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Understanding Health Insurance A Guide to Billing and Reimbursement

ISBN-10: 1401895956

ISBN-13: 9781401895952

Edition: 8th 2006 (Revised)

Authors: Michelle A. Green, Jo Ann C. Rowell

List price: $128.95
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Description:

Understanding Health Insurance: A Guide to Billing and Reimbursement, 8th Edition is a comprehensive source for teaching the subject of health insurance and reimbursement. The book contains chapters on introductory information on the health insurance field, managed health care, legal and regulatory issues, coding systems, reimbursement methodologies, coding for medical necessity, and common health insurance plans. Each chapter contains exercises to illustrate content and reinforce learning. Numerous opportunities are provided throughout the book for manual completion of CMS-1500 claims. A CD-ROM at the back of the book allows for electronic data entry of CMS-1500 claim form information. End of chapter review questions in objective format (e.g., multiple choice) test learners on their understanding of book content. Appendices I and II provide case studies that are also included on the Student Practice CD-ROM. Additional appendices provide instruction in dental claims processing and completion of the UB-92 (claim used for inpatient and outpatient hospital claims). The accompanying workbook provides application based assignments for each chapter, additional content review (multiple choice questions), and additional case studies for practice in completing CMS-1500 claims. This edition of the book contains the most up to date information regarding health insurance claims processing and coding and reimbursement issues.
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Book details

List price: $128.95
Edition: 8th
Copyright year: 2006
Publisher: Delmar Cengage Learning
Publication date: 8/25/2005
Binding: Paperback
Pages: 720
Size: 8.50" wide x 11.00" long x 1.00" tall
Weight: 3.212
Language: English

Michelle A. Green, MPS, RHIA, FAHIMA, CPC, is a SUNY Distinguished Teaching Professor at Alfred State College in Alfred, New York. Her teaching responsibilities include health information management, insurance and reimbursement, and ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT, and HCPCS level II coding courses. She is an active member of the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA). Her numerous teaching honors include the State University of New York Chancellor's Award for Excellence in Teaching, Alfred State College's Alumni Association Teacher of the Year, Who's Who Among America's Teachers, and AHIMA's Educator Award. In addition to this title, she also authored 3-2-1 CODE IT! and UNDERSTANDING HEALTH INSURANCE.

Founder and Former Chairperson, Medical Assisting Department Anne Arundel Community College, Arnold, MD

Preface
Health Insurance Specialist?
Roles and Responsibilities
Introduction to Health Insurance
Managed Health Care
Life Cycle of an Insurance Claim
Legal & Regulatory Considerations
ICD-9-CM Coding
CPT Coding
HCPCS Coding (name change from HCPCS Coding System)
CMS Reimbursement Issues (name change from HCFA Reimbursement Issues)
Coding for Medical Necessity (name change from Coding from Source Documents)
Essential Claims Completion Guidelines (name change from Essential Claim Form Instructions)
Commercial Claims (name change from Filing Commercial Claims)
Blue Cross and Blue Shield Plans
? Medicare
? Medicaid
Tricare
Workers' Compensation
Case Study Set 1
Case Study Set 2
Blank Forms
Answers to Coding Exercises
Dental Claims Processing
Essential UB-92 Billing Instructions
Bibliography
Glossary
Index