Health Insurance Today - 4th Edition - ISBN: 9781455708192, 9781455775231

Health Insurance Today

4th Edition

A Practical Approach

Authors: Janet Beik
Paperback ISBN: 9781455708192
eBook ISBN: 9781455775231
Imprint: Saunders
Published Date: 24th September 2012
Page Count: 512
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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 Health Insurance
  4. Types and Sources of Health Insurance
  5. Unit 2: Health Insurance Basics

  6. Claim Submission Methods
  7. Traditional Fee-for-Service/Private Plans
  8. Unraveling the Mysteries of Managed Care
  9. Understanding Medicaid
  10. Conquering Medicare’s Challenges
  11. Military Carriers
  12. Miscellaneous Carriers: Workers’ Compensation and Disability Insurance
  13. Unit 3: Cracking the Codes

  14. Diagnostic Coding
  15. Procedural, E&M, and HCPCS Coding
  16. Unit 4: The Claims Process

  17. The Patient
  18. The Claim
  19. Unit 5: Advanced Application

  20. The Role of Computers in Health Insurance
  21. Reimbursement Procedures: Getting Paid
  22. Hospital Billing and the UB-04

Appendixes

Appendix A: Sample Blank CMS-1500 (08/05)

Appendix B: CMS-1500 Claim Form and Completion Instructions

Appendix C: UB-40 Claim Form and Completion Instructions

Glossary


Description

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 Health Insurance
  4. Types and Sources of Health Insurance
  5. Unit 2: Health Insurance Basics

  6. Claim Submission Methods
  7. Traditional Fee-for-Service/Private Plans
  8. Unraveling the Mysteries of Managed Care
  9. Understanding Medicaid
  10. Conquering Medicare’s Challenges
  11. Military Carriers
  12. Miscellaneous Carriers: Workers’ Compensation and Disability Insurance
  13. Unit 3: Cracking the Codes

  14. Diagnostic Coding
  15. Procedural, E&M, and HCPCS Coding
  16. Unit 4: The Claims Process

  17. The Patient
  18. The Claim
  19. Unit 5: Advanced Application

  20. The Role of Computers in Health Insurance
  21. Reimbursement Procedures: Getting Paid
  22. Hospital Billing and the UB-04

Appendixes

Appendix A: Sample Blank CMS-1500 (08/05)

Appendix B: CMS-1500 Claim Form and Completion Instructions

Appendix C: UB-40 Claim Form and Completion Instructions

Glossary

Key Features

  • Clear, attainable learning objectives help you focus on the most important information.
  • What Did You Learn? review questions allow you to ensure you understand the material already presented before moving on to the next section.
  • Direct, conversational writing style makes reading fun and concepts easier to understand.
  • 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.
  • HIPAA Tips emphasize the importance of privacy and following government rules and regulations.
  • Chapter summaries relate to learning objectives, provide a thorough review of key content, and allow you to quickly find information for further review.

Details

No. of pages:
512
Language:
English
Copyright:
© Saunders 2013
Published:
Imprint:
Saunders
Paperback ISBN:
9781455708192
eBook ISBN:
9781455775231
eBook ISBN:
9781455708253
eBook ISBN:
9780323291767

About the Authors

Janet Beik Author

Affiliations and Expertise

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