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Medical
Topics
Spinal surgery, anesthesia, AIDS, anesthesia, allergy testing and treatment, dental conditions, diabetes treatment, infertility, newborn and well baby care, obesity, pregnancy and childbirth, psoriasis, obstructive sleep apnea, TMJ, varicose veins, erectile dysfunction, cleft lip and palate, hyperhidrosis, diagnostic imaging services, DME, prosthetic devices, bone healing systems, infant apnea monitors, hospital beds, home oxygen therapy, genetic testing, nerve conduction studies, eating disorders, autistic spectrum and learning disorders, attention deficit hyperactivity disorder, mental health, behavioral health, substance abuse/chemical dependency, maxillofacial prosthetics and surgery, lithotripsy, lung volume reduction surgery, skin lesion removal, transplants, high dose chemotherapy, fetal surgery, cosmetic surgery, gender reassignment, and laparoscopic surgery.
Legislative Topics
State surcharges, veterans eligibility right, Mental Health Parity Acts of 1996 and 2008, Newborns’ and Mothers’ Health Protection Act of 1996, Genetic Information Nondiscrimination Act of 2008, TRICARE, Medicaid, COBRA, Medicare, common law marriage, domestic partner benefits, student coverage, no-fault automobile coverage, workers compensation, and flexible benefits administration.
Procedural Topics
Provider definitions, inpatient and outpatient hospital claims, hospital revenue codes, hospital cost containment, rehabilitation hospitals, experimental/investigational treatment, home health care, private duty nursing, hospice care, ambulance, STD and other disability income sources, coordination of benefits, third party reimbursement, product liability, prescription drug overview, dental claim administration, assignment of benefits, grace period, timely filing, ICD-9-CM, CPTIV, DSM-IV, HCPCS, NDC, CDT, CMS-1500, UB, and surgery payment guidelines.
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| Operational Topics
Overpayment recovery, organizational structure/staffing, training programs, auto-adjudication, internet capabilities, legal actions available to claimants, mission statement overview, organizational security and disaster planning, claims cost containment, and TPA questionnaires.
Listings and Directories
Organizations in the insurance industry, CMS regional offices, internet sites, medical/professional abbreviations, postal inspector locations, state dental board directory, state insurance department directory, state intoxification levels, state licensing agencies for nursing homes, state medical associations, state medical board directory, and regional organ procurement organizations.
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