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Understanding Health Insurance

(Autor)

Buch | Softcover
832 Seiten
2016 | 13th edition
Delmar Cengage Learning (Verlag)
978-1-305-64738-1 (ISBN)
169,95 inkl. MwSt
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Discover the essential tool to prepare for a career in medical insurance billing -- UNDERSTANDING HEALTH INSURANCE, 13E. This comprehensive, easy-to-understand, updated book presents the latest code sets and guidelines. You cover today’s most important topics, such as managed care, legal and regulatory issues, coding systems, reimbursement methods, medical necessity, and common health insurance plans. Updates introduce new legislation that impacts health care, including the Affordable Care Act (Obamacare); ICD-10-CM coding; electronic health records; Medicaid Integrity Contractors; case mix management; hospital-acquired conditions; present on admission; and value-based purchasing. Practice exercises and the workbook (available separately) provides application-based assignments and case studies to reinforce your understanding, as well as CMRS, CPC-P, and CPB Mock Exams. New editions include online access to SimClaim™ CMS-1500 claims completion software and Optum’s EncoderPro.com Expert™.

Michelle Green has been a SUNY Distinguished Teaching Professor in the health information technology department at Mohawk Valley Community College in Utica, New York, since 2017. She was the SUNY Distinguished Teaching Professor in the physical and life sciences department at the State University of New York College of Technology for more than 30 years. She has authored three popular textbooks related to coding, revenue management and health information management. An active member of the American Academy of Professional Coders and American Health Information Management Association, Green has been recognized for her excellence in teaching as well as her significant contributions to the health information management profession. Her numerous accolades 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 FORE Triumph Educator Award. In addition, she is a Registered Health Information Administrator, a fellow of the American Health Information Management Association and a Certified Professional Coder. She earned an MPS from Alfred University and a Bachelor of Science from Daemen College.

1. Health Insurance Specialist Career.
2. Introduction to Health Insurance.
3. Managed Health Care.
4. Processing an Insurance Claim.
5. Legal and Regulatory Issues.
6. ICD-10-CM Coding.
7. CPT Coding.
8. HCPCS Level II Coding.
9. CMS Reimbursement Methodologies.
10. Coding for Medical Necessity.
11. Essential CMS-1500 Claim Instructions.
12. Commercial Insurance.
13. Blue Cross Blue Shield.
14. Medicare.
15. Medicaid.
16. TRICARE.
17. Workers? Compensation.
Appendices.
Bibliography.
Glossary.
Index.

Erscheint lt. Verlag 31.1.2016
Verlagsort Clifton Park
Sprache englisch
Gewicht 1565 g
Themenwelt Medizin / Pharmazie Gesundheitswesen
Betriebswirtschaft / Management Spezielle Betriebswirtschaftslehre Versicherungsbetriebslehre
ISBN-10 1-305-64738-6 / 1305647386
ISBN-13 978-1-305-64738-1 / 9781305647381
Zustand Neuware
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