Full Description
Enhance your skills and establish a strong foundation for success with Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2025 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, HCPCS Level II and CPT® codes, complete health insurance claims and master revenue management and reimbursement concepts. Key areas covered include managed care, legal and regulatory matters, coding systems, reimbursement methods and common health insurance plans. MindTap online courseware offers an interactive simulation for completing CMS-1500 claims and assigning medical 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. CMS-1500 and UB-04 Claims.
11. Commercial Insurance.
12. BlueCross BlueShield.
13. Medicare.
14. Medicaid.
15. TRICARE.
16. Workers' Compensation.
Appendices.
Bibliography.
Glossary.
Index.
