Corresponding chapter-by-chapter to Health Insurance Today, 5e, Elsevier Adaptive Learning combines the power of brain science with sophisticated, patented Cerego algorithms to help you learn faster and remember longer. It’s fun; it’s engaging; and it’s constantly tracking your performance and adapting to deliver content precisely when it’s needed to ensure core information is transformed into lasting knowledge.
Unit 1: Building a Foundation 1. The Origins of Health Insurance 2. Tools of the Trade: A Career as a Health (Medical) Insurance Professional 3. The Legal and Ethical Side of Health Insurance 4. Types and Sources of Health Insurance
Unit 2: Health Insurance Basics 5. Claim Submission Methods 6. Traditional Fee-for-Service/Private Plans 7. Unraveling the Mysteries of Managed Care 8. Understanding Medicaid 9. Conquering Medicare’s Challenges 10. Military Carriers 11. Miscellaneous Carriers: Workers’ Compensation and Disability Insurance
Unit 3: Cracking the Codes 12. Diagnostic Coding 13. Procedural, E&M, and HCPCS Coding
Unit 4: The Claims Process 14. The Patient 15. The Claim
Unit 5: Advanced Application 16. The Role of Computers in Health Insurance 17. Reimbursement Procedures: Getting Paid 18. Hospital Billing and the UB-04 Appendixes Appendix A: Sample Blank CMS-1500 (08/05) Appendix B: CMS-1500 Claim Form and Completion Instructions Appendix C: UB-40 Claim Form and Completion Instructions Glossary