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Author:   Julie Pepper, BS, CMA (AAMA) (Professor Emeritus, Medical Assistant Program, Chippewa Valley Technical College, Eau Claire, Wisconsin, USA)
Publisher:   Elsevier - Health Sciences Division
Imprint:   Elsevier - Health Sciences Division
Edition:   8th edition
Weight:   1.090kg
ISBN:  

9780323884006

ISBN 10:   0323884008
Pages:   504
Publication Date:   08 November 2023
Audience:   College/higher education ,  Tertiary & Higher Education
Replaced By:   9780323655538
Format:   Paperback
Publisher's Status:   Active
Availability:   Available To Order  
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Table of Contents

UNIT I BUILDING A FOUNDATION 1 The Origins of Health Insurance 2 Tools of the Trade: A Career as a Health Insurance Professional 3 The Legal and Ethical Side of Health Insurance 4 Healthcare Reform: Coverage Types and Sources 5 The Patient and the Billing Process UNIT II HEALTH INSURANCE BASICS 6 Reimbursement Models 7 Understanding Managed Care 8 Understanding Medicare 9 Understanding Medicaid 10 Understanding Military Carriers 11 Understanding Miscellaneous Carriers: Workers' Compensation and Disability Insurance UNIT III CLAIMS SUBMISSION 12 Claim Submission Methods 13 Diagnostic Coding 14 Procedural, Evaluation and Management, and HCPCS Coding 15 Claims Management UNIT IV ADVANCED APPLICATION 16 The Role of Computers in Health Insurance 17 Reimbursement Procedures: Getting Paid 18 Hospital Billing and the UB-04 Appendix A: Sample Blank CMS-1500 (02/12) Appendix B: CMS-1500 Claim Forms and Completion Instructions Appendix C: UB-04 Claim Forms and Completion Instructions Glossary Index

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Author Information

Julie Pepper has spent her entire career in health care as a medical assistant in a variety of offices and clinics, developing expertise in the electronic health record and as an instructor in a medical assistant program. She combines her education in dietetics with her clinical and administrative experience as an instructor in the Medical Assisting program at Chippewa Valley Technical College in Wisconsin, where she taught for 21 years and from where she retired from teaching. Julie was also the program director for the college's Health Navigator program. She has served as a reviewer and contributor to numerous Medical Assisting educational products over the last decade, including Sim Chart for the Medical Office. She currently serves as the sole author of The Electronic Health Record for the Physician's Office and The Simulated Administrative Medical Office. She has been leading author of Beik's Health Insurance Today text and workbook since the 8th edition. She also has been a coauthor for Kinn's Medical Assisting Fundamentals, Kinn's The Medical Assistant, and Today's Medical Assistant. Julie strives to bring the needed information to students in a way to keep them interested in learning all that they need to be wonderful employees working in healthcare.

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