Master the complexities of health insurance with this easy-to-understand guide! Beik’s Health Insurance Today, 8th Edition provides a solid foundation in basics such as the types and sources of health insurance, the submission of claims, and the ethical and legal issues surrounding insurance. It follows the claims process from billing and coding to reimbursement procedures, with realistic practice on the Evolve companion website. This edition adds up-to-date coverage of cybersecurity, COVID-19, crowdfunding for medical bills, and cost/value calculators. Making difficult concepts seem anything but, this resource prepares you for a successful career as a health insurance professional.
· Direct, conversational writing style makes learning insurance and billing concepts easier.· Learning features include review questions, scenarios, and additional exercises to ensure comprehension, critical thought, and application to practice.· Clear and attainable learning objectives with chapter content that follow the order of the objectives make learning easier for students and make chapter content easier to teach for educators.· Hands-on practice on Evolve with a fillable CMS-1500 form and accompanying case studies and Unique! UB-04 forms, ensuring practicum- and job-readiness.· HIPAA Tips emphasize the importance of privacy and government rules and regulations, ensuring a solid foundation in regulatory compliance.1. Cover - p. c 2. Inside Front Cover - p. i 3. Table of Contents - p. ii 4. Beik’shealthinsurance today - p. iii 5. Copyright - p. iv 6. Contributors and Reviewers - p. v 7. Preface - p. vi 8. A Word About HIPAA - p. ix 9. About the Author - p. x 10. Acknowledgments - p. xi 11. Contents - p. xii 12. List of Illustrations - p. xiii 13. List of Tables - p. xiv 14. 1 : The Origins of Health Insurance - p. 1 15. 2 : Tools of the Trade: A Career as a Health Insurance Professional - p. 14 16. 3 : The Legal and Ethical Side of Health Insurance - p. 26 17. 4 : Healthcare Reform: Coverage Types and Sources - p. 46 18. 5 : The Patient and the Billing Process - p. 66 19. 6 : Reimbursement Models - p. 90 20. 7 : Understanding Managed Care - p. 108 21. 8 : Understanding Medicare - p. 130 22. 9 : Understanding Medicaid - p. 178 23. 10 : Understanding Military Carriers - p. 204 24. 11 : Understanding Miscellaneous Carriers: Workers’ Compensation and Disability Insurance - p. 239 25. 12 : Claim Submission Methods - p. 267 26. 13 : Diagnostic Coding - p. 288 27. 14 : Procedural, Evaluation and Management, and HCPCS Coding - p. 316 28. 15 : Claims Management - p. 338 29. 16 : The Role of Computers in Health Insurance - p. 358 30. 17 : Reimbursement Procedures: Getting Paid - p. 373 31. 18 : Hospital Billing and the UB-04 - p. 395 32. Sample Blank CMS-1500 (02/12) - p. 431 33. CMS-1500 Claim Forms and Completion Instructions - p. 441 34. UB-04 Claim Forms and Completion Instructions - p. 453 35. Glossary - p. 457 36. Index - p. 475
Master the complexities of health insurance with this easy-to-understand guide! Beik’s Health Insurance Today, 8th Edition provides a solid foundation in basics such as the types and sources of health insurance, the submission of claims, and the ethical and legal issues surrounding insurance. It follows the claims process from billing and coding to reimbursement procedures, with realistic practice on the Evolve companion website. This edition adds up-to-date coverage of cybersecurity, COVID-19, crowdfunding for medical bills, and cost/value calculators. Making difficult concepts seem anything but, this resource prepares you for a successful career as a health insurance professional.
· Direct, conversational writing style makes learning insurance and billing concepts easier.· Learning features include review questions, scenarios, and additional exercises to ensure comprehension, critical thought, and application to practice.· Clear and attainable learning objectives with chapter content that follow the order of the objectives make learning easier for students and make chapter content easier to teach for educators.· Hands-on practice on Evolve with a fillable CMS-1500 form and accompanying case studies and Unique! UB-04 forms, ensuring practicum- and job-readiness.· HIPAA Tips emphasize the importance of privacy and government rules and regulations, ensuring a solid foundation in regulatory compliance.1. Cover - p. c 2. Inside Front Cover - p. i 3. Table of Contents - p. ii 4. Beik’shealthinsurance today - p. iii 5. Copyright - p. iv 6. Contributors and Reviewers - p. v 7. Preface - p. vi 8. A Word About HIPAA - p. ix 9. About the Author - p. x 10. Acknowledgments - p. xi 11. Contents - p. xii 12. List of Illustrations - p. xiii 13. List of Tables - p. xiv 14. 1 : The Origins of Health Insurance - p. 1 15. 2 : Tools of the Trade: A Career as a Health Insurance Professional - p. 14 16. 3 : The Legal and Ethical Side of Health Insurance - p. 26 17. 4 : Healthcare Reform: Coverage Types and Sources - p. 46 18. 5 : The Patient and the Billing Process - p. 66 19. 6 : Reimbursement Models - p. 90 20. 7 : Understanding Managed Care - p. 108 21. 8 : Understanding Medicare - p. 130 22. 9 : Understanding Medicaid - p. 178 23. 10 : Understanding Military Carriers - p. 204 24. 11 : Understanding Miscellaneous Carriers: Workers’ Compensation and Disability Insurance - p. 239 25. 12 : Claim Submission Methods - p. 267 26. 13 : Diagnostic Coding - p. 288 27. 14 : Procedural, Evaluation and Management, and HCPCS Coding - p. 316 28. 15 : Claims Management - p. 338 29. 16 : The Role of Computers in Health Insurance - p. 358 30. 17 : Reimbursement Procedures: Getting Paid - p. 373 31. 18 : Hospital Billing and the UB-04 - p. 395 32. Sample Blank CMS-1500 (02/12) - p. 431 33. CMS-1500 Claim Forms and Completion Instructions - p. 441 34. UB-04 Claim Forms and Completion Instructions - p. 453 35. Glossary - p. 457 36. Index - p. 475
