Comprehensive Health Insurance: Billing, Coding, and Reimbursement by Deborah Vi

Description: Comprehensive Health Insurance by Deborah Vines, Ann Braceland, Elizabeth Rollins, Susan Miller Preceded by: Comprehensive health insurance / Deborah Vines ... [et al.]. 2nd ed. 2013. FORMAT Paperback LANGUAGE English CONDITION Brand New Publisher Description For courses in Introduction to Healthcare Billing and Medical Coding A clear illustration of the key health insurance concepts readers need to learn to be workplace ready Comprehensive Health Insurance: Billing, Coding, and Reimbursement provides readers with the knowledge and skills needed to work in a variety of administrative positions in the medical field. It covers the foundations of insurance, billing, coding, and reimbursement, offering a comprehensive view of how each element in the process affects all other steps. Students learn not only the submission of claims to the insurance carrier, but also reviewing medical records, verifying patient benefits, submitting a secondary claim, posting payments and appealing the insurance carriers decision. Numerous case studies and patient files are included throughout to demonstrate refunds and appeals, auditing, and compliance, Medicare calculations, and professionalism. The Third Edition includes 2017 ICD-10, CPT, and HCPCS codes; information about the ramifications of the Affordable Care Act; and current information on health care changes, trends, and the future of health care. For even more practice and review opportunities pair Comprehensive Health Insurance with the Student Workbook. The Workbook (ISBN: 0134787293) contains key terms, chapter objectives, chapter outlines, critical-thinking questions, practice exercises, review questions, and end-of-workbook tests/case study-type problems that test student knowledge of the key concepts presented in the core textbook. Also available with MyLab Health Professions for the Comprehensive Health Insurance course MyLab is an online homework, tutorial, and assessment program designed to work with this text to engage students and improve results. Within its structured environment, students have ample opportunity to practice what they learn and test their understanding to better absorb course material and understand difficult concepts. Note: You are purchasing a standalone product; MyLab does not come packaged with this content. Students, if interested in purchasing this title with MyLab, ask your instructor for the correct package ISBN and Course ID. Instructors, contact your Pearson representative for more information. If you would like to purchase both the physical text and MyLab, search for: 0134699815 / 9780134699813 Comprehensive Health Insurance: Billing, Coding, and Reimbursement Plus MyLab Health Professions with Pearson eText -- Access Card Package Package consists of: 013445877X / 9780134458779 Comprehensive Health Insurance: Billing, Coding, and Reimbursement 0134709705 / 9780134709703 MyLab Health Professions with Pearson eText -- Access Card -- for Comprehensive Health Insurance Author Biography Deborah Vines has worked extensively for more than 30 years in the healthcare industry as a practice administrator and manager in physical therapy, dermatopathology, and pediatrics. She has also held management positions in the hospital setting. As director of operations for a national healthcare staffing corporation, she has traveled across the United States, working directly with physicians and medical human resources personnel to secure jobs for individuals in the medical billing, coding, and collection fields. One of Ms. Viness mentionable achievements is that in one fiscal year, through mentoring and training, she assisted 300 recruits to find employment in the medical billing industry. This achievement led her to opening Allied Career Center in Dallas, Texas, a successful vocational school specializing in medical office specialist training. Ann Braceland, NCICS, has been working in the medical field since graduating from Gwynedd Mercy College with an associates degree in nursing science. As a practice manager, her extensive work in the field of managed care and medical billing and coding have allowed her to research and find means to inform others through her teaching of the changes and challenges that arise in the medical field. Mrs. Braceland has established and managed satellite offices in physical and occupational medicine. She is a Medicare representative with a vast spectrum of knowledge that she uses to train staff and physicians in compliance coding and billing. As director of training for the instructors of Allied Career Center in Dallas, Texas, her presentation of the material for students led to the publication of this book. Mrs. Braceland is a National Certified Insurance and Coding Specialist. Susan Miller has worked in the health care Industry for 25 years, managing and supervising medical billing processes. She has lectured in a classroom setting, providing students with knowledge and skills on medical billing and coding. Ms. Miller continues her health care career in Medical Billing, providing support to staff members on billing & coding guidelines. Table of Contents SECTION I: A CAREER IN HEALTH CARE 1. Introduction to Professional Billing and Coding Careers SECTION II: THE RELATIONSHIP BETWEEN THE PATIENT, PROVIDER, AND CARRIER 2. Understanding Managed Care: Insurance Plans 3. Understanding Managed Care: Medical Contracts and Ethics 4. Introduction to the Health Insurance Portability and Accountability Act (HIPAA) SECTION III: MEDICAL CODING 5. ICD-10-CM Medical Coding 6. Introduction to CPT and Place of Service Coding 7. Coding Procedures and Services 8. HCPCS and Coding Compliance 9. Auditing SECTION IV: MEDICAL CLAIMS 10. Physician Medical Billing 11. Hospital Medical Billing SECTION V: GOVERNMENT MEDICAL BILLING 12. Medicare Medical Billing 13. Medicaid Medical Billing 14. TRICARE Medical Billing SECTION VI: ACCOUNTS RECEIVABLE 15. Explanation of Benefits and Payment Adjudication 16. Refunds, Follow-Up, and Appeals SECTION VII: INJURED EMPLOYEE MEDICAL CLAIM 17. Workers Compensation Appendix A: Completing the CMS-1500 Form for Physician Outpatient Billing Appendix B: Completing the CMS-1500 Form for Physician Outpatient Billing Plus Determining the Correct Diagnostic and Procedure Codes Appendix C: Completing the UB-04 Form for Hospital Billing Appendix D: Medical Forms Appendix E: Acronyms and Abbreviations Appendix F: Medical Terminology Word Parts Appendix G: Helpful Websites Glossary Index Long Description For courses in Introduction to Healthcare Billing and Medical Coding A clear illustration of the key health insurance concepts readers need to learn to be workplace ready Comprehensive Health Insurance: Billing, Coding, and Reimbursement provides readers with the knowledge and skills needed to work in a variety of administrative positions in the medical field. It covers the foundations of insurance, billing, coding, and reimbursement, offering a comprehensive view of how each element in the process affects all other steps. Students learn not only the submission of claims to the insurance carrier, but also reviewing medical records, verifying patient benefits, submitting a secondary claim, posting payments and appealing the insurance carriers decision. Numerous case studies and patient files are included throughout to demonstrate refunds and appeals, auditing, and compliance, Medicare calculations, and professionalism. The Third Edition includes 2017 ICD-10, CPT, and HCPCS codes; information about the ramifications of the Affordable Care Act; and current information on health care changes, trends, and the future of health care. For even more practice and review opportunities pair Comprehensive Health Insurance with the Student Workbook. The Workbook (ISBN: 0134787293) contains key terms, chapter objectives, chapter outlines, critical-thinking questions, practice exercises, review questions, and end-of-workbook tests/case study-type problems that test student knowledge of the key concepts presented in the core textbook. Also available with MyLab Health Professions for the Comprehensive Health Insurance course MyLab is an online homework, tutorial, and assessment program designed to work with this text to engage students and improve results. Within its structured environment, students have ample opportunity to practice what they learn and test their understanding to better absorb course material and understand difficult concepts. Note: You are purchasing a standalone product; MyLab does not come packaged with this content. Students, if interested in purchasing this title with MyLab, ask your instructor for the correct package ISBN and Course ID. Instructors, contact your Pearson representative for more information. If you would like to purchase both the physical text and MyLab, search for: 0134699815 / 9780134699813 Comprehensive Health Insurance: Billing, Coding, and Reimbursement Plus MyLab Health Professions with Pearson eText -- Access Card Package Package consists of: 013445877X / 9780134458779 Comprehensive Health Insurance: Billing, Coding, and Reimbursement 0134709705 / 9780134709703 MyLab Health Professions with Pearson eText -- Access Card -- for Comprehensive Health Insurance Feature Comprehensive Health Insurance: Billing, Coding, and Reimbursement, Third Edition, features: Work-related presentation focuses on the most practical information students need to learn about healthcare billing and coding to be successful on the job. Step-by-step organization progresses through each stage of the medical billing process and uses each chapter to build on the other. Hands-on practice exercises provide experiences that helps students retain information, stay involved in the course, and achieve mastery of skills. Case studies with critical-thinking questions offer thought-provoking glimpses at real work conditions and help students hone their decision-making skills. Examples stress the correct billing and coding guidelines and reinforce best practice. Professional tips provide additional information related to billing and coding processes the student might use on the job. HIPAA material is covered in detail in Chapter 4 so that students can identify important information concerning the "need to know" law. Student-friendly features appear in each chapter, including: Chapter Objectives; Key Terms; Chapter Introductions; Chapter Summaries; Chapter Reviews; For Additional Practice Case Studies; and Resources. UPDATED: Content throughout the text reflects current information on health care changes, trends, and the future of health care. Ten highlighted trends include: more patients; more technology; more information; the patient as the ultimate consumer; development of a different delivery model; innovation driven by competition; increasing costs; increasing numbers of uninsured; less pay for providers; and the continued need for a new healthcare system. UPDATED: The Affordable Care Act (ACA) is discussed in the text, giving readers a better understanding of this law and its impact on healthcare insurance and billing. Additionally, Chapter 13 briefly discusses changes in Medicaid implemented by the ACA that allow states to opt in or opt out of the Medicaid expansion program. NEW: The Concierge Medicine and Telemedicine, new methods of healthcare treatment and cost saving programs, are discussed. UPDATED: 2017 ICD-10, CPT, and HCPCS codes are used throughout all of the coding information and exercises. Chapter 5 addresses the new way to code the International Classification of Diseases using 4-7 alpha characters for more specificity about the patients health problem. UPDATED: The new CMS-1500 form is reviewed in detail and all related exercises and examples include the (02-2012) form, the official standard Medicare and Medicaid health insurance claim form required by the Centers for Medicare & Medicaid Services. UPDATED: New Figures and Tables illustrate key concepts, helping students better make connections between important ideas. Also available with MyLab Health Professions for the Comprehensive Health Insurance course MyLab(tm) Health Professions is an online homework, tutorial, and assessment program designed to work with this text to engage students and improve results. Within its structured environment, students have ample opportunity to practice what they learn and test their understanding to better absorb course material and understand difficult concepts. Engage different types of learners. Students are encouraged to interact and apply what theyve learned through a variety of exercises. Pre-test, Post-test, and Review help students identify areas where they have or need knowledge. Homework allows students to test and understand chapter concepts. CMS-1500 and UB-04 Exercises give students an opportunity to practice on actual forms used in the medical office. Activities for CPT, Benefits & Payment, and Refunds & Appeals case studies help students think through and apply information critically. Help your students get exam ready! Our practice AAPC CPC and AHIMA CCA Certification Exams are modeled after the actual exam blueprints. Auto-graded to save you time, your students will receive feedback and rationale on each question upon completion of the exams. The two full-length practice exams are pre-populated and ready to assign. Track students progress. Assessment tied to thousands of exercises enables both instructors and students to track progress and get immediate feedback. With results feeding into a powerful gradebook , the assessment program helps instructors identify student challenges early-and find the best resources with which to help students. Digital access anytime, anywhere. The Pearson eText gives students access to their textbook anytime, anywhere. Features include note taking, highlighting, and bookmarking. Instructors can share their comments or highlights, and students can add their own, creating a tight community of learners in your class. The Pearson eText companion app allows existing subscribers to access their titles on an iPad or Android tablet for either online or offline viewing. New Feature UPDATED: Content throughout the text reflects current information on health care changes, trends, and the future of health care. Ten highlighted trends include: more patients; more technology; more information; the patient as the ultimate consumer; development of a different delivery model; innovation driven by competition; increasing costs; increasing numbers of uninsured; less pay for providers; and the continued need for a new healthcare system. UPDATED: The Affordable Care Act (ACA) is discussed in the text, giving readers a better understanding of this law and its impact on healthcare insurance and billing. Additionally, Chapter 13 briefly discusses changes in Medicaid implemented by the ACA that allow states to opt in or opt out of the Medicaid expansion program. The Concierge Medicine and Telemedicine, new methods of healthcare treatment and cost saving programs, are discussed. UPDATED: 2017 ICD-10, CPT, and HCPCS codes are used throughout all of the coding information and exercises. Chapter 5 addresses the new way to code the International Classification of Diseases using 4-7 alpha characters for more specificity about the patients health problem. UPDATED: The new CMS-1500 form is reviewed in detail and all related exercises and examples include the (02-2012) form, the official standard Medicare and Medicaid health insurance claim form required by the Centers for Medicare & Medicaid Services. UPDATED: New Figures and Tables illustrate key concepts, helping students better make connections between important ideas. Details ISBN013445877X Author Susan Miller ISBN-10 013445877X ISBN-13 9780134458779 Format Paperback Pages 800 Year 2017 Short Title Comprehensive Health Insurance Language English Edition 3rd Subtitle Billing, Coding, and Reimbursement Publication Date 2017-06-15 UK Release Date 2017-06-15 Country of Publication United States Place of Publication Upper Saddle River Imprint Pearson AU Release Date 2017-06-15 NZ Release Date 2017-06-15 US Release Date 2017-06-15 Publisher Pearson Education (US) Edition Description 3rd edition Replaces 9780134294278 DEWEY 368.382 Audience Tertiary & Higher Education We've got this At The Nile, if you're looking for it, we've got it. With fast shipping, low prices, friendly service and well over a million items - you're bound to find what you want, at a price you'll love! TheNile_Item_ID:136547109;

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