Health

Understanding Health Insurance

With Understanding Health Insurance: A Guide to Billing and Reimbursement, you will learn about managed health care, legal and regulatory issues, coding systems, reimbursement methodologies, coding for medical necessity, and common health insurance plans. Exercises in each chapter give you plenty of practice to learn how to bill and reimburse. The accompanying workbook provides more application-based assignments for each chapter, content review, and additional case studies.

Medical Insurance: An Integrated Claims Process Approach

The fourth edition of Medical Insurance: An Integrated Claims Process Approach is designed for medical insurance courses. The textbook provides medical assisting, medical insurance, and health information technology students with the knowledge and skills needed to successfully perform insurance and billing related duties.

The chapters’ organization follows the medical billing process to enhance learning, moving from a comprehensive introductory chapter through processing RA/EOBs and handling patient collections. Every chapter has extensive illustrations, forms, and exercises to develop the required competencies as well as exercises to improve underlying essential math and communications skills. This text also provides a fundamental understanding of diagnostic and procedural coding needed to submit claims in compliance with payers’ requirements. New for this edition is a text-specific workbook which provides both review and applications of each textbook chapter.

Insurance Handbook for the Medical Office

Trusted by medical insurance specialists for more than 30 years, Insurance Handbook for the Medical Office helps you excel at all aspects of insurance billing for a full range of today's health care plans. This edition helps you keep pace with industry changes, featuring the latest information on HIPAA regulations, diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, and more. The accompanying Student Workbook with CD-ROM (sold separately) lets you practice "real world" billing with patient simulations using Altapoint and the Student Software Challenge.

• Procedural (CPT and HCPCS) and diagnostic (ICD-9-CM) coding and documentation are emphasized, since they are the keystones to obtaining maximum reimbursement.
• Key terms are bolded at first mention, explained within the context of the discussion, and defined in the glossary.
• Separate chapters on Electronic Data Interchange and HIPAA Compliance and Privacy in Insurance Billing provide essential knowledge of electronic claims filing, informing you of submission guidelines used in the majority of medical offices today.
• Icons clearly identify each insurance payer with a specific color and graphic, making specific information easy to locate.
• Compliance features located at appropriate points throughout most chapters offer tips to ensure compliance with correct billing and coding practice, particularly HIPAA and OIG.
• A separate chapter on documentation in the medical office describes how proper documentation can prevent penalties and refund requests, and help you prove compliance in the case of an audit or review.
• Detailed examples and samples of completed insurance forms show you how to apply knowledge in the real world.
• Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist's role in filing clean claims, solving problems that do occur, and collecting overdue payments.
• Service to Patient feature throughout the chapters focuses on ways to provide quality service to the patient as well as your co-workers.

• All content has been reviewed by industry experts and meticulously updated to reflect recent changes in insurance claim filing.
• In addition to the list of key terms at the beginning of each chapter, a separate list of key abbreviations clarifies common terms identified in the field primarily by their abbreviations.
• Key points at the end of each chapter briefly summarize important chapter content to help you better understand the subject matter.

Life and Health Insurance License Exam Cram

If you are studying for your life and health insurance licensing exam, we have the ultimate study tool for you. Life and Health Insurance License Exam Cram is a great resource to help you learn the concepts, laws, rate calculations and state and federal regulations that will be covered on the exam. You'll also receive a CD that includes a fully-customizable test engine, detailed score report and state-specific law supplement. No matter where you are taking your exam or which area you need to focus on during your studying, Life and Health Insurance License Exam Cram is your smartest way to get certified.

One Nation, Uninsured: Why the U.S. Has No National Health Insurance

Every industrial nation in the world guarantees its citizens access to essential health care services--every country, that is, except the United States. In fact, one in eight Americans--a shocking 43 million people--do not have any health care insurance at all.
One Nation, Uninsured offers a vividly written history of America's failed efforts to address the health care needs of its citizens. Covering the entire twentieth century, Jill Quadagno shows how each attempt to enact national health insurance was met with fierce attacks by powerful stakeholders, who mobilized their considerable resources to keep the financing of health care out of the government's hands. Quadagno describes how at first physicians led the anti-reform coalition, fearful that government entry would mean government control of the lucrative private health care market. Doctors lobbied legislators, influenced elections by giving large campaign contributions to sympathetic candidates, and organized "grassroots" protests, conspiring with other like-minded groups to defeat reform efforts. As the success of Medicare and Medicaid in the mid-century led physicians and the AMA to start scaling back their attacks, the insurance industry began assuming a leading role against reform that continues to this day.
One Nation, Uninsured offers a sweeping history of the battles over health care. It is an invaluable read for anyone who has a stake in the future of America's health care system.

Medical Insurance Made Easy: Understanding the Claim Cycle

This combination textbook and workbook, explains each phase of the medical claim cycle, from the time the patient calls for an appointment until the financial transaction for the encounter is completed. Coverage includes types of insurance payers, basic coding and billing rules, and standard requirements for outpatient billing using the CMS-1500 claim form. It also emphasizes legal aspects related to each level of the medical claim cycle and the importance of the medical office employee, showing their responsibility for and impact on successful reimbursement.

• 3 separate chapters offer coverage of the basic concepts of medical coding.
• A comprehensive overview of the CMS-1500 claim form with step-by-step guidelines and illustrations thoroughly covers reimbursement issues and explains the billing process.
• Includes detailed information on various insurance payers and plans including Medicare, government medical plans, disability plans, private indemnity plans, and managed care.
• Stop & Review sections illustrate how the concepts presented in each chapter relate to real-life billing situations.
• Sidebars and Examples highlight key concepts and information related to the core text lesson.
• A companion CD-ROM contains sample patient and insurance information that readers can use to practice completing the accompanying CMS-1500 claim form, as well as a demonstration of Altapoint practice management software.

• Features completely updated information that reflects the many changes in the insurance industry.
• Contains a new chapter on UB-92 insurance billing for hospitals and outpatient facilities.
• Includes a new appendix, Quick Guide to HIPAA for the Physician's Office, to provide a basic overview of the important HIPAA-related information necessary on the job.

Medical Billing 101

Learn the basics of physician-based medical billing with Medical Billing 101. Clear and practical guidelines introduce you to the job responsibilities and basic processes comprising the medical billing world. Case studies and application tools offer you practice on actual forms to build confidence in your new knowledge and skills. This resource starts you off right on your journey to becoming a medical billing professional.

Uninsured in America: Life and Death in the Land of Opportunity

Uninsured in America goes to the heart of why more than forty million Americans are falling through the cracks in the health care system, and what it means for society as a whole when so many people suffer the consequences of inadequate medical care. Based on interviews with 120 uninsured men and women and dozens of medical providers, policymakers, and advocates from around the nation, this book takes a fresh look at one of the most important social issues facing the United States today. A new afterword updates the stories of many of the people who are so memorably presented here.

Insurance Handbook for the Medical Office

Keep current with all the latest changes with this complete resource! Trusted by medical insurance instructors and billers for more than 30 years, Insurance Handbook for the Medical Office helps you excel at all aspects of insurance billing for a full range of today's health care plans. In full color, this edition includes all the new regulations, such as the latest information on HIPAA, diagnostic coding, procedural coding, bill collection strategies, and Medicare.

• Meticulously reviewed by a panel of industry experts.
• Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist's role in filing clean claims, solving problems, and collecting overdue payments.
• Key terms are bolded at first mention, explained within the context of the discussion, and defined in the glossary.
• Key points summarize important chapter content.
• Block-by-block explanations and examples demonstrate the correct way to complete the CMS-1500 claim form.
• Completed sample insurance forms apply concepts to real life.
• Unique payer icons clarify CMS claim form completion.
• Form icons and Computer icons ease the transition from paper to electronic filing.
• Special HIPAA Alerts ensure compliance with governmental privacy regulations.
• Guidelines for the filing and submission of electronic claims include the do's and don'ts for the electronic environment.
• Service to Patient features discuss ways to provide quality service to the patient as well as to your co-workers.
• A documentation chapter covers the principles of documentation and shows how proper documentation can prevent penalties and refund requests, and help you prove compliance in the case of an audit or review.
• An Evolve website includes supplemental Medisoft activities, self-assessment quizzes, updates of content, and web links for further research and study.
• A workbook contains learning tips, review exercises, cases, and critical thinking activities for hands-on experience with real-world cases. (Available separately.)

• Updated learning objectives correlate directly to the text, making it easier to study and to measure your progress.
• New CMS-1500 form filler software on Evolve provides additional exercises for hands-on practice.

Workbook for Insurance Handbook for the Medical Office

WORKBOOK FOR INSURANCE HANDBOOK FOR THE MEDICAL OFFICE, 10th Edition is an essential learning resource that will enhance and improve your study of Fordney's Insurance Handbook for the Medical Office. The workbook conveniently parallels material in the text, and provides realistic, hands-on exercises that help you apply concepts and develop important critical-thinking skills. An accompanying CD-ROM lets you practice "real world" billing with patient simulations using Altapoint and the Student Software Challenge.

• Student Software Challenge, on the enclosed CD, contains 10 patients cases you can use for practice in completing the CMS-1500 claim form.
• Practice management software (AltaPoint), also on the enclosed CD, for use with select claim form completion exercises within the workbook.
• Evolve online resources provide Internet activities and active weblinks from the text.
• Key terms, performance objectives, and a study outline for each chapter, are designed to be used as a quick reference for faster, more effective study.
• The self-study review provides an interactive review in the form of matching, true/false, multiple choice, and fill-in-the-blank questions and answers, so you can test your retention of key material.
• Critical thinking assignments present short, real-world scenarios that prepare you for work in today's medical office environment.

• Key Abbreviation list clarifies the multitude of common abbreviations used in health insurance billing.
• Improved software instructions clearly explain how to install, access, and use all software elements. All software instructions are now conveniently located in the Appendix - one central location for fast reference and ease of use.