Workbook for Health Insurance Today - Elsevier eBook on VitalSource, 8th Edition

Performance-based activities include hands-on, application-based learning exercises that provide practice in areas such as completing claim forms, posting payments to a patient's ledger, filling out Release to Return to Work forms, and filling out Medicare appeals. Critical thinking activities strengthen your ability to apply health insurance concepts to a variety of challenging situations. Chapter assessments test your knowledge with multiple choice, true/false, short answer, fill-in-the-blank, and matching questions. Problem-solving and collaborative (group) activities emphasize the importance of teamwork in the healthcare field. Case studies ask you to solve real-world problems related to health insurance, such as completing a CMS-1500 claim form or explaining how HIPAA could affect someone recently out of work. Application exercises ask you to apply your knowledge and skills to real-world situations. In-class projects and discussion topics enhance your understanding of specific content from the text. Internet Exploration exercises in each chapter help you learn how to perform and evaluate research online. Defining Chapter Terms activities help you review and understand the key terms in each chapter.

UNIT ONE. BUILDING A FOUNDATION
1. The Origins of Health Insurance
2. Tools of the Trade. A Career as a Health Insurance (Medical) 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 TWO. 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 THREE. CLAIMS SUBMISSION
12. Claim Submission Methods
13. Diagnostic Coding
14. Procedural, Evaluation and Management, and HCPCS Coding
15. Claims Management

UNIT FOUR. ADVANCED APPLICATION
16. The Role of Computers in Health Insurance
17. Reimbursement Procedures. Getting Paid
18. Hospital Billing and the UB-04

Appendix. Blank Forms

Julie Pepper, BS, CMA (AAMA), Professor Emeritus, Medical Assistant Program, Chippewa Valley Technical College, Eau Claire, Wisconsin, USA