Main description:

Develop the skills and background for a career in medical billing and insurance processing or revenue management with Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2021 Edition. This complete resource explains the latest medical code sets and coding guidelines as you learn how to assign ICD-10-CM, CPT, and HCPCS level II codes; complete health care claims and master revenue management concepts. You focus on today's most important topics, including managed care, legal and regulatory issues, coding systems and compliance, reimbursement methods, clinical documentation improvement, coding for medical necessity and common health insurance plans. Updates address changes to ICD-10-CM and CPT 2021 codes and introduce electronic claims processing, clinical quality language and other developments. A helpful workbook provides assignments; case studies and CPC-P and CPB mock exams, while MindTap online resources offer practice in CMS-1500 claims and assigning codes.

Contents:

1. Health Insurance Specialist Career.
2. Introduction to Health Insurance.
3. Managed Health Care.
4. Revenue Cycle Management.
5. Legal Aspects of Health Insurance and Reimbursement.
6. ICD-10-CM Coding.
7. CPT Coding.
8. HCPCS Level II Coding.
9. CMS Reimbursement Methodologies.
10. Coding Compliance, Clinical Documentation Improvement, and Coding for Medical Necessity.
11. CMS-1500 and UB-04 Claims.
12. Commercial Insurance.
13. BlueCross BlueShield.
14. Medicare.
15. Medicaid.
16. TRICARE.
17. Workers' Compensation.
Appendices.
Bibliography.
Glossary.
Index.