- 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.

A bestseller for over 25 years, this text helps users excel at all aspects of insurance billing: submitting, tracing, appealing, and transmitting claims. Its comprehensive coverage also includes important information on diagnostic coding, procedural coding, office and insurance collection strategies, Medicare, Managed Care, and more. This edition has been reviewed by industry experts and carefully updated to reflect recent changes in the industry - including the addition of special HIPAA Compliance Alerts throughout the book to help users comply with important governmental privacy regulations. Instructor resources are available; please contact your Elsevier sales representative for details. Icons help students identify each insurance payer with a specific color and graphic, making the learning process more effective. Emphasizes procedural (CPT and HCPCS) and diagnostic (ICD-9-CM) coding and documentation since they are the keystones to obtaining maximum reimbursement. Block-by-block teaching approach organized by payer category for the CMS-1500 claim form facilitates understanding, effective learning, and greater productivity. Detailed examples and samples of completed insurance forms help students see how knowledge is applied in the real world. Accompanying CD-ROM of practice software bound in the back of the book features the CMS-1500 claim form and 10 scored patient case studies with related insurance information to simulate real-life situations. Updated to reflect recent changes in the industry. Special sections highlight areas pertinent to HIPAA regulations.

How does a medical practice thrive in a business environment where the margin of management error has all but disappeared? Profit margins are being squeezed by declining reimbursement rates, capitation plans, gamesmanship on the part of the payors, and increasing operating costs. Addressing the specific needs of today’s medical practice, Medical Practice Business Plan Workbook, Third Edition supplies a detailed and ordered work plan to tackle some of the most pressing issues facing the field. Peter D. Lucash delves into decades of experience helping physician groups develop business plans to guide you along the process of building the profitable practice you want and deserve. This updated edition of a bestseller begins with a review of the fundamentals, including the questions your plan should answer, how to get started, how to organize and develop your plan, and the staff support and resources you will need. Complete with a wealth of helpful sample plans and worksheets, this workbook: Reflects recent changes in the healthcare industry, including federal healthcare reform Offers a one-of-a-kind design and approach tailored to the medical practice Covers conceptualization, organization, and implementation of your business plan This updated edition reflects current and forecasted challenges for practices, including the Affordable Care Act, data security, and quality and outcome measures. It supplies detailed coverage of the different types of organizations, governance and management, personnel needs, key business relationships and contacts, demographics and economic factors, patients as customers, competitor analysis, marketing, information technology, disaster and business continuity planning, and financial strategies. The final section outlines a process for implementing your plan. Sticking to this process will help ensure your plan covers what is needed to succeed in today’s complex medical environment. Visit www.Lucash.com for videos and other resources to help you develop and implement your practice business plan.

Surveys health occupations. Includes information on anatomy and physiology, medical terminology, basic health care skills, and careers.

Corresponding to the chapters in Health Insurance Today, 5th Edition, this workbook gives you practice with the skills you will need to succeed as a health insurance professional. Practical assignments reinforce the information in the text, and engaging learning activities and exercises challenge you to apply your knowledge to real-world situations. Performance objectives include hands-on, application-based learning activities with practice in areas such as completing claim forms, posting payments to a patient's ledger, filling out "Release to Return to Work" forms, and filling out Medicare appeals. Critical thinking activities strengthen your ability to apply health insurance concepts to a variety of challenging situations. Defining Chapter Terms activities help you review and understand key terms in each chapter. Chapter assessments test your knowledge of text content with multiple choice, true/false, short answer, fill-in-the-blank, and matching questions. Problem solving/collaborative (group) activities emphasize the importance of teamwork in the health care field. Case studies ask you to solve a real-world problem related to health insurance, such as completing a CMS-1500 claim form or explaining how HIPAA could affect someone recently out of work. Application exercises ask you to apply your knowledge and skills to real-world situations. In-class projects and discussion topics enhance your understanding of specific content from the text. Internet Exploration exercises in each chapter help you learn how to perform research online. NEW! Key coverage of new topics includes Medicare, Electronic Health Records, and Version 5010. UPDATED! Additional ICD-10 coding content prepares you for the upcoming switch to the new coding system in October 2015. NEW! Content on Patient Protection and Affordable Care Act ensures you stay current on these significant healthcare system changes.

Prepare for a successful career in medical billing and insurance processing or revenue management with the help of Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2020 Edition. This comprehensive, inviting book presents the latest medical code sets and coding guidelines as you learn to complete health plan claims and master revenue management concepts. This edition focuses 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 introduce new legislation that impacts health care. You also examine the impact on ICD-10-CM, CPT, and HCPCS level II coding; revenue cycle management; and individual health plans. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version.

Understanding Health Insurance: A Guide to Professional Billing, 7th edition,utilizes a step-by-step approach to provide instruction about the completion of health insurance claims. the objectives of this edition are to 1) introduce information about major third party payer programs and federal health care regulations, 2) clarify coding guidelines and provide application exercises for each national diagnosis and procedure coding system, and 3) simplify the process of completing claims. Case studies and review exercises provide users with numerous opportunities to apply knowledge and to build s

Corresponding to the chapters in Beik’s Health Insurance Today, 8th Edition, this workbook lets you practice the skills you will need to succeed as a health insurance professional. Practical assignments reinforce the information in the text, and engaging learning activities and case studies challenge you to apply your knowledge to real-world situations. This edition adds up-to-date coverage of cybersecurity, COVID-19, crowdfunding for medical bills, and more. Performance-based activities include hands-on, application-based learning exercises that provide practice in areas such as completing claim forms, posting payments to a patient's ledger, filling out Release to Return to Work forms, and filling out Medicare appeals. Critical thinking activities strengthen your ability to apply health insurance concepts to a variety of challenging situations. Chapter assessments test your knowledge with multiple choice, true/false, short answer, fill-in-the-blank, and matching questions. Problem-solving and collaborative (group) activities emphasize the importance of teamwork in the healthcare field. Case studies ask you to solve real-world problems related to health insurance, such as completing a CMS-1500 claim form or explaining how HIPAA could affect someone recently out of work. Application exercises ask you to apply your knowledge and skills to real-world situations. In-class projects and discussion topics enhance your understanding of specific content from the text. Internet Exploration exercises in each chapter help you learn how to perform and evaluate research online. Defining Chapter Terms activities help you review and understand the key terms in each chapter. NEW! Additional content on cybersecurity emphasizes the importance of keeping digital information private and secure. NEW! Information on crowdfunding for medical bills discusses how this practice affects billing. NEW! Interactive VST eBook provides a seamless digital experience. NEW! Coverage of COVID-19 explores its impact on billing, reimbursement, and employment.

This is the eBook of the printed book and may not include any media, website access codes, or print supplements that may come packaged with the bound book. COMPREHENSIVE HEALTH INSURANCE: BILLING, CODING & REIMBURSEMENT, 2/e provides students with the knowledge and skills needed to work in a variety of medical billing and coding positions in the medical field. Comprehensive in approach, it covers the foundations of insurance, billing, coding and reimbursement. 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 carrier's decision. This edition includes new chapters devoted to HIPAA and ICD-10-CM Medical Coding, as well as outstanding coverage of electronic records. Numerous case studies and patient files are included throughout and demonstrate refunds and appeals, auditing and compliance, Medicare calculations and professionalism.

The Eighth edition of Medical Insurance: A Revenue Cycle Process Approach emphasizes the revenue cycle—ten steps that clearly identify all the components needed to successfully manage the medical insurance claims process . The cycle shows how administrative medical professionals “follow the money .” Medical insurance specialists must be familiar with the rules and guidelines of each health plan in order to submit proper documentation, which then ensures that offices receive maximum, appropriate reimbursement for services provided . Learn the skills you need for your health professions career using multiple digital resources . Read and study the content more effectively—spending more time on topics you don’t know and less time on the topics you do by using SmartBook®, McGraw-Hill Education’s revolutionary adaptive learning technology