Understanding Health Insurance: A Guide to Billing and Reimbursement, 8th Edition is a comprehensive source for teaching the subject of health insurance and reimbursement. The book contains chapters on introductory information on the health insurance field, managed health care, legal and regulatory issues, coding systems, reimbursement methodologies, coding for medical necessity, and common health insurance plans. Each chapter contains exercises to illustrate content and reinforce learning. Numerous opportunities are provided throughout the book for manual completion of CMS-1500 claims. A CD-ROM at the back of the book allows for electronic data entry of CMS-1500 claim form information. End of chapter review questions in objective format (e.g., multiple choice) test learners on their understanding of book content. Appendices I and II provide case studies that are also included on the Student Practice CD-ROM. Additional appendices provide instruction in dental claims processing and completion of the UB-92 (claim used for inpatient and outpatient hospital claims). The accompanying workbook provides application based assignments for each chapter, additional content review (multiple choice questions), and additional case studies for practice in completing CMS-1500 claims. This edition of the book contains the most up to date information regarding health insurance claims processing and coding and reimbursement issues.

Features:

• At-a-glance table format simplifies the confusing task of completing insurance claims for each major payer
• One-stop-shop approach is used in that diagnosis and procedure coding and health insurance claims processing are discussed along with reimbursement and legal issues.
• HIPAA Alerts raise awareness of the security and privacy issues related to management of personal health information in the physician's office.
• Appendices and CD-ROM contain case studies for practice in claims form completion (manual and electronic). CD-ROM contains a "Block Help" feature that recaps instructions for completing each CMS-1500 block for a specific payer.