Health Insurance Today : A Practical Approach

by Beik, Janet I.

• ISBN13: 9781437717709
• ISBN10: 1437717705
• Edition: 3rd
• Format: Paperback
• Copyright: 2010-09-09
• Publisher: Elsevier Science Health Science div

Summary

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. Learning objectives makes learning easier and more meaningfulDirect, conversational writing style makes reading and absorbing the material more enjoyable"What Did You Learn?" review questions ensure that you understand the material already covered, before progressing to the next section."Imagine This!" scenarios help you apply information from the book to real-life situations"Stop and Think" exercises let you apply critical thinking skills to solve a problem or answer a question.HIPAA Tips help you understand this very important piece of legislation.Activities on the Evolve site give you hands-on practice electronically completing a claim form as efficiently as possible. More content on electronic medical records to reflect the future of record-keepingThoroughly updated chapters include more in-depth information and guidelines on achieving and succeeding in a health insurance careerRevised information covering the latest Medicare updates keeps you in-step with the latest Medicare practicesChapters include more content on ICD-10-CM, ICD-10-PCS, and updates to the CPT and HCPCS so you know all the latest information in the fieldMedisoft Activities on the Evolve Learning Resource site help to reinforce information and provide additional opportunities for practice

Table of Contents

Building A Foundation

The Origins of Health Insurance

Tools of the Trade: A Career as a Health (Medical) Insurance Professional

The Legal & Ethical Side of Medical Insurance

Types and Sources of Health Insurance

Health Insurance Basics

The "Universal" Claim Form: CMS-1500

Traditional Fee-For-Service/Private Plans

Unraveling the Mysteries of Managed Care

Understanding Medicaid

Conquering Medicare's Challenges

Military Carriers

Miscellaneous Carriers: Worker's Compensation and Disability Insurance

Cracking The Codes

Diagnostic Coding

Procedural, Evaluation & Management and HCPCS Coding

The Claims Process

The Patient

The Claim

Advanced Application

The Role of Computers in Health Insurance

Reimbursement Procedures: Getting Paid

Hospital Claim Form: The UB-04

Glossary

Index

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