Health Insurance Today - Elsevier eBook on VitalSource, 7th Edition

• What Did You Learn? review questions, Imagine This! scenarios, and Stop and Think exercises ensure that you understand the material, can apply it to real-life situations, and develop critical thinking skills.
• Clear, attainable learning objectives highlight the most important information in each chapter.
• CMS-1500 software with case studies on the Evolve companion website provides hands-on practice with filling in a CMS-1500 form electronically.
• UNIQUE! UB-04 software with case studies on Evolve provides hands-on practice with filling in UB-04 forms electronically.
• UNIQUE! SimChart^® for the Medical Office (SCMO) cases on Evolve give you real-world practice in an EHR environment.
• HIPAA Tips emphasize the importance of privacy and of following government rules and regulations.
• Direct, conversational writing style makes it easier to learn and remember the material.
• End-of-chapter summaries relate to the chapter-opening learning objectives, provide a thorough review of key content, and allow you to quickly find information for further review.
• Chapter review questions on Evolve help you assess your comprehension of key concepts

• NEW and UNIQUE! Patient’s Point of View boxes enable you to imagine yourself on the other side of the desk.
• NEW and UNIQUE! Opening and closing chapter scenarios present on-the-job challenges that must be resolved using critical thinking skills.
• NEW! End-of-chapter review questions ensure that you can understand and apply the material.
• NEW! Clear explanations show how electronic technology is used in patient verification, electronic claims, and claims follow-up.
• NEW! Coverage of the Affordable Care Act introduces new and innovative ways that modifications to the ACA allow people to acquire healthcare coverage.
• NEW! Updated information addresses all health insurance topics, including key topics like Medicare and Electronic Health Records.
• NEW! More emphasis on electronic claims submission has been added.
• NEW! Updated figures, graphs, and tables summarize the latest health insurance information.

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 Medical 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, Evaluation and Management, and HCPCS Coding
Unit 4: The Claims Process
14. The Patient
15. Keys to Successful Claims Management
Unit 5: 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 Form and Completion Instructions
Glossary