Understanding Health Insurance (häftad)
Häftad (Paperback / softback)
Antal sidor
14 ed
CENGAGE Learning Custom Publishing
273 x 215 x 25 mm
1324 g
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Understanding Health Insurance (häftad)

Understanding Health Insurance

A Guide to Billing and Reimbursement

Häftad Engelska, 2018-01-01
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Prepare for a career in health information management and medical billing and insurance processing with Green's UNDERSTANDING HEALTH INSURANCE, 14E. This comprehensive, inviting book presents the latest code sets and guidelines. Examine today's most important topics, such as 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, including changes to the Affordable Care Act (Obamacare); ICD-10-CM, CPT, and HCPCS level II coding; revenue cycle management; and individual health plans. Workbook exercises provide application-based assignments and case studies, as well as CMRS, CPC-P, and CPB mock exams.
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"The book provides a strong and detailed look at the main insurance companies in the USA - Medicare, Medicaid, and BC/BS. The product has MindTap which allows students many more options than before...In addition to the electronic grade book in MindTap, there is also the SimClaim assignments that students can accomplish through the web...The fact that it is all web based is a MAJOR PLUS!" "Chapter 11, "Essential CMS-1500 Claim Instructions": Very detailed explanation. Lesson is timed appropriately. Good mention of optical scanning guidelines (and) national provider identifier. This chapter provides good detail on all portions of the form. Students retain the information and are able to immediately apply it."

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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 and Regulatory Issues. 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. Blue Cross Blue Shield. 14. Medicare. 15. Medicaid. 16. TRICARE. 17. Workers' Compensation. Appendices. Bibliography. Glossary. Index.