Understanding Health Insurance: A Guide to Billing and Reimbursement (with Premium Website Printed Access Card and Cengage EncoderPro.com Demo Printed Access Card) / Edition 11

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Overview

Understanding Health Insurance, Eleventh Edition, is the essential learning tool you need when preparing for a career in medical insurance billing. This comprehensive and easy-to-understand text is fully-updated with the latest code sets and guidelines, and covers important topics in the field like managed care, legal and regulatory issues, coding systems, reimbursement methods, medical necessity, and common health insurance plans. The eleventh edition has been updated to include new legislation that affects healthcare, ICD-10-CM coding, implementing the electronic health record, the Medical Integrity Program (MIP), medical review process, and more. The practice exercises in each chapter provide plenty of review, and the accompanying workbook provides even more application-based assignments and additional case studies for reinforcement. Includes free online StudyWARE™ software that allows you to test your knowledge, free online SimClaim™ CMS-1500 claims completion software, and free-trial access to Ingenix's EncoderPro.com—Expert encoder software.

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Editorial Reviews



Text is clear and easy to understand, it is practical on how to complete and submit accurate claim forms for major insurance companies. The case studies are realistic and beneficial in helping students extract information from a patients chart to a claim form. Both paper and electronic claims are emphasized.

I would recommend this text to any instructor or School Administrator looking for new text on Health Insurance and Billing. This text far supercedes the current text I am using. It is in-depth, full of exercises and examples, and really explains the topics at hand. Health Insurance and Billing can sometimes be boring for students but this text really keeps things interesting and would keep the students busy.

This text combines all concepts of Health Insurance into one, user-friendly text. It has excellent pedagogical elements presented to keep the students attention and help make information easily understandable. This text will make the transition from classroom to medical office easy for students. There is an outstanding supplement package available for instructors.

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Product Details

Table of Contents

1. Health Insurance Specialist Career. 2. Introduction to Health Insurance. 3. Managed Health Care. 4. Processing an Insurance Claim. 5. Legal and Regulatory Issues. 6A. ICD-9-CM Coding. 6B. ICD-10-CM Coding. 7. CPT Coding. 8. HCPCS Level II Coding. 9. CMS Reimbursement Methodologies. 10. Coding for Medical Necessity. 11. Essential CMS-1500 Claim Instructions. 12. Commercial Insurance. 13. Blue Cross Blue Shield. 14. Medicare. 15. Medicaid. 16. TRICARE. 17. Workers' Compensation. Appendices. Bibliography. Glossary. Index.

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Customer Reviews

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  • Anonymous

    Posted Thu Dec 09 00:00:00 EST 2010

    Major errors in book...found numerous mistakes

    The need to do a major reprint. I found numerous errors that would confuse any individual trying to understand health insurance. Poorly edited and content looks like it was trown together. Some sections even repeat themselves...pg 499 bottom section is the same on page 501. Answers are not within chapters. page 545 block 10d is filled out wrong, page 438 11a-11d should state primary and not secondary, and these are just a few of the many many errors.

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  • Posted Sat Apr 10 00:00:00 EDT 2010

    more from this reviewer

    Understanding Health Insurance

    This is a well laid out book. It is pleasure to read, the objectives given are actually covered throughly and not skimmed over. The layout is organized and if important text needs to be highlighted it does not bleed through to the next page. I can literally find what I need in this book. I will not be selling this book when the class has ended.

    Of course, there is an array of online bookstores or websites to choose. B&N always come through right on time for me.

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  • Anonymous

    Posted Mon Jun 06 00:00:00 EDT 2011

    No text was provided for this review.

  • Anonymous

    Posted Fri Mar 04 00:00:00 EST 2011

    No text was provided for this review.

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