Full Description
Enhance your skills and establish a strong foundation for success with Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2024 Edition. This practical, reader-friendly resource delivers an updated guide to current medical code sets and coding guidelines, equipping you to assign ICD-10-CM, CPT®, and HCPCS Level II codes, complete health insurance claims and master revenue management concepts. Key areas covered include managed care, legal and regulatory matters, coding systems and compliance, reimbursement methods, clinical documentation improvement and coding for medical necessity and common health insurance plans. A workbook provides hands-on assignments and case studies, and MindTap online courseware offers interactive simulation for completing CMS-1500 claims and assigning codes.
Contents
1. Health Insurance Specialist Career.
2. Introduction to Health Insurance and Managed Care.
3. Introduction to Revenue Management.
4. Revenue Management: Insurance Claims, Denied Claims and Appeals, and Credit and Collections.
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.
