Prepare your students for career success with this trusted introduction to the world of health insurance billing and the dynamic, growing field of health information management. A GUIDE TO HEALTH INSURANCE BILLING, Fourth Edition, provides a thorough, practical overview of key principles and current practices, from patient registration to claims submission. Now updated to reflect the latest trends, technology, terminology, legal and regulatory guidelines, and coding systems—including ICD-10—the new edition also features a dynamic full-color layout designed to engage today's students. The text includes abundant exercises, examples, case studies, and activities focused on real-world applications, including step-by-step procedures for generating, processing, and submitting health insurance claims to commercial, private, and government insurance programs. An access code for SimClaim interactive online billing software is also provided; this program puts students' skills to the test with case studies that require form completion.
Table of Contents
1. The Insurance Billing Specialist.
2. Legal Aspects of Insurance Billing.
3. Introduction to Health Insurance.
4. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM/PCS).
5. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM).
6. Current Procedural Terminology (CPT) and Healthcare Common Procedure.
7. Developing An Insurance Claim.
8. Common CMS-1500 Completion Guidelines: Private/Commercial Insurance.
9. Electronic Claims Submission.
10. UP-04 (CMS-1450) Completion Guidelines.
11. Blue Cross/Blue Shield.
14. TRICARE and CHAMPVA.
15. Workers Compensation.
Appendix A: Superiorland Clinic Practice Manual.
Appendix B: Assignments: Case Study 2-1 Through Case Study 2-10.
Appendix C: Abbreviations.