Understanding Health Insurance: A Guide to Billing and Reimbursement / Edition 9by Michelle A. Green, Joann C. Rowell
Pub. Date: 01/01/2008
Publisher: Cengage Learning
Discover the essential tool to prepare for a career in medical insurance billing UNDERSTANDING HEALTH INSURANCE, 13E. This comprehensive, easy-to-understand, updated book presents the latest code sets and guidelines. You cover today's most important topics, such as managed care, legal and regulatory issues, coding systems, reimbursement methods, medical… See more details below
Discover the essential tool to prepare for a career in medical insurance billing UNDERSTANDING HEALTH INSURANCE, 13E. This comprehensive, easy-to-understand, updated book presents the latest code sets and guidelines. You cover today's most important topics, such as managed care, legal and regulatory issues, coding systems, reimbursement methods, medical necessity, and common health insurance plans. Updates introduce new legislation that impacts health care, including the Affordable Care Act (Obamacare); ICD-10-CM coding; electronic health records; Medicaid Integrity Contractors; case mix management; hospital-acquired conditions; present on admission; and value-based purchasing. Practice exercises and the workbook (available separately) provides application-based assignments and case studies to reinforce your understanding, as well as CMRS, CPC-P, and CPB Mock Exams. New editions include online access to SimClaim™ CMS-1500 claims completion software and Optum's EncoderPro.com Expert™.
- Cengage Learning
- Publication date:
- Product dimensions:
- 8.60(w) x 10.90(h) x 1.50(d)
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. 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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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.