Description: With Understanding Health Insurance: A Guide to Billing and Reimbursement, you will learn about managed health care, legal and regulatory issues, coding systems, reimbursement methodologies, coding for medical necessity, and common health insurance plans. Exercises in each chapter give you plenty of practice to learn how to bill and reimburse. The accompanying workbook provides more application-based assignments for each chapter, content review, and additional case studies. Product Benefits: - Fully updated to latest code sets, guidelines, CMS-1500, and UB-04 claim forms
- "One-stop-shopping" approach sets discussions of diagnosis and procedure coding alongside reimbursement and legal issues
- Patient case studies on CD-ROM and in Appendices I and II provide opportunity for manual or electronic CMS-1500 form completion
- The CD case studies also appear in Appendix I and II of the text for easy reference
- Accompanying Workbook provides application-based exercises for each chapter, plus additional case studies that require CMS-1500 claim form completion
- Chapter 9 provides instruction on the UB-04 hospital claim form, revenue codes, and the Chargemaster
- Chapter 11 has been updated to reflect changes in the CMS-1500 form and claim instructions, including the addition of the National Provider Identification (NPI) number
- SIMClaim student practice software now features a 'print to PDF' function that makes it easier to save and e-mail forms
- In addition to chapter quizzes and games, the StudyWare CD-ROM now features unique, scenario-based coding cases that use multimedia to enhance coding practice
- Free trial CD-ROM of EncoderPro, Ingenix's powerful coding tool
Table of Contents: Chapter 1: Health Insurance Specialist Career
Chapter 2: Introduction to Health Insurance
Chapter 3: Managed Health Care
Chapter 4: Development of an Insurance Claim
Chapter 5: Legal and Regulatory Issues
Chapter 6: ICD-9-CM Coding
Chapter 7: CPT Coding
Chapter 8: HCPCS Coding
Chapter 9: CMS Reimbursement Methodologies
Chapter 10: Coding for Medical Necessity
Chapter 11: Essential CMS-1500 Claim Instructions
Chapter 12: Commercial Insurance
Chapter 13: Blue Cross and Blue Shield Plans
Chapter 14: Medicare Ch 15: Medicaid
Chapter 16: Tricare
Chapter 17: Workers'' Compensation |
