Medical Insurance A Revenue Cycle Process Approach 2026 EverGreen Release By Joanne Valerius, Nenna L. Bayes
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- Pages
- 609
- File size
- 10.7 MB
- Format
- Digital PDF
- Course
- Medical Studies
- Category
- eBook[PDF]
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About this ebook
Medical Insurance: A Revenue Cycle Process Approach (2026 EverGreen Release) by Joanne Valerius and Nenna L. Bayes is a comprehensive educational textbook published by McGraw Hill. It is designed to teach medical billing, coding, and administrative health professionals how to navigate healthcare financial systems. [1, 2, 3, 4]
Core Focus: The 10-Step Revenue Cycle
The book revolves around a 10-step Revenue Cycle Management (RCM) model that teaches students how to "follow the money" in a healthcare facility. This structured framework ensures that medical practices capture, manage, and collect appropriate reimbursement for patient services. [1, 2, 3]
- Preregistering patients and scheduling appointments.
- Establishing financial responsibility and verifying insurance eligibility.
- Checking in patients and ensuring clinical documentation accuracy.
- Medical coding compliance (ICD-10-CM, CPT, and HCPCS Level II).
- Reviewing billing compliance before claim transmission.
- Checking out patients and collecting co-pays.
- Preparing and transmitting electronic claims (like the CMS-1500).
- Monitoring payer adjudication and handling claim denials.
- Generating patient statements and managing collections.
- Post-payment posting and final accounts receivable cleanup. [1, 2]
Key Features of the 2026 Release
- Up-to-Date Regulatory Material: Contains updated coding regulations, healthcare reform guidelines, and compliance standards crucial for modern medical practice. [1, 2]
- Practical Simulations: Provides hands-on activities, often pairing with McGraw Hill Connect, containing Medisoft simulated exercises and CMS-1500 form practice. [1]
- Adaptive Learning Technology: Utilizes adaptive study tools like SmartBook to help students focus on complex billing rules they struggle with the most. [1]
Book Specifications
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10.7 MB
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