Internet Resources

Hospital Billing
Finance Information Center: Billing / Coding / Reimbursement Online resources from HCPro A "provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance."
Health Information Management Information Center: Billing And Coding Online resources from HCPro A "provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance."
Hospital-Data.com: Hospital and Nursing Home Profiles Provides information on specific medical facilities such as bed size and compliance with standards organizations.
Internet Hospital Directory An international directory of hospitals and clinics on the web; from Doxys.
Publication of the OIG Compliance Program Guidance for Third-Party Medical Billing Companies From the Office of Inspector General, Federal Register, Vol. 63, No. 243, Friday, December 18, 1998.
TRICARE Providers Site includes billing information.
Journals
Federal Register Available online from the Government Printing Office.
Medical Economics Open-access online magazine.
Agencies, Organizations and Associations
American Academy of Professional Coders - AAPC (AAPC) offers certification as a Certified Professional Coder-Hospital (CPC-H).
Centers for Medicare and Medicaid Services - CMS and State Children's Health Insurance Program Agency. Includes sections on Medicare and Medicaid.
The Joint Commission

Disability Income Insurance and Disability Benefits Programs
Facilities Locator and Directory An interactive online site from the Department of Veterans Affairs.
Glossary of Disability, Aging and Long-Term Care Terms From the U.S. Department of Health & Human Services.
Hawaii Temporary Disability Laws Department of Labor & Industrial Relations, Hawaii.
Resources for Injured Workers Includes care provider information and forms. From the State of New York.
WorkersCompensation.com Forms, statutes, news bulletins, and links to all states.
 
Workers' Compensation
WorkersCompensation.com Forms, statutes, news bulletins, and links to all states
 
Retire Guide
 
TRICARE and Veteran's Health Care
 
TRICARE University. The Official Website for the Staff Development and Training Branch; requires registration.
U.S. Department of Defense Includes TRICARE (Military Health System).

Medi-Cal
  • Medi-Cal Information. Medi-Cal References have an assortment of helpful materials, listings and announcements to facilitate participation in the Medi-Cal program.            http://www.medi-cal.ca.gov/references.asp
  • Medi-Cal Billing. Medi-Cal Billing Tips provides links to important billing information. http://files.medi-cal.ca.gov/pubsdoco/billing_tips.asp
  • Medi-Cal Education. Medi-Cal Outreach & Education provides information and phone numbers to Provider Training Seminars and Webinars which offer basic and advanced billing courses for all provider types, The 22 Regional Representatives that live and work in cities throughout California that are ready to visit providers at their office to assist with billing needs or provide training to office staff at no cost, and The Small Provider Billing Unit which is no cost billing assistance for one year to providers who submit fewer than 100 claim lines per month and would like some extra help. You can also find info on The Medi-Cal Learning Portal (MLP) which is the new, easy-to-use, one-stop learning center for Medi-Cal billers and providers.  http://www.medi-cal.ca.gov/education.asp
The Blue Plans, Private Insurance, and Manages Care Plans
 
Compliance Assistance: Employee Retirement Income Security Act of 1974 (ERISA) You can used the "find" function to locate specific regulations and forms related to ERISA located on this page.
Health Plan Report Card An "interactive tool designed to help you find the health plan that's right for you. NCQA is a private nonprofit organization committed to improving the quality of our nation's health care." Available online from the National Committee for Quality Assurance.
National Conference of State Legislatures.This website shows various state insurance exchanges due to the legislation brought about by the health care reform. Within the site, there is a map of all the states and notes the state’s status on various reform issues.
Journals
Federal Register Available online from the Government Printing Office.
Agencies, Organizations and Associations
America's Health Insurance Plans Formerly the American Association of Health Plans, formed by a merger of the Group Health Association of America and the American Managed Care and Review Association.
 
Office and Insurance Collection Strategies

American Medical Billing Association - AMBA Sponsors a certification examination for Certified Medical Reimbursement Specialist (CMRS).
Appeal Solutions Appeal software company.
Bankruptcy Information site from the American Bar Association.
Fair Credit Report Laws Includes information on FACTA - the Fair and Accurate Credit Transactions Act.
Fair Credit Reporting Act Information and additional links from the Federal Trade Commission, Fair Credit Reporting Act complete text.
Fair Debt Collection Practices Act Information and additional links from the Federal Trade Commission.
Nolo Commercial provider of legal information for consumers and small businesses.
Prompt Pay Statutes by State A downloadable document with information on specific states. One of several tools available online from Karen Zupko & Associates, Inc.
Small Claims Court.com "How to file in small claims court with free court forms and in-depth information about garnishment and judgment collection actions!" From Rich's Enterprises, L.L.C.
Uniform Commercial Code Locator Site from the Legal Information Institute, Cornell University Law School.
Journals
Family Practice Management From the American Academy of Family Physicians. While this is a medical title, it contains many useful items related to professional office practices.
Medical Economics Open-access online, includes information on collections.
Resources for Locating People
Anywho Skip tracing resources, Anywho Reverse Directory.
Bigfoot Site includes a PeopleSearch option.
InfoSpace Skip tracing resources.
InfoUSA Skip tracing resources.
Search Bug Skip tracing resources.
Switchboard.com Skip tracing resources.
WhoWhere? Skip tracing resources from Lycos.
Yahoo People Search Skip tracing resources.

Receiving Payments

Receiving Payments and Insurance Problem-Solving
Finance Information Center: Billing / Coding / Reimbursement Online resources from HCPro A "provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance."
Your Guide to Medicare Medical Savings Accounts (MSA) Plans The official government booklet from Centers for Medicare and Medicaid Services.
QuickBooks Support Site Includes online videos for troubleshooting problems.
Journals
Appeal Letters Online Online newsletter for regulatory information on appeals, from the commercial site Appeal Solutions.
Agencies, Organizations and Associations
American Bankers Association There is also an online site for the ABA Banking Journal Online.
American Medical Billing Association - AMBA Sponsors a certification examination for Certified Medical Reimbursement Specialist (CMRS).
NDCLytec Commercial company for practice management and billing software.
Electronic Claims

AAFP's Center for Health Information Technology and resources from the Practice Management site of the American Academy of Family Physicians.
Coding Gateway site to many resources from the American Health Information Management Association (AHIMA).
TRICARE Providers Site includes billing information.
Workers' Compensation related links From the North Carolina Industrial Commission, maintained by Robert W. McDowell.
Journals
Advance for Health Information Professionals Biweekly magazine for health professionals.
CIO Magazine In addition to online articles, contains an extensive set of links to other web resources.
Federal Register Available online from the Government Printing Office.
Healthcare Informatics Online Includes a section on Financial issues, including coding and payment systems.
Healthcare IT News Covers technology and the business of health care.
Agencies, Organizations and Associations
North Carolina Healthcare Information and Communications Alliance, Inc. - NCHICA A "nonprofit consortium of over 200 organizations dedicated to improving healthcare by accelerating the adoption of information technology."
Office of Inspector General, Department of Health and Human Services.
VeriSign Online security services.
Workgroup for Electronic Data Interchange - WEDI A membership organization promoting health related electronic commerce.
 
 
Special Guidelines for Claim Forms

Blue Cross Blue Shield
https://www.blueshieldca.com/provider/claims/policies-guidelines/special.sp

Tricare
http://www.tricare.mil/Resources/Claims/MedicalClaims/CompletingClaimForm.aspx

Worker's Compensation
http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm

The Paper Claim: CMS-1500 (02-12)

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) From the Centers for Medicare & Medicaid Services.
The In's and Out's of Incident to Reimbursement Family Practice Management, November/December 2001.
Making Your Balance Sheet Work for You Online article on accounting methods from Family Practice Management, June 2001.
Manager's Electronic Resource Center Includes online resources and links covering many management topics for health services managers, including Financial Management. Produced by Management Sciences for Health with support from the U.S. Agency for International Development.
Professional paper claim form (CMS-1500) Information site from the Centers for Medicare and Medicaid Services.
Wisconsin Online Resource Center Select "Business", then "Accounting", to view interactive activities on specific accounting topics.
Agencies, Organizations and Associations
DFL Enterprises, Inc. Commercial site for CMS-1500 forms.
Medicare and Medicaid From the Centers for Medicare & Medicaid Services, formerly the Health Care Financing Administration. Includes a site on Coordination of Benefits Part D and Prescription Drug Coverage - General Information.
Procedural Coding Internet Resources

ABC Coding Solutions  A commercial site with a patented Complementary and Alternative Medicine Billing & Coding Reference system for the accurate reimbursement of complementary and alternative medicine CAM services.
AHA Central Office of the American Hospital Association Includes ordering information for coding materials and resources.
Coding Better for Better Reimbursement Online article from Family Practice Management, January 2003.
CPT® (Current Procedural Terminology) An extensive resource site from the American Medical Association. Some sections require membership/subscription.
FPM Coding Tools Open-access materials available online from the American Academy of Family Physicians.
HCPCS Release and Code Sets Includes Transaction and Code Sets Standards and Quarterly Update. From the Centers for Medicare & Medicaid Services.
Health Information Management Information Center: Billing And Coding Online resources from HCPro A "provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance."
Medicare Provider-Supplier Enrollment  Site from the Centers for Medicare & Medicaid Services. See also the Durable Medical Equipment (DME) Center,
National Correct Coding Initiatives Edits From the Centers for Medicare & Medicaid Services.
Part B News Enrollment Form for our FREE PartB-L Internet discussion forum from Decision Health.
Sample Office Forms Scroll down to access these items available from the web site of the Florida Society of Medical Assistants.
Journals
Advance for Health Information Professionals Biweekly magazine for health professionals.
Federal Register Available online from the Government Printing Office.
Agencies, Organizations and Associations
Other CPT coding Internet Resources are:
AMA Resources
http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt.page
AMA CPT and RVS Codes
https://ocm.ama-assn.org/OCM/CPTRelativeValueSearch.do?submitbutton=accept
AAPC Resources
 https://www.aapc.com/resources/medical-coding/cpt.aspx
CMS.gov Site
http://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/TransactionCodeSetsStands/CodeSets.html

One of the most informative is the Centers for Medicare & Medicaid Services Website
cms.gov


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