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- Features completely updated information that reflects the many changes in the insurance industry. - Contains a new chapter on UB-92 insurance billing for hospitals and outpatient facilities. - Includes a new appendix, Quick Guide to HIPAA for the Physician's Office, to provide a basic overview of the important HIPAA-related information necessary on the job.
Realistic, hands-on exercises prepare students to work effectively in the managed care environment with all types of insurance claims. Self-study review questions and complete, competency-based tests are presented. Easily removable sample practice forms are provided, as well as case study information and practice exercises. Available separately.
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.
A source of information for submitting, tracing, appealing and transmitting claims for the full range of health plans. The text places special emphasis on procedural and diagnostic coding and illustrates correct and incorrect CPT codes and appropriate versus inappropriate documentation. This student workbook is designed to accompany the main text, ISBN 0-7216-6987-5.
Health Insurance Systems: An International Comparison offers united and synthesized information currently available only in scattered locations - if at all - to students, researchers, and policymakers. The book provides helpful contexts, so people worldwide can understand various healthcare systems. By using it as a guide to the mechanics of different healthcare systems, readers can examine existing systems as frameworks for developing their own. Case examples of countries adopting insurance characteristics from other countries enhance the critical insights offered in the book. If more information about health insurance alternatives can lead to better decisions, this guide can provide an essential service. Delivers fundamental insights into the different ways that countries organize their health insurance systems Presents ten prominent health insurance systems in one book, facilitating comparisons and contrasts, to help draw policy lessons Countries included are Australia, Canada, France, Germany, Japan, the Netherlands, Sweden, Switzerland, the United Kingdom, and the United States Helps students, researchers, and policymakers searching for innovative designs by providing cases describing what countries have learned from each other
This new edition of the Handbook of Insurance reviews the last forty years of research developments in insurance and its related fields. A single reference source for professors, researchers, graduate students, regulators, consultants and practitioners, the book starts with the history and foundations of risk and insurance theory, followed by a review of prevention and precaution, asymmetric information, risk management, insurance pricing, new financial innovations, reinsurance, corporate governance, capital allocation, securitization, systemic risk, insurance regulation, the industrial organization of insurance markets and other insurance market applications. It ends with health insurance, longevity risk, long-term care insurance, life insurance financial products and social insurance. This second version of the Handbook contains 15 new chapters. Each of the 37 chapters has been written by leading authorities in risk and insurance research, all contributions have been peer reviewed, and each chapter can be read independently of the others.
The Clinton administration's failed health care reform was not the first attempt to establish government-sponsored medical coverage in the United States. From 1915 to 1920, Progressive reformers led a spirited but ultimately unsuccessful crusade for compulsory health insurance in New York State. Beatrix Hoffman argues that this first health insurance campaign was a crucial moment in the creation of the American welfare state and health care system. Its defeat, she says, gave rise to an uneven and inegalitarian system of medical coverage and helped shape the limits of American social policy for the rest of the century. Hoffman examines each of the major combatants in the battle over compulsory health insurance. While physicians, employers, the insurance industry, and conservative politicians forged a uniquely powerful coalition in opposition to health insurance proposals, she shows, reformers' potential allies within women's organizations and the labor movement were bitterly divided. Against the backdrop of World War I and the Red Scare, opponents of reform denounced government-sponsored health insurance as "un-American" and, in the process, helped fashion a political culture that resists proposals for universal health care and a comprehensive welfare state even today.
Navigating Health Insurance examines health insurance from the perspective of the consumer. Students are introduced to basic health insurance principles and terminology as well as types of insurance such as Medicaid, Medicare, Medigap, Exchanges, and others.The impacts of the ACA on health insurance are explored as well as essential services and coverage decisions, long term care, workers compensation, administration/paper work, filing claims and more.Students will also be challenged to consider market and social justice philosophies, for example the impact on health insurance and access to health care services, international comparisons, and advantages and disadvantages of the U.S. system.
A bestseller for over 25 years, this text helps users excel at all aspects of insurance billing: submitting, tracing, appealing, and transmitting claims. Its comprehensive coverage also includes important information on diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, Managed Care, and more. This edition has been reviewed by industry experts and carefully updated to reflect recent changes in the industry - including the addition of special HIPAA Compliance Alerts throughout the book to help users comply with important governmental privacy regulations. Instructor resources are available; please contact your Elsevier sales representative for details. Icons help students identify each insurance payer with a specific color and graphic, making the learning process more effective. Emphasizes procedural (CPT and HCPCS) and diagnostic (ICD-9-CM) coding and documentation since they are the keystones to obtaining maximum reimbursement. Block-by-block teaching approach organized by payer category for the CMS-1500 claim form facilitates understanding, effective learning, and greater productivity. Detailed examples and samples of completed insurance forms help students see how knowledge is applied in the real world. Accompanying CD-ROM of practice software bound in the back of the book features the CMS-1500 claim form and 10 scored patient case studies with related insurance information to simulate real-life situations. Updated to reflect recent changes in the industry. Special sections highlight areas pertinent to HIPAA regulations.