Prepare for a successful career in medical billing and insurance processing or revenue management with the help of Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2020 Edition. This comprehensive, inviting book presents the latest medical code sets and coding guidelines as you learn to complete health plan claims and master revenue management concepts. This edition focuses on today’s most important topics, including managed care, legal and regulatory issues, coding systems and compliance, reimbursement methods, clinical documentation improvement, coding for medical necessity, and common health insurance plans. Updates introduce new legislation that impacts health care. You also examine the impact on ICD-10-CM, CPT, and HCPCS level II coding; revenue cycle management; and individual health plans. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.
Understanding Health Insurance: A Guide to Professional Billing, 7th edition,utilizes a step-by-step approach to provide instruction about the completion of health insurance claims. the objectives of this edition are to 1) introduce information about major third party payer programs and federal health care regulations, 2) clarify coding guidelines and provide application exercises for each national diagnosis and procedure coding system, and 3) simplify the process of completing claims. Case studies and review exercises provide users with numerous opportunities to apply knowledge and to build s
Strengthen your skills and develop a solid foundation in medical insurance processing and revenue management with Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2022 Edition. This reader-friendly, comprehensive resource explains the latest developments and medical code sets and coding guidelines as you learn how to assign ICD-10-CM, CPT 2022 codes and HCPCS level II codes, complete health care claims and master revenue management concepts. You focus on important topics such as the latest managed care, legal and regulatory issues, coding systems and compliance, reimbursement methods, clinical documentation improvement, coding for medical necessity and common health insurance plans. New material introduces electronic claims, performance measurement and processing clinical quality language. A helpful workbook provides hands-on assignments and case studies, while MindTap online resources offer practice in CMS-1500 claims completion and assigning codes.
New edition of one of the most used texts in medical terminology. Key features are up-to-date content, clearly stated definitions, the generous of illustrations and tables help to clarify content, and learning exercises that provide students with valuable learning reinforcement.
This is the eBook of the printed book and may not include any media, website access codes, or print supplements that may come packaged with the bound book. COMPREHENSIVE HEALTH INSURANCE: BILLING, CODING & REIMBURSEMENT, 2/e provides students with the knowledge and skills needed to work in a variety of medical billing and coding positions in the medical field. Comprehensive in approach, it covers the foundations of insurance, billing, coding and reimbursement. Students learn not only the submission of claims to the insurance carrier, but also reviewing medical records, verifying patient benefits, submitting a secondary claim, posting payments and appealing the insurance carrier's decision. This edition includes new chapters devoted to HIPAA and ICD-10-CM Medical Coding, as well as outstanding coverage of electronic records. Numerous case studies and patient files are included throughout and demonstrate refunds and appeals, auditing and compliance, Medicare calculations and professionalism.
The student workbook is designed to help you retain key chapter content. Included within this resource are chapter objective questions; key-term definition queries; and multiple choice, fill-in-the-blank, and true-or-false problems.
History of Health Insurance in the United States -- The Affordable Care Act -- A Summary of Insurance Coverage -- The Demand for Insurance -- Adverse Selection -- Underwriting and Rate Making -- Risk Adjustment -- Moral Hazard and Prices -- Utilization Management -- Managed Care, Selective Contracting, and the Insurance Industry -- Provider Consolidation, Monopsony Power, and the Managed Care Backlash -- Insurance Market Structure, Conduct, and Performance -- Premium Sensitivity and Health Insurance -- Compensating Differentials -- Taxes and Employer-Sponsored Health Insurance -- Employers as Agents -- Health Savings Accounts and Consumer-Directed Health Plans -- The Small-Group Market -- The Individual Insurance Market -- Health Insurance Regulation -- High-Risk Pools -- An Overview of Medicare -- Retiree Coverage -- Medicaid, Crowd-Out, and Long-Term Care Insurance.
CPT(R) 2022 Professional Edition is the definitive AMA-authored resource to help healthcare professionals correctly report and bill medical procedures and services.
CPT® 2021 Professional Edition is the definitive AMA-authored resource to help health care professionals correctly report and bill medical procedures and services. Providers want accurate reimbursement. Payers want efficient claims processing. Since the CPT® code set is a dynamic, everchanging standard, an outdated codebook does not suffice. Correct reporting and billing of medical procedures and services begins with CPT® 2021 Professional Edition. Only the AMA, with the help of physicians and other experts in the health care community, creates and maintains the CPT code set. No other publisher can claim that. No other codebook can provide the official guidelines to code medical services and procedures properly. FEATURES AND BENEFITS The CPT® 2021 Professional Edition codebook covers hundreds of code, guideline and text changes and features: CPT® Changes, CPT® Assistant, and Clinical Examples in Radiology citations -- provides cross-referenced information in popular AMA resources that can enhance your understanding of the CPT code set E/M 2021 code changes - gives guidelines on the updated codes for office or other outpatient and prolonged services section incorporated A comprehensive index -- aids you in locating codes related to a specific procedure, service, anatomic site, condition, synonym, eponym or abbreviation to allow for a clearer, quicker search Anatomical and procedural illustrations -- help improve coding accuracy and understanding of the anatomy and procedures being discussed Coding tips throughout each section -- improve your understanding of the nuances of the code set Enhanced codebook table of contents -- allows users to perform a quick search of the codebook's entire content without being in a specific section Section-specific table of contents -- provides users with a tool to navigate more effectively through each section's codes Summary of additions, deletions and revisions -- provides a quick reference to 2020 changes without having to refer to previous editions Multiple appendices -- offer quick reference to additional information and resources that cover such topics as modifiers, clinical examples, add-on codes, vascular families, multianalyte assays and telemedicine services Comprehensive E/M code selection tables -- aid physicians and coders in assigning the most appropriate evaluation and management codes Adhesive section tabs -- allow you to flag those sections and pages most relevant to your work More full color procedural illustrations Notes pages at the end of every code set section and subsection
Now in its 9th Edition, Schroeder/Ehrlich/Schroeder Smith/Ehrlich's MEDICAL TERMINOLOGY FOR HEALTH PROFESSIONS focuses on the current, relevant terms you need to know to succeed in the health care field. The program is designed to simplify the process of memorizing complex medical terminology by focusing on the importance of word parts -- common prefixes, suffixes and root words. Every chapter helps you practice the pronunciation and understanding of key terms through interactive activities, real-life medical scenarios and critical thinking exercises. Reflecting real-world practice, all terms, definitions, procedures, illustrations and data are completely up to date. The new edition includes expanded coverage of sexual orientation and gender identity, COVID-19, advanced directives, holistic health care and much more. Also available: MindTap digital learning solution.
