Understanding Health Insurance: A Guide to Billing and Reimbursement (with Premium Website Printed Access Card and Cengage EncoderPro.com Demo Printed Access Card) / Edition 11by Michelle A. Green
Pub. Date: 02/03/2012
Publisher: Cengage Learning
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,… See more details below
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--sold separately--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.
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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Most Helpful Customer Reviews
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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.
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.