Understanding Health Insurance (häftad)
Häftad (Paperback / softback)
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15 ed
CENGAGE Learning Custom Publishing
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Understanding Health Insurance (häftad)

Understanding Health Insurance

A Guide to Billing and Reimbursement - 2020

Häftad Engelska, 2020-01-02
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Prepare for a successful career in medical billing and insurance processing or revenue management with Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2020 Edition. This comprehensive, inviting presentation explains the latest medical code sets and coding guidelines as you learn how to complete health care 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; ICD-10-CM, CPT, and HCPCS level II coding; revenue cycle management; and individual health plans. Helpful workbook exercises provide application-based assignments and case studies as well as CMRS, CPC-P, and CPB mock exams. In addition, MindTap digital learning tools offer hands-on practice.
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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 also serves as an adjunct faculty member for the Health Information Management Department at Mount Wachusett Community College in Gardner, Massachusetts. Ms. Green held the position of 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. An active member of the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA), Ms. Green has been recognized both for her excellence in teaching and for her significant contributions to the health information management profession. She has earned numerous awards, including 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. Ms. Green is a Registered Health Information Administrator (RHIA), a Fellow of the American Health Information Management Association (FAHIMA), and a Certified Procedural Coder (CPC). She earned an M.P.S. degree from Alfred University and a B.S. from Daemen College. Ms. Green has authored three successful textbooks related to coding, revenue management, and health information management.


1. Health Insurance Specialist Career. 2. Introduction to Health Insurance. 3. Managed Health Care. 4. Revenue Cycle Management. 5. Legal Aspects of Health Insurance and Reimbursement. 6. ICD-10-CM Coding. 7. CPT Coding. 8. HCPCS Level II Coding. 9. CMS Reimbursement Methodologies. 10. Coding Compliance, Clinical Documentation Improvement, and Coding for Medical Necessity. 11. CMS-1500 and UB-04 Claims. 12. Commercial Insurance. 13. BlueCross BlueShield. 14. Medicare. 15. Medicaid. 16. TRICARE. 17. Workers' Compensation. Appendices. Bibliography. Glossary. Index.