Corresponding to the chapters in Health Insurance Today, 7th Edition, this workbook gives you practice with the skills you will need to succeed as a health insurance professional. Practical assignments reinforce the information in the text, and engaging learning activities and exercises challenge you to apply your knowledge to real-world situations. This edition expands its focus on case studies and the use of practice management software, adding more opportunities for application in the medical office.
- Performance-based activities include hands-on, application-based learning exercises that provide practice in areas such as completing claim forms, posting payments to a patient's ledger, filling out Release to Return to Work forms, and filling out Medicare appeals.
- Critical thinking activities strengthen your ability to apply health insurance concepts to a variety of challenging situations, with Stop and Think exercises allowing you to apply critical thinking skills to solve a problem or answer a question.
- Chapter assessments test your knowledge with multiple choice, true/false, short answer, fill-in-the-blank, and matching questions.
- Problem-solving and collaborative (group) activities emphasize the importance of teamwork in the healthcare field.
- Case studies ask you to solve a real-world problem related to health insurance, such as completing a CMS-1500 claim form or explaining how HIPAA could affect someone recently out of work.
- Application exercises ask you to apply your knowledge and skills to real-world situations.
- In-class projects and discussion topics enhance your understanding of specific content from the text.
- Internet Exploration exercises in each chapter help you learn how to perform research online.
- Defining Chapter Terms activities help you review and understand the key terms in each chapter.
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. Types and Sources of Health Insurance
Unit 2: Health Insurance Basics
5. Claim Submission Methods
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: 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 2021
- 1st November 2020
- Paperback ISBN:
- eBook ISBN:
Southeastern Community College (retired), Administrative Instructor, Medical Assistant Program, West Burlington, IA, USA
Julie Pepper, BS, CMA (AAMA), has spent her entire career in health care, first as a medical assistant in a variety of offices and clinics, developing expertise in the electronic health record. She combines her education in dietetics with her clinical and administrative experience as an instructor in the Medical Assisting program at Chippewa Valley Technical College in Wisconsin, where she has taught for the past 18 years. Julie is also the program director for the college’s new Health Navigator program.
Medical Assistant Instructor, Chippewa Valley Technical College, Eau Claire, Wisconsin
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