Wednesday, June 1, 2016

A Guide to Health Insurance Billing (with Premium Website, 2 term (12 months) Printed Access Card) 4th Edition

health insurance

Prepare 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. The text also 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 billing skills to the test with case studies that require form completion.


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. 12. Medicare. 13. Medicaid. 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. References. Glossary. Index.

About the Author

Marie A. Moisio, M.A., RHIA, has 25 years of experience in health information management. In addition to teaching medical billing, medical coding and health information processing for more than 15 years, she served as director of health information departments in a 400-bed regional medical center and a 450-bed regional psychiatric treatment facility. Her professional experience also includes service as a consultant for several long-term care facilities and physician offices as well as positions in health information management, compliance, coding practices, insurance claim auditing and patient record documentation. Moisio has taught numerous workshops covering legal aspects of health information management and documentation. She is also the author of A GUIDE TO HEALTH INSURANCE BILLING and UNDERSTANDING LABORATORY & DIAGNOSTIC TESTS.

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