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 patients 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
UNIT 1 - BUILDING A FOUNDATION
1. The Origins of Health Insurance
2. Tools of the Trade: A Career as a Health (Medical) Insurance Professional3. The Legal & Ethical Side of Medical Insurance
4. Types and Sources of Health InsuranceUNIT 2 - HEALTH INSURANCE BASICS5. The "Universal" Claim Form: CMS-1500
6. Traditional Fee-For-Service/Private Plans7. Unraveling the Mysteries of Managed Care
8. Understanding Medicaid9. Conquering Medicares Challenges
10. Military Carriers11. Miscellaneous Carriers: Workers Compensation and Disability Insurance
UNIT 3 - CRACKING THE CODES
12. Diagnostic Coding13. Procedural, Evaluation & Management and HCPCS Coding
UNIT 4 - THE CLAIMS PROCESS
14. The Patient15. The Claim
UNIT 5 - ADVANCED APPLICATION
16. The Role of Computers in Health Insurance17. Reimbursement Procedures: Getting Paid
18. Hospital Claim Form: The UB-04Appendix AAppendix B
Appendix CGlossaryIndex
