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Doody's Review ServiceReviewer: LouAnn Schraffenberger, MBA, RHIA, CCS, CCS-P(Advocate Health Care)
Description: This is a textbook to teach how to do health insurance or medical billing. A CD-ROM complete with source documents for insurance claims submission practice accompanies the book. Available supplements include an instructor's guide and electronic classroom manager.
Purpose: According to the author, the primary objective is to expose students to various health insurance billing topics. The book is intended to provide students with opportunities to become familiar with health insurance terminology, understand the legal implications of insurance billing, develop a basic understanding of medical coding systems, and accurately complete insurance claim forms.
Audience: The audience would likely be students in structured health career programs, such as medical billing, billing and coding, health information technology, and others with coursework in health insurance billing in a technical or community college. This is the second edition of the book written by the author, a registered health information administrator and former college educator.
Features: Introductory chapters focus on the career of an insurance billing specialist, legal aspects of insurance billing, introduction to health insurance, and introduction to diagnosis and procedure coding systems. The major portion of the book is devoted to developing an insurance claim, guidelines for completing professional and institutional insurance claim forms, and electronic data interchange. Specific chapters address major health insurance payers' programs, such as Medicare, Medicaid, Blue Cross/Blue Shield, Workers' Compensation, Tricare, and CHAMPVA. The appendixes include a sample clinic practice manual, assignments, and references and the book includes a glossary of terms. Chapters contain learning objectives, key terms, abbreviations, and terminology. Coding exercises are included. Numerous exercises and end of chapter reviews provide measures of student comprehension. The instructor's manual contains answers to all exercises, sample source syllabi, quizzes, midterm, and final examinations.
Assessment: This very comprehensive book has a lot of information for students. Many examples, tables, figures, and exercises are presented to explain concepts and measure student comprehension. The subject matter is covered in a very detailed manner and the book appears to provide students with the knowledge and skills they need to be competent and efficient as medical insurance billers. One small detail that I would change is the orange type used for the exercises, examples, and chapter/paragraph headings, because it is difficult to read. Otherwise, I would recommend that instructors in health career programs who teach a health insurance billing course to seriously consider this book and the supplements for their class.