Understanding Health Insurance: A Guide to Billing and Reimbursement – 2022 Edition: 2022 Edition PDF Free Download [Direct Link]

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Overview

So, we understand that you are interested in learning more about health insurance. It is a highly read topic especially medical insurance and life insurance. You have come to right place as in this blog post, we are going to share with you very helpful study material for the said topic. Here’s the complete overview of Understanding Health Insurance PDF:

Strengthen your skills and develop a solid foundation in medical insurance processing and revenue management with Green’s UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2022 Edition. This reader-friendly, comprehensive resource explains the latest developments and medical code sets and coding guidelines as you learn how to assign ICD-10-CM, CPT 2022 codes and HCPCS level II codes, complete health care claims and master revenue management concepts. You focus on important topics such as the latest managed care, legal and regulatory issues, coding systems and compliance, reimbursement methods, clinical documentation improvement, coding for medical necessity and common health insurance plans. New material introduces electronic claims, performance measurement and processing clinical quality language. A helpful workbook provides hands-on assignments and case studies, while MindTap online resources offer practice in CMS-1500 claims completion and assigning codes.

Features of Understanding Health Insurance: A Guide to Billing and Reimbursement – 2022 Edition

Here’s a quick overview of the essential features of this book:

• Detailed information on complete healthcare insurance claims

Table of Contents

Below is the complete table of contents offered inside Understanding Health Insurance: A Guide to Billing and Reimbursement – 2022 Edition:

1. Table of Contents
2. Preface
3. About the Author
4. Reviewers
5. Acknowledgments
6. How to Use This Text
7. SimClaim CMS-1500 Software User Guide
8. Chapter 1: Health Insurance Specialist Career
9. Health Insurance Overview
10. Career Opportunities
11. Education and Training
12. Job Responsibilities
13. Independent Contractor and Employer Liability
14. Professionalism
15. Telephone Skills for the Health Care Setting
16. Professional Associations and Credentials
17. Chapter 2: Introduction to Health Insurance and Managed Care
18. Overview of Health Insurance and Managed Care
19. Major Developments in Health Insurance and Managed Care
20. Managed Care
21. Characteristics of Health Plans and Managed Care
22. Consumer-Directed Health Plans
23. Health Care Documentation
24. Electronic Health Record (EHR)
25. Chapter 3: Introduction to Revenue Management
26. Revenue Management
27. Managing Patients
28. Encounter Form and Chargemaster
29. Processing an Insurance Claim
30. Posting Charges to Patient Accounts
31. Monitoring and Auditing for Revenue Management
32. Chapter 4: Revenue Management: Insurance Claims, Denied Claims and Appeals, and Credit and Collectio
33. Insurance Claim Cycle
34. Maintaining Insurance Claim Files
35. Denied Claims and the Appeals Process
36. Credit and Collections
37. Chapter 5: Legal Aspects of Health Insurance and Reimbursement
38. Overview of Laws and Regulations
39. Federal Laws and Events That Affect Health Care
40. Retention of Records
41. Health Care Audit and Compliance Programs
42. Health Insurance Portability and Accountability Act (HIPAA)
43. Chapter 6: ICD-10-CM Coding
44. General Equivalence Mappings
45. Overview of ICD-10-CM and ICD-10-PCS
46. ICD-10-CM Coding Conventions
47. ICD-10-CM Index and Tabular List
48. Official Guidelines for Coding and Reporting
49. Chapter 7: CPT Coding
50. Organization of CPT
51. CPT Index
52. CPT Modifiers
53. Evaluation and Management Section
54. Anesthesia Section
55. Surgery Section
56. Radiology Section
57. Pathology and Laboratory Section
58. Medicine Section
59. CPT Category II and Category III Codes
60. Chapter 8: HCPCS Level II Coding
61. Purpose of HCPCS Level II Codes
62. Organization of HCPCS Level II Codes
63. Documentation and Submission Requirements for Reporting HCPCS Level II Codes
64. Assigning HCPCS Level II Codes and Modifiers
65. Chapter 9: CMS Reimbursement Methodologies
66. CMS Reimbursement
67. CMS Fee Schedules
68. CMS Payment Systems
69. Chapter 10: Coding Compliance Programs, Clinical Documentation Improvement, and Coding for Medical N
70. Coding Compliance Programs
71. Clinical Documentation Improvement
72. Coding for Medical Necessity
73. Coding from Case Scenarios and Patient Records
74. Chapter 11: CMS-1500 and UB-04 Claims
75. General Claims Information
76. CMS-1500 Data Entry
77. Processing Secondary CMS-1500 Claims
78. Common Errors That Delay CMS-1500 Claims Processing
79. Final Steps in Processing CMS-1500 Claims
80. Maintaining CMS-1500 Insurance Claim Files for the Medical Practice
81. UB-04 Claim
82. Chapter 12: Commercial Insurance
83. Commercial Health Insurance
84. Automobile, Disability, and Liability Insurance
85. Commercial Claims Instructions
86. Commercial Secondary Coverage Claims Instructions
87. Commercial Group Health Plan Coverage Claims Instructions
88. Chapter 13: BlueCross BlueShield
89. BlueCross BlueShield
90. BlueCross BlueShield Plans
91. BlueCross BlueShield Billing Notes
92. BlueCross BlueShield Claims Instructions
93. BlueCross BlueShield Secondary Coverage Claims Instructions
94. Chapter 14: Medicare
95. Medicare Eligibility and Enrollment
96. Medicare Coverage
97. Medicare Participating, Nonparticipating, and Opt-Out Providers
98. Advance Beneficiary Notice of Noncoverage
99. Medicare as Primary and Secondary Payer
100. Medicare Summary Notice
101. Medicare Billing Notes
102. Medicare Claims Instructions
103. Medicare and Medigap Claims Instructions
104. Medicare-Medicaid (Medi-Medi) Crossover Claims Instructions
105. Medicare as Secondary Payer Claims Instructions
106. Medicare Roster Billing for Mass Vaccination Programs Claims Instructions
107. Chapter 15: Medicaid
108. Medicaid Eligibility
109. Medicaid Coverage
110. Medicaid Reimbursement
111. Medicaid Billing Notes
112. Medicaid Claims Instructions
113. Medicaid as Secondary Payer Claims Instructions
114. Medicaid Parent/Newborn Claims Instructions
115. CHIP Claims Instructions
116. Chapter 16: TRICARE
117. TRICARE History
118. TRICARE Administration
119. CHAMPVA
120. TRICARE Coverage
121. TRICARE Billing Notes
122. TRICARE Claims Instructions
123. TRICARE as Secondary Payer Claims Instructions
124. TRICARE and Supplemental Coverage Claims Instructions
125. Chapter 17: Workers’ Compensation
126. Federal and State Workers’ Compensation Programs
127. Eligibility for Workers’ Compensation Coverage
128. Classification and Billing of Workers’ Compensation Cases
129. Workers’ Compensation and Managed Care
130. Forms and Reports
131. Appeals and Adjudication
132. Fraud and Abuse
133. Workers’ Compensation Billing Notes
134. Workers’ Compensation Claims Instructions
135. Appendix I: Forms
136. Appendix II: Dental Claims Processing
137. Appendix III: Abbreviations
138. Bibliography
139. Glossary
140. Index

Understanding Health Insurance: A Guide to Billing and Reimbursement PDF Free Download

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