- Shopping Bag ( 0 items )
Health Insurance Today: A Practical Approach simplifies health insurance concepts through abundant real-world examples, case studies and application exercises. Practice-based instruction, supported by the direct, conversational writing style, makes the often-complicated insurance billing and coding process understandable and accessible.
• Each chapter develops the learning objective in a manageable, direct narrative, followed by a short application exercise to ensure student comprehension.
• Key terms are highlighted and defined in the margins to facilitate immediate understanding and build familiarity with industry terms.
• Compliance tips located throughout teach correct billing and coding practices to comply with federal and state mandates.
• Case studies, critical thinking exercises and collaborative learning activities provide ample opportunities for practice, self-assessment and confidence building.
• Features the new CMS-1500 (8-05 version) throughout, to prepare students for real-world practice.
• Each chapter has been carefully developed to stand on its own, making the text ideal for open entry programs.
UNIT 1 - THE FIRST STEP: BUILDING A FOUNDATION
1. Medical Insurance: Where Did it Come From?
2. Tools of the Trade: A Career as a Health (Medical) Insurance Professional
3. The Legal & Ethical Side of Medical Insurance
4. Types and Sources of Health Insurance
UNIT 2 - THE SECOND STEP: HEALTH INSURANCE BASICS
5. The “Universal” Claim Form: CMS-1500
6. Traditional Fee-For-Service/Private Plans
7. Unraveling the Mysteries of Managed Care
8. Understanding Medicaid
9. Conquering Medicare’s Challenges
10. Military Carriers - TRICARE/CHAMPVA
11. Miscellaneous Carriers: Worker’s Compensation and Disability Insurance
UNIT 3 - THE THIRD STEP: CRACKING THE CODES
12. Diagnostic Coding
13. Procedural, Evaluation & Management and HCPCS Coding
UNIT 4 - THE FOURTH STEP: THE CLAIMS PROCESS
14. The Patient
15. The Claim
UNIT 5 - AN EXTRA STEP
16. The Role of Computers in Health Insurance
17. Reimbursement Procedures: Getting Paid
18. Hospital Claim Form: The UB-92