Health Insurance Today, A Practical Approach, 3rd Edition

Health Insurance Today

3rd Edition A Practical Approach

By Janet I. Beik, AA, BA, MEd, Southeastern Community College (retired), Administrative Instructor, Medical Assistant Program, West Burlington, IA, USA


 

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 & Ethical Side of Medical Insurance

4. Types and Sources of Health Insurance

UNIT 2 - HEALTH INSURANCE BASICS

5. The "Universal" Claim Form: CMS-1500

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: Worker?s Compensation and Disability Insurance

UNIT 3 - CRACKING THE CODES

12. Diagnostic Coding

13. Procedural, Evaluation & Management 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 Claim Form: The UB-04

Appendix A

Appendix B

Appendix C

Glossary

Index