Main description:

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 (R) 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.

Contents:

1. Health Insurance Specialist Career.
2. Introduction to Health Insurance and Managed Care.
3. Introduction to Revenue Management.
4. Revenue Management of the Insurance Claim Cycle, Maintaining Insurance Claim Files, and Credit and Collections.
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.