LCCN2013-947428
Reviews"I would highly recommend this book as I use it and have used this book for 6 years. It is very well organized, laid out, and explains aspects of the major insurance players very well."Mary M. Cantwell, RHIT,CPC,CPC-I,CPC-H,CPC-P,RMC, Metro Community College, Omaha, NE, "It is a great text that thoroughly covers all major topics but provides flexibility for adaptation in any course. Honestly, this is the most thorough textbook I have seen for this area of study, and it is a great resource for anyone entering or already working in this field."- Denise Kearney, CPC, Wayne Community College, Goldsboro, NC
Dewey Decimal368.38/2/00973
Table Of Content1. 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.
SynopsisUnderstanding Health Insurance, 12th Edition, is the essential learning tool your students 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 twelfth 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 workbook (available separately) provides even more application-based assignments and additional case studies for reinforcement. Includes free online SimClaimâ„¢ CMS-1500 claims completion software, and free-trial access to Optum's EncoderPro.com-Expert encoder software., Understanding Health Insurance, 12th Edition, is the essential learning tool your students 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 twelfth 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 workbook (available separately) provides even more application-based assignments and additional case studies for reinforcement. Includes free online SimClaimCMS-1500 claims completion software, and free-trial access to Optum's EncoderPro.comExpert encoder software., Understanding Health Insurance, 12th Edition, is the essential learning tool your students 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 twelfth 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 workbook (available separately) provides even more application-based assignments and additional case studies for reinforcement. Includes free online SimClaim(TM) CMS-1500 claims completion software, and free-trial access to Optum's EncoderPro.com--Expert encoder software.
LC Classification NumberHG9396.R68 2015