Health Insurance Today - 6th Edition - ISBN: 9780323400749, 9780323509572

Health Insurance Today

6th Edition

A Practical Approach

Author: Janet Beik
eBook ISBN: 9780323509572
Paperback ISBN: 9780323400749
Imprint: Saunders
Published Date: 5th August 2017
Page Count: 528

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Learn to comprehend the complexities of health insurance! Using a reader-friendly approach, Health Insurance Today, A Practical Approach, 6th Edition gives you a solid understanding of health insurance, its types and sources, and the ethical and legal issues surrounding it. This new edition incorporates the latest information surrounding ICD-10, the Patient Protection and Affordable Care Act, and other timely federal influencers, as it guides you through the important arenas of health insurance such as claims submission methods, the claims process, coding, reimbursement, hospital billing, and more. Plus, with hands-on UB-04 and CMS-1500 (02-12) case studies on Evolve, you will come away with a clear understanding and working knowledge of the latest advances and issues in health insurance.

Key Features

  • CMS-1500 (02-12) software with case studies gives you hands-on practice filling in a CMS-1500 (02-12) form electronically.
  • What Did You Learn? review questions ensure you understand the material already presented before moving on to the next section.
  • Imagine This! scenarios help you understand how information in the book applies to real-life situations.
  • Stop and Think exercises challenge you to use your critical thinking skills to solve a problem or answer a question. 
  • Clear, attainable learning objectives help you focus on the most important information and make chapter content easier to teach.
  • Chapter summaries relate to learning objectives, provide a thorough review of key content, and allow you to quickly find information for further review.
  • Direct, conversational writing style makes reading fun and concepts easier to understand.
  • HIPAA tips emphasize the importance of privacy and following government rules and regulations.

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 and Ethical Side of Medical Insurance
4. Healthcare Reform: Coverage Types and Sources

Unit 2: Health Insurance Basics
5. Claim Submission Methods
6. New and Traditional Reimbursement Methods
7. The Changing Face of Managed Care
8. Understanding Medicaid
9. Conquering Medicare’s Challenges
10. Military Carriers
11. Miscellaneous Carriers: Workers’ Compensation and Disability Insurance

Unit 3: Cracking the Codes
12. Diagnostic Coding
13. Procedural, Evaluation and Management, and HCPCS Coding

Unit 4: The Claims Process
14. The Patient
15. Keys to Successful Claims Management
Unit 5: Advanced Application
16. The Role of Computers in Health Insurance
17. Reimbursement Procedures: Getting Paid
18. Hospital Billing and the UB-04

Appendix A: Sample Blank CMS-1500 (02-12)
Appendix B: CMS-1500 Claim Forms and Completion Instructions
Appendix C: UB-04 Claim Form and Completion Instructions


No. of pages:
© Saunders 2017
5th August 2017
eBook ISBN:
Paperback ISBN:

About the Author

Janet Beik

Janet Beik has degrees in business and higher education. Janet was an instructor in the Medical Assistant Program at Southeastern Community College, in West Burlington, Iowa, for several years. She authored the first edition of her book, Health Insurance Today in 2003, and the 7th edition has just published.

Affiliations and Expertise

Southeastern Community College (retired), Administrative Instructor, Medical Assistant Program, West Burlington, Iowa