A Guide to Health Insurance Billing with Ingenix Trial Printed Access Card and Premium Website Printed Access Card / Edition 3

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Begin your career in the world of health insurance billing with A Guide to Health Insurance Billing, Third Edition. This resource introduces you to medical billing, covering everything from patient registration to claims submission. Become familiar with appropriate terminology, understand legal and regulatory guidelines, and develop an understanding of coding systems. Finally, put your skills to the test with the Superiorland Clinic practical simulation in Appendix A with 20 case studies that require forms completion.

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Editorial Reviews

From the Publisher
"I definitely would use this text in an introductory billing course. It gives a good overview of the tools needed to develop insurance claims…I have always admired Moisio's practice exercises, and have often supplemented them in my classroom"

"I am very glad to see that the author has included UB-04 claim preparation. A lot of my students don't want to work in a doctor's office and I usually have to teach outside of the text to cover the hospital billing information… I am glad to see that the author added a separate chapter on ICD-10. I really think that the implementation of ICD-10 is rapidly approaching and its good that we are preparing our students for the implementation…I would definitely recommend this text…for adoption consideration. This text is extremely thorough and is on the cutting edge of the constant changes in the healthcare billing arena."

An entry-level text for anyone learning about the insurance-billing process. Includes a step-by-step guide for submitting insurance claims for commercial insurance, Blue Cross/Blue Shield, Medicare, TRICARE, CHAMPVA, and worker's compensation. Medical coding chapters cover the fundamentals of ICD-9-CM, an introduction to ICD 10, CPT, and HCPS coding systems. The accompanying CD-ROM provides a billing simulation so users can apply skills from the text. Annotation c. Book News, Inc., Portland, OR (booknews.com)
From The Critics
Reviewer: LouAnn Schraffenberger, MBA, RHIA, CCS, CCS-P(Univ of Illinois at Chicago School of Biomed & Health Info Mgmt)
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.
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Product Details

  • ISBN-13: 9781435492981
  • Publisher: Cengage Learning
  • Publication date: 8/5/2010
  • Edition number: 3
  • Pages: 640
  • Product dimensions: 8.40 (w) x 10.80 (h) x 0.90 (d)

Meet the Author

Marie A. Moisio, M.A., RHIA, has 25 years of experience in health information management. In addition to teaching medical billing, medical coding and health information processing for more than 15 years, she served as director of health information departments in a 400-bed regional medical center and a 450-bed regional psychiatric treatment facility. Her professional experience also includes service as a consultant for several long-term care facilities and physician offices as well as positions in health information management, compliance, coding practices, insurance claim auditing and patient record documentation. Moisio has taught numerous workshops covering legal aspects of health information management and documentation. She is also the author of A GUIDE TO HEALTH INSURANCE BILLING and UNDERSTANDING LABORATORY & DIAGNOSTIC TESTS.

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Table of Contents

1. The Insurance Billing Specialist. 2. Legal Aspects of Insurance Billing. 3. Introduction to Health Insurance. 4. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). 5. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). 6. Current Procedural Terminology (CPT) and Healthcare Common Procedure. 7. Developing An Insurance Claim. 8. Common CMS-1500 Completion Guidelines. 9. Common UB-92 (HCFA-1450) Completion Guidelines. 10. Electronic Data Interchange (EDI). 11. Blue Cross/Blue Shield. 12. Medicare. 13. Medicaid. 14. TRICARE and CHAMPVA. 15. Workers Compensation. Appendix A: Superiorland Clinic Practice Manual. Assignments: Case Study 2-1 Through Case Study 2-10. Appendix B. References. Glossary. Index.

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