Overview

COMPREHENSIVE HEALTH INSURANCE: BILLING, CODING & REIMBURSEMENT, 2/e provides students with the knowledge and skills needed to work in a variety of medical billing and coding positions in the medical field. Comprehensive in approach, it covers the foundations of insurance, billing, coding and reimbursement. Students learn not only the submission of claims to the insurance carrier, but also reviewing medical records, verifying patient benefits, submitting a secondary claim, posting payments and appealing the insurance carrier's decision. This edition includes new chapters devoted to HIPAA and ICD-10-CM Medical Coding, as well as outstanding coverage of electronic records. Numerous case studies and patient files are included throughout and demonstrate refunds and appeals, auditing and compliance, Medicare calculations and professionalism.

Full Product Details

Author:   Deborah Vines ,  Ann Braceland ,  Elizabeth Rollins ,  Susan Miller
Publisher:   Pearson Education (US)
Imprint:   Pearson
Edition:   2nd edition
Dimensions:   Width: 22.00cm , Height: 3.00cm , Length: 27.50cm
Weight:   1.820kg
ISBN:  

9780132966894

ISBN 10:   0132966891
Pages:   984
Publication Date:   30 October 2012
Audience:   College/higher education ,  Tertiary & Higher Education
Format:   Paperback
Publisher's Status:   Active
Availability:   In Print  
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Table of Contents

SECTION I: A CAREER IN HEALTH CARE 1. Introduction to Professional Billing and Coding Careers SECTION II: THE RELATIONSHIP BETWEEN THE PATIENT, PROVIDER, AND CARRIER 2. Understanding Managed Care: Insurance Plans 3. Understanding Managed Care: Medical Contracts and Ethics 4. HIPAA: Health Insurance Portability and Accountability Act of 1996 SECTION III: MEDICAL CODING 5. ICD-9-CM Medical Coding 6. ICD-10-CM Medical Coding 7. Introduction to CPT and Place of Service Coding 8. Coding Procedures and Services 9. HCPCS and Coding Compliance 10. Auditing SECTION IV: MEDICAL CLAIMS 11. Physician Medical Billing 12. Hospital Medical Billing SECTION V: GOVERNMENT MEDICAL BILLING 13. Medicare Medical Billing 14. Medicaid Medical Billing 15. TRICARE Medical Billing SECTION VI: ACCOUNTS RECEIVABLE 16. Explanation of Benefits and Payment Adjudication 17. Refunds and Appeals SECTION VII: INJURED EMPLOYEE MEDICAL CLAIM 18. Workers' Compensation SECTION VIII: USE OF MEDICAL PRACTICE MANAGEMENT SOFTWARE 19. Electronic Medical Claims Processing

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