’s Important
What are CPT Codes? I highlight my experience with medical billing errors, how to look up a 5-digit AMA CPT code search, & how it will save you thousands.

Current Procedural Technology: History, Structure, Process & Controversies

How to Look Up CPT Codes for Free
Look up CPT codes for free to get answers about what codes relate to what medical procedures and services, and how much your doctor and hospital may have been paid for those services.

Chapter 3 CPT and HCPCS Coding [FLASHCARDS]
Vocabulary words for Medical Coding. Includes studying games and tools such as flashcards.

So You Want To Learn Medical Coding?: Introduction to CPT and Modifiers

CPT Basics for the Inpatient Coder

Sections of the CPT Manual [FLASHCARDS]
Vocabulary words for Sections of the CPT Manual. Includes studying games and tools such as flashcards.

HCPCS – General Information

Code Sets

CPT® Category III Codes
New and revised immunization and vaccine product codes to facilitate immunization reporting.

Definitions E/M coding, EM evaluation and management coding, e&m documentation, 99214, 99213

Coding From the Bottom Up
Outlines an approach to CPT coding for common evaluation and management services that works from medical decision making backwards to physical exam and history.

A simple system for coding E/M services

IDSA : Evaluation & Management Coding Resources

E/M Guidelines

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Medical Insurance

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Overview of health Insurance

Health Insurance
Learn about public and private health insurance options: Medicare, Medicaid, children’s insurance (CHIP), COBRA coverage to continue your insurance when you leave your job, and disputing an insurance claim.

Health Insurance Market Overview

Overview of Health Insurance [Infographic]

Patient Care Partnership
Replacing the AHA’s Patients’ Bill of Rights, this plain language brochure informs patients about what they should expect during their hospital stay with regard to their rights and responsibilities.

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Patient and Provider Roles in Medical Insurance

When Customer Service and Patient Care Collide

7 Ways To Improve Patient Satisfaction, Experience, And Customer Service, From Consulting In Hospitals And Healthcare

Employer-Sponsored Plan Definition
A type of benefit plan that an employer offers for the benefit of his/her employees at no or a relatively low cost to the employees. If employees participate in the plan, they will benefit from its low-cost method of obtaining discounted services. The benefit to the employer is that initiating these plans usually has some tax-deductible component, and sponsoring benefits is generally a good method of retaining valuable employees. the official U.S. government site for Medicare

What Medicare covers
Read about what providers, services, supplies, and prescription drugs Medicare (Part A, Part B, Part D) covers. Find out how to get medical care and prescription drugs in disaster and emergency areas.

Medicaid Home
The Center for Medicaid and CHIP Services (CMCS) is one of six centers within the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services (HHS). CMCS serves as the focal point for all national program policies and operations related to Medicaid and the Children’s Health Insurance Program (CHIP).

How to Qualify For Medicaid and CHIP Health Care Coverage
Find out how to qualify for Medicaid at You can apply for or re-enroll in Medicaid or CHIP any time of year.


CHAMPVA – Chief Business Office Purchased Care
This Webpage provides information on CHAMPVA, the Civilian Health and Medical Program of the Veterans Administration.

Workers Compensation
This topic provides information about four major disability compensation programs administered by DOL (Department of Labor) that provide wage replacement benefits, medical treatment, vocational rehabilitation, workplace regulations and other benefits to federal workers or their dependents who are injured at work or acquire an occupational disease.

Medical Savings Account (MSA) Definition

Medicare Medical Savings Account (MSA) Plans
Read about the Medicare Medical Savings Account (MSA) Plan, a type of Medicare Advantage Plan. Some MSAs cover Medicare services and extra benefits such as dental, vision, or long-term care. Medicare MSA plans don’t cover Medicare Part D prescription drugs.

What’s Medicare Supplement Insurance (Medigap)?
Read about Medigap (Medicare Supplement Insurance), which helps pay some of the health care costs that Original Medicare doesn’t cover.

Coordination of Benefits

Health Insurance & the Birthday Rule
Find out what you need to know about health insurance and the birthday rule. explains this topic and how it applies to you, your family and your coverage.

The AMA’s role in U.S. health care

Physician-Patient Relationship: Ethical Topic in Medicine

Team-Based Care: Optimizing Primary Care for Patients and Providers

What is a Health Savings Account (HSA)?

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Medical Insurance Policies and Plans

Types of health insurance

Indemnity Plan – Indemnity Health Insurance Plans
Learn about Indemnity insurance plans. Get information on how indemnity plans work. Discover if an indemnity health plan is right for you.

Questions and Answers About Health Insurance (continued)
AHRQ consumer health information for people with a disease or chronic condition on how to obtain reliable treatment information.

10 health care benefits covered in the Health Insurance Marketplace
Read about 10 health care benefits covered by the Health Insurance Marketplace at Learn about your coverage options and create an account today.

Essential Health Benefits

Co-pay Definition
A type of insurance policy where the insured pays a specified amount of out-of-pocket expenses for health-care services such as doctor visits and prescriptions drugs at the time the service is rendered, with the insurer paying the remaining costs. However, unlike coinsurance, where the insured is required to pay a certain percentage of the covered costs, co-pay plans require the insured to pay a specified dollar amount.

What is a Copayment? Health Insurance Glossary
What is a Copayment? Visit the health insurance glossary at for definition of copayments and related healthcare terms.


What is an Allowed Amount?
What is an Allowed Amount? Visit the health insurance glossary at for definition of allowed amounts and related healthcare terms.

comprehensive coverage definition
Comprehensive coverage – also known as major medical health insurance – refers to plans that cover a wide range of health services (i.e., not a limited-benefit plan or supplemental policy). All new individual policies sold after January 1, 2014 must be at least as comprehensive as the Affordable Care Act requires.

Preferred Provider

Participating Versus Nonparticipating Health Insurance Providers
Is the medical provider participating or nonparticipating according to your medical insurance? How does this effect you?

Managed Care

What Are the Differences Between HMOs and PPOs?
The most common types of managed care plans are health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Less common are point-of-service (POS) plans that combine the features of an HMO and a PPO. Learn the differences between HMOs and PPOs.

Health Maintenance Organizations and Preferred Provider Organizations

Choosing a primary care provider

Primary Care
Read the AAFP’s definition of primary care related terms and appropriate usage recommendations.

The Basics of Independent Practice Associations
Here’s a primer on independent practice associations. Not all are created alike, so be aware of the differences.


Point of Service (POS) Plans

POS Health Insurance Plans – Point of Service

UCR (Usual, Customary, and Reasonable)

Usual, Customary and Reasonable Fees Definition
Out-of-pocket fees that an insurance policy holder must pay for services.

Episode of Care (Health Care) Law & Legal Definition

Capitation Payments – Understanding Capitation
ACP helps you understand capitation payments, used by managed care organizations to control health care costs.

RBRVS: The Resource-Based Relative Value Scale
As part of the physician resources program, American Medical Association offers information on Resource Based Relative Value Scale (RBRVS), the Medicare physician payment schedule.

Overview of the RBRVS
With this implementation and final transition of the resource-based practice expense relative units on January 1, 2002, all components of the RBRVS are resource-based.Annual updates to the physician work relative values are based on recommendations from a committee involving the AMA and national medical specialty societies.

RVUs: A valuable tool for aiding practice management

Introduction to Relative Value Units and How Medicare Reimbursement in Calculated

Calculate Your RVU Payment
Looking for a way to get a handle on Relative Value Units (RVUs) tied to Medicare payments or even use of RVUs in your own practice? Here’s the formula Medicare uses to calculate payments for the services you provide.

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Third-Party Medical Insurance

Define Third-Party Health Insurance

About the Blue Cross and Blue Shield Association the official U.S. government site for Medicare

What Part A covers
Read about what Medicare Part A (hospital insurance) covers, including inpatient care at a hospital, skilled nursing facility (SNF), and hospice. Part A also covers services like lab tests, surgery, doctor visits, and home health care.

What Part B covers
Learn about what Medicare Part B (medical insurance) covers, including doctor and other health care providers’ services, outpatient care, durable medical equipment, home health care, and some preventive services.

Medicare Advantage Plans
Learn about the Medicare Advantage Plan, a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. Most Medicare Advantage Plans offer prescription drug coverage.

What drug plans cover
Learn what Medicare drug plans cover, including information about a drug formulary and tiers.

Medicaid Home
The Center for Medicaid and CHIP Services (CMCS) is one of six centers within the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services (HHS). CMCS serves as the focal point for all national program policies and operations related to Medicaid and the Children’s Health Insurance Program (CHIP).


CHAMPVA – Chief Business Office Purchased Care
This Webpage provides information on CHAMPVA, the Civilian Health and Medical Program of the Veterans Administration.

Workers Compensation
This topic provides information about four major disability compensation programs administered by DOL (Department of Labor) that provide wage replacement benefits, medical treatment, vocational rehabilitation, workplace regulations and other benefits to federal workers or their dependents who are injured at work or acquire an occupational disease.

The Federal Employees’ Compensation Act (FECA)
Information regarding the Federal Employees’ Compensation Act (FECA) which provides workers compensation to certain federal civilian employees who have a work-related injury or disease.

Disability-Income (DI) Insurance Definition
An insurance product that provides supplementary income in the event of an illness or accident resulting in a disability that prevents the insured from working at their regular employment. Benefits are usually provided on a monthly basis so that the individual can maintain their standard of living and continue to pay their regular expenses.

Types of Disability Insurance – Disabled World
Disability Insurance also called DI or disability income insurance is insurance that insures an earned income against the risk that disability will make working impossible.

What are the types of disability insurance?

6 Types of Disability Insurance Policies

How Disability Income Insurance Policies Define Disability

Benefits for People with Disabilities

Supplemental Security Income

What’s Medicare Supplement Insurance (Medigap)?
Read about Medigap (Medicare Supplement Insurance), which helps pay some of the health care costs that Original Medicare doesn’t cover.

Medicare Secondary Payer

Curing the prior authorization headache
Getting upfront approvals for some procedures and prescriptions is an unavoidable fact of life for most primary care doctors, but they can take steps to minimize the cost and hassles involved.


Prior authorization

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Medical Insurance Claim Cycle

The Life Cycle of a Medical Bill (Claim): Simplified [VIDEO]

Life Cycle Of Health Insurance ClaimS [FLASHCARDS]
Vocabulary words for LIFE CYCLE OF HEALTH INSURANCE CLAIMS. Includes studying games and tools such as flashcards.

What Steps Comprise the Life Cycle of a Medical Claim?
It is important to recognize and distinguish each stage from the other within the total life cycle of a medical claim to decrease errors and cost.

Sample HIPAA Authorization Form

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Submitting Claims

Form CMS1500

Encounter Forms

FAQ – Retention of Encounter Sheets

Outpatient Encounter Form Sample

Medicare Claims Processing Manual -Completing and Processing Form CMS-1500 Data Set

Electronic Claims Submission
Automating the claims submission process can save a practice thousands of dollars while eliminating time-consuming tasks.

Electronic Health Care Claims

What is the Function of the Clearinghouse in Medical Billing?

What Is Claims Processing?

Insurance Chapter 9 The Claims Process and Chapter 10 Office and Insurance Collection Strategies [FLASHCARDS]
Vocabulary words for Insurance -The Claims Process and Office and Insurance Collection Strategies. Includes studying games and tools such as flashcards.

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Preventing Rejections and delays

Healthcare Claim Processing, Why Medical Billing Claims are Rejected

Common Reasons Medical Billing Claims Get Rejected

Top 6 Ways Medical Billers Can Avoid Claim Rejections and Denials

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Claims Follow-Up

Explanation of Benefits

Explanation of Benefits (EOB)

Patient Advocate Foundation

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