Heath Insurance Today - Pageburst E-Book on VitalSource (Retail Access Card) book cover

Heath Insurance Today - Pageburst E-Book on VitalSource (Retail Access Card)

This is a Pageburst digital textbook; Learn to complete and submit clean claim forms for major insurance carriers. Health Insurance Today, 3rd Edition, provides case studies for each of the chapters covering these major payers so you can learn how to abstract the information from the patient’s chart to complete the CMS-1500. You will learn to complete and submit paper claims, but the emphasis is on electronic claims filing, keeping you up-to-date on HIPAA, electronic health records, and the latest industry standards. Select exercises on the companion Evolve Resource site let you gain experience entering information into a practice management program; producing an electronic CMS-1500; and submitting a claim electronically.

Book,

Published: September 2010

Imprint: Saunders

ISBN: 978-1-4557-3708-6

Contents

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    UNIT 1 - BUILDING A FOUNDATION

    1. The Origins of Health Insurance

    2. Tools of the Trade: A Career as a Health (Medical) Insurance Professional

    3. The Legal & Ethical Side of Medical Insurance

    4. Types and Sources of Health Insurance

    UNIT 2 - HEALTH INSURANCE BASICS

    5. The "Universal" Claim Form: CMS-1500

    6. Traditional Fee-For-Service/Private Plans

    7. Unraveling the Mysteries of Managed Care

    8. Understanding Medicaid

    9. Conquering Medicare’s Challenges

    10. Military Carriers

    11. Miscellaneous Carriers: Worker’s Compensation and Disability Insurance

    UNIT 3 - CRACKING THE CODES

    12. Diagnostic Coding

    13. Procedural, Evaluation & Management and HCPCS Coding

    UNIT 4 - THE CLAIMS PROCESS

    14. The Patient

    15. The Claim

    UNIT 5 - ADVANCED APPLICATION

    16. The Role of Computers in Health Insurance

    17. Reimbursement Procedures: Getting Paid

    18. Hospital Claim Form: The UB-04

    Appendix A

    Appendix B

    Appendix C

    Glossary

    Index

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