Understanding Health Insurance: A Guide to Billing and Reimbursement (Book Only) / Edition 10

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Overview

UNDERSTANDING HEALTH INSURANCE, 12th 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.

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Product Details

  • ISBN-13: 9781111318789
  • Publisher: Cengage Learning
  • Publication date: 1/22/2010
  • Edition description: Older Edition
  • Edition number: 10
  • Pages: 720
  • Product dimensions: 8.50 (w) x 10.60 (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 Healthcare. 4. Processing an Insurance Claim. 5. Legal and Regulatory Issues. 6. 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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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.

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  • 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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