Welcome, Introduction & Overview
Getting Started
Contracting/ Credentialing Or Self Pay
Practice Management Software
Service Fees
The Medical Office Flow/Cycle
The Group Practice Mindset
Council for Affordable Quality Healthcare - CAQH
Contracting/Credentialing Aka (Paneling) With Insurance Companies
Contracting With Medicare
Contracting With Railroad (RR) Medicare
Contracting With Medicaid
Hiring A Credentialing Company
Understanding Insurance Coverages & Their Differences
Understanding Deductibles Coinsurance & Co-pays
Calling To Verify Insurance Coverage/Benefits
Utilizing Insurance Portals/Websites To Verify Coverage/Benefits
Single Case Agreements (SCA’s)
Employee Assistance Programs (EAP’s)
Consolidated Omnibus Budget Reconciliation Act (COBRA)
Blue Cross & Blue Shield
Primary, Secondary & Supplemental Insurance
CPT/Procedure codes
CPT & HCPCS Modifiers
HCFA 1500/CMS 1500 Claim Form
Submitting Claims
"Courtesy" Claim Submissions
Remit/Explanation of Benefits/Payment & Electronic Remit Advice
Insurance Denials, Rejections & Adjustments
Handling Insurance Denials
Resubmissions, Corrected Claims & Appeals
Posting Insurance Payments
Insurance Aging Reports
Client/Patient Aging Reports
Patient/Client Statements
Collections
Action Plan/Task List
