Health Insurance Today : A Practical Approach

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