Understanding Health Insurance: A Guide to Billing and Reimbursement / Edition 10

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Overview

Understanding Health Insurance, Tenth Edition is fully updated to the latest code sets, guidelines, and claim forms to provide you with the most essential and up-to-date knowledge on billing and reimbursement. With Understanding Health Insurance, Tenth Edition, you will learn about managed health care, legal and regulatory issues, coding systems, reimbursement methods, coding for medical necessity, and common health insurance plans. Exercises in each chapter provide plenty of practice for learning how to bill and reimburse, and the accompanying workbook provides more application-based assignments for each chapter as well as additional case studies to reinforce your knowledge. The text includes free software that allows you to test your knowledge.

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Editorial Reviews

From the Publisher
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.

From The Critics

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.

Read More Show Less

Product Details

  • ISBN-13: 9781111035181
  • Publisher: Cengage Learning
  • Publication date: 1/22/2010
  • Edition number: 10
  • Pages: 720
  • Product dimensions: 8.40 (w) x 10.80 (h) x 1.10 (d)

Meet the Author

Michelle A. Green is a SUNY Distinguished Teaching Professor in the Physical and Life Sciences Department of the College of Technology at Alfred State College. An active member of the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA), she has been recognized for teaching and her contributions to the Health Information Management profession. Awards include the State University of New York Chancellor's Award for Excellence in Teaching, Alfred State College's Alumni Association Teacher of the Year, Who's Who Among America's Teachers, and the FORE Triumph Educator Award from the AHIMA. Ms. Green is a Registered Health Information Administrator (RHIA), a Fellow of the American Health Information Management Association (FAHIMA), and a Certified Procedural Coder (CPC). She earned a BS from Daemen College and an MPS degree from Alfred University. Ms. Green also authored 3-2-1 CODE IT! and ESSENTIALS OF HEALTH INFORMATION MANAGEMENT, both from Delmar-Cengage Learning.

Founder and Former Chairperson, Medical Assisting Department Anne Arundel Community College, Arnold, MD

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Table of Contents

1. Health Insurance Specialist Career. 2. Introduction to Health Insurance. 3. Managed Health Care. 4. Processing of an Insurance Claim. 5. Legal and Regulatory Issues. 6. ICD-9-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. 14. Medicare. 15. Medicaid. 16. TRICARE. 17. Workers' Compensation. APPENDICES. Bibliography. Glossary. Index.

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Sort by: Showing all of 4 Customer Reviews
  • Anonymous

    Posted December 9, 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 April 10, 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.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted June 6, 2011

    No text was provided for this review.

  • Anonymous

    Posted March 4, 2011

    No text was provided for this review.

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