Congress has seen a renewed interest in the market for private health insurance since the passage of the Patient Protection and Affordable Care Act (ACA). This book provides an overview of private-sector (as opposed to government-provided) health insurance. It serves as an introduction to health insurance from the point of view of many consumers under the age of 65. Furthermore, the book provides background information about modifying or building on the current health insurance system; discusses how understanding the potential impact of such proposals requires a working knowledge of how health insurance is provided, purchased, and regulated; and describes various ACA provisions that affect the private insurance market.
Understanding Health Insurance: A Guide to Billing and Reimbursement, 8th Edition is a comprehensive source for teaching the subject of health insurance and reimbursement. The book contains chapters on introductory information on the health insurance field, managed health care, legal and regulatory issues, coding systems, reimbursement methodologies, coding for medical necessity, and common health insurance plans. Each chapter contains exercises to illustrate content and reinforce learning. Numerous opportunities are provided throughout the book for manual completion of CMS-1500 claims. A CD-ROM at the back of the book allows for electronic data entry of CMS-1500 claim form information. End of chapter review questions in objective format (e.g., multiple choice) test learners on their understanding of book content. Appendices I and II provide case studies that are also included on the Student Practice CD-ROM. Additional appendices provide instruction in dental claims processing and completion of the UB-92 (claim used for inpatient and outpatient hospital claims). The accompanying workbook provides application based assignments for each chapter, additional content review (multiple choice questions), and additional case studies for practice in completing CMS-1500 claims. This edition of the book contains the most up to date information regarding health insurance claims processing and coding and reimbursement issues.
Discover the essential tool to prepare for a career in medical insurance billing -- UNDERSTANDING HEALTH INSURANCE, 13E. This comprehensive, easy-to-understand, updated book presents the latest code sets and guidelines. You cover today's most important topics, such as managed care, legal and regulatory issues, coding systems, reimbursement methods, medical necessity, and common health insurance plans. Updates introduce new legislation that impacts health care, including the Affordable Care Act (Obamacare); ICD-10-CM coding; electronic health records; Medicaid Integrity Contractors; case mix management; hospital-acquired conditions; present on admission; and value-based purchasing. Practice exercises and the workbook (available separately) provides application-based assignments and case studies to reinforce your understanding, as well as CMRS, CPC-P, and CPB Mock Exams. New editions include online access to SimClaim CMS-1500 claims completion software and Optum's EncoderPro.com Expert.
Use your social work skills to advocate for more effective health care!
?VERY USEFUL TO STUDENTS. . . . One of the few works available that includes a useful discussion of social work practice in nursing homes.?
?EFFECTIVE. . . . presents generic and special knowledge requirements for social work practice in health care settings, including values, ethics, and issues of diversity.?
?Social Work Agenda
?The book is CLEARLY WRITTEN, and is thought-provoking concerning the role of the social work practitioner in health settings and the nature of the linkage between health and social care. Despite the fact that it is American in origin, it is of relevance to multi-disciplinary and international audiences and contains much which will be OF INTEREST TO STUDENTS AND EDUCATORS AS WELL AS PRACTITIONERS.?
?Journal of Social Work
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