Synopses & Reviews
Understanding Health Insurance: A Guide to Billing and Reimbursement, 8th Edition is a comprehensive source for teaching the subject of health insurance and reimbursement. The book contains chapters on introductory information on the health insurance field, managed health care, legal and regulatory issues, coding systems, reimbursement methodologies, coding for medical necessity, and common health insurance plans. Each chapter contains exercises to illustrate content and reinforce learning. Numerous opportunities are provided throughout the book for manual completion of CMS-1500 claims. A CD-ROM at the back of the book allows for electronic data entry of CMS-1500 claim form information. End of chapter review questions in objective format (e.g., multiple choice) test learners on their understanding of book content. Appendices I and II provide case studies that are also included on the Student Practice CD-ROM. Additional appendices provide instruction in dental claims processing and completion of the UB-92 (claim used for inpatient and outpatient hospital claims). The accompanying workbook provides application based assignments for each chapter, additional content review (multiple choice questions), and additional case studies for practice in completing CMS-1500 claims. This edition of the book contains the most up to date information regarding health insurance claims processing and coding and reimbursement issues.
Review
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.
Synopsis
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.
Synopsis
With Understanding Health Insurance: A Guide to Billing and Reimbursement, you will learn about managed health care, legal and regulatory issues, coding systems, reimbursement methodologies, coding for medical necessity, and common health insurance plans. Exercises in each chapter give you plenty of practice to learn how to bill and reimburse. The accompanying workbook provides more application-based assignments for each chapter, content review, and additional case studies.
About 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
Table of Contents
Preface. Chapter 1 - Health Insurance Specialist Career. Chapter 2 - Introduction to Health Insurance. Chapter 3 - Managed Health Care Chapter 4 - Life Cycle of an Insurance Claim. Chapter 5 - Legal and Regulatory Considerations. Chapter 6 - ICD-9-CM Coding. Chapter 7 - CPT Coding. Chapter 8 - HCPCS Coding (name change from HCPCS Coding System).Chapter 9 - CMS Reimbursement Issues (name change from HCFA Reimbursement Issues).Chapter 10 - Coding for Medical Necessity (name change from Coding from Source Documents).Chapter 11 - Essential Claims Completion Guidelines (name change from Essential Claim Form Instructions).Chapter 12 - Commercial Claims (name change from Filing Commercial Claims).Chapter 13 - Blue Cross and Blue Shield Plans. Chapter 14 - Medicare. Chapter 15 - Medicaid. Chapter 16 - TRICARE. Chapter 17 - Workers' Compensation. Appendix I - Case Study Set One. Appendix II - Case Study Set Two. Appendix III - Blank Forms. Appendix IV - Answers to Coding Exercises. Appendix V - Dental Claims Processing. Appendix VI - Essential UB-92 Billing Instructions. Appendix VII - Bibliography. Appendix VIII - Glossary. Index.