The Practice of Health Claims Examining
The Practice of Health Claims Examining

Author: ICDC Publishing Inc

Publisher: Prentice Hall

Published: 2006-10

Total Pages: 484

ISBN-13: 9780132193894

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Formally known as Exercises in Health Claims Examining, The Practice of Health Claims Examining, 2e, contains a simulated work program to help you experience the real life situations that a claims examiner experiences on a daily basis. This book is created for use in conjunction with ICDC Publishing's Guide to Health Claims Examining. Some of the exercises in the simulated work portion of the book are based upon concepts learned in the Guide to Health Claims Examining (i.e., procedures for processing claims, interpretation of contracts, understanding UCR and deductibles, etc.). This book alone should not be considered a complete text for learning health claims examining. It is suggested that a trainee take a complete health claims examining course prior to using this book. The simulated work portion of this text incorporates concepts which are not taught by simple data entry, for example UCR calculations, privacy guidelines, client record keeping, correspondence, and manual completion of claims processing. This text is designed to allow the student to work through the material at their own pace.

Model Rules of Professional Conduct
Model Rules of Professional Conduct

Author: American Bar Association. House of Delegates

Publisher: American Bar Association

Published: 2007

Total Pages: 216

ISBN-13: 9781590318737

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The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.

Care Without Coverage
Care Without Coverage

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2002-06-20

Total Pages: 213

ISBN-13: 0309083435

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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Improving Diagnosis in Health Care
Improving Diagnosis in Health Care

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2015-12-29

Total Pages: 473

ISBN-13: 0309377722

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Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Guide to Health Claims Examining
Guide to Health Claims Examining

Author: ICDC Publishing, Inc

Publisher: Prentice Hall

Published: 2007

Total Pages: 676

ISBN-13: 9780132194082

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This comprehensive text presents the principles and theories behind health claims examining. It builds a complete understanding of all the skills necessary to process, pay, and apply claims as an examiner accurately and consistently. Highlights include: Learning objectives that identify key skills and concepts, "On the Job Now"-Professional self-assessment sections, "Practice Pitfalls"-Bad habits to avoid in the workplace, Chapter review questions and in-text exercises. This book should be used in conjunction with the workbook, The Practice of Health Claims Examining, Second Edition, which simulates daily duties as if the student were working for an insurance carrier. Book jacket.