9780766832060

Understanding Health Insurance

by
  • ISBN13:

    9780766832060

  • ISBN10:

    0766832066

  • Edition: 6th
  • Format: Paperback
  • Copyright: 6/20/2001
  • Publisher: Cengage Learning
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List Price: $183.95

Summary

nderstanding Health Insurance is a comprehensive guide for those learning about health insurance claim processing. Objectives of this edition are 1) to introduce information about major insurance programs and federal health care legislation, 2) to provide basic information on national diagnosis and procedure coding systems and 3) simplify the process of completing claim forms. Contains pertinent, easy-to-understand information on common health insurance plans, with separate chapters on coding and reimbursement issues, and step-by-step instructions for HCFA-1500 claim completion. Case studies and review exercises give users numerous opportunities to apply knowledge to build skill in completing HCFA-1500 claims accurately. CD-ROM in text and accompanying workbook provides additional exercises and practice in completing HCFA-1500 claims electronically. Includes new information regarding CPT-5, ICD-10-CM and HCFA reimbursement issues

Table of Contents

Health Insurance Specialist-Roles and Responsibilities
1(2)
Introduction to Health Insurance
3(4)
Managed Health Care
7(6)
Life Cycle of an Insurance Claim
13(4)
Legal and Regulatory Considerations
17(6)
ICD-9-CM Coding
23(14)
CPT Coding
37(14)
HCPCS Coding System
51(4)
HCFA Reimbursement Issues
55(4)
Coding From Source Documents
59(8)
Essential HCFA-1500 Claim Form Instructions
67(14)
Filing Commercial Claims
81(26)
Blue Cross and Blue Shield Plans
107(28)
Medicare
135(40)
Medicaid
175(16)
TRICARE
191(14)
Workers' Compensation
205

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