Description
**Selected for Doody's Core Titles® 2024 in Managed Care** Master the complexities of health insurance with this easy-to-understand guide! Beik's Health Insurance Today, 8th Edition provides a solid foundation in basics such as the types and sources of health insurance, the submission of claims, and the ethical and legal issues surrounding insurance. It follows the claims process from billing and coding to reimbursement procedures, with realistic practice on the Evolve companion website. This edition adds up-to-date coverage of cybersecurity, COVID-19, crowdfunding for medical bills, and cost/value calculators. Making difficult concepts seem anything but, this resource prepares you for a successful career as a health insurance professional.- Direct, conversational writing style makes learning insurance and billing concepts easier.- Clear and attainable learning objectives, with chapter content that follows the order of the objectives, make learning easier for students and make chapter content easier to teach for educators.- Learning features include review questions, scenarios, and additional exercises to ensure comprehension, critical thought, and application to practice.- Hands-on practice with a fillable CMS-1500 form and accompanying case studies and unique UB-04 forms on the companion Evolve website, ensure practicum- and job-readiness.- HIPAA Tips emphasize the importance of privacy and government rules and regulations, ensuring a solid foundation in regulatory compliance.- NEW! Additional content on cybersecurity emphasizes the importance of keeping digital information private and secure.- NEW! Information on crowdfunding for medical bills discusses how this practice affects billing.- NEW! Geographic Practice Cost Indexes/Resource Based Relative Value Scale (GPCI/RBPVU) calculators are included.- NEW! Coverage of COVID-19 explores its impact on billing, reimbursement, and employment.
Table of Contents
UNIT I BUILDING A FOUNDATION1 The Origins of Health Insurance2 Tools of the Trade: A Career as a Health Insurance Professional3 The Legal and Ethical Side of Health Insurance4 Healthcare Reform: Coverage Types and Sources5 The Patient and the Billing ProcessUNIT II HEALTH INSURANCE BASICS6 Reimbursement Models7 Understanding Managed Care8 Understanding Medicare9 Understanding Medicaid10 Understanding Military Carriers11 Understanding Miscellaneous Carriers: Workers' Compensation and Disability InsuranceUNIT III CLAIMS SUBMISSION12 Claim Submission Methods13 Diagnostic Coding14 Procedural, Evaluation and Management, and HCPCS Coding15 Claims ManagementUNIT IV ADVANCED APPLICATION16 The Role of Computers in Health Insurance17 Reimbursement Procedures: Getting Paid18 Hospital Billing and the UB-04Appendix A: Sample Blank CMS-1500 (02/12)Appendix B: CMS-1500 Claim Forms and Completion InstructionsAppendix C: UB-04 Claim Forms and Completion InstructionsGlossaryIndex
