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

By

  • Janet Beik, AA, BA, MEd, Southeastern Community College (retired), Administrative Instructor, Medical Assistant Program, West Burlington, IA, USA

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.
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Book information

  • Published: September 2010
  • Imprint: SAUNDERS
  • ISBN: 978-1-4557-3708-6


Table of Contents

 

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