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Student Workbook for Green's Understanding Health Insurance: A Guide to Billing and Reimbursement - 2021 Edition 16th edition [Minkštas viršelis]

(Naujas leidimas: 9780357621363)
(Mohawk Valley Community College, Utica, New York)
  • Formatas: Paperback / softback, aukštis x plotis x storis: 277x217x15 mm, weight: 658 g
  • Išleidimo metai: 11-Jan-2021
  • Leidėjas: Delmar Cengage Learning
  • ISBN-10: 0357515595
  • ISBN-13: 9780357515594 (Naujas leidimas: 9780357621363)
Kitos knygos pagal šią temą:
Student Workbook for Green's Understanding Health Insurance: A Guide to Billing and Reimbursement - 2021 Edition 16th editionDidesnis paveikslėlis
  • Formatas: Paperback / softback, aukštis x plotis x storis: 277x217x15 mm, weight: 658 g
  • Išleidimo metai: 11-Jan-2021
  • Leidėjas: Delmar Cengage Learning
  • ISBN-10: 0357515595
  • ISBN-13: 9780357515594 (Naujas leidimas: 9780357621363)
Kitos knygos pagal šią temą:
Pastovi nuoroda: https://www.kriso.lt/db/9780357515594.html
Raktažodžiai:
The student workbook is design to help you retain key chapter content. Included within this resource are chapter objective questions; key-term definition queries; and multiple choice, fill-in-the-blank, and true-or-false problems.
Preface viii
Chapter 1 Health Insurance Specialist Career 1(26)
Assignment 1.1 Interview a Professional
1(1)
Assignment 1.2 Ready, Set, Get a Job!
2(15)
Assignment 1.3 Journal Abstract
17(1)
Assignment 1.4 Professional Discussion Forums (Listservs)
18(1)
Assignment 1.5 Learning About Professional Credentials
19(2)
Assignment 1.6 Professionalism
21(1)
Assignment 1.7 Telephone Messages
21(3)
Assignment 1.8 Multiple Choice Review
24(3)
Chapter 2 Introduction To Health Insurance 27(14)
Assignment 2.1 Health Insurance Coverage Statistics
27(3)
Assignment 2.2 Major Developments in Health Insurance (Research Paper)
30(4)
Assignment 2.3 Calculating Reimbursement
34(1)
Assignment 2.4 Health Insurance Marketplace
35(1)
Assignment 2.5 Quality Payment Program-Merit-Based Incentive Payment System
36(2)
Assignment 2.6 Multiple Choice Review
38(3)
Chapter 3 Managed Health Care 41(14)
Assignment 3.1 National Committee for Quality Assurance (NCQA) Health Plan Report Card
41(1)
Assignment 3.2 Managed Health Care Federal Legislation
42(1)
Assignment 3.3 The Joint Commission
43(1)
Assignment 3.4 Fairview Health Services Integrated Delivery System
44(1)
Assignment 3.5 Creating a Managed Care Contract Quick Reference Sheet
44(8)
Assignment 3.6 Multiple Choice Review
52(3)
Chapter 4 Revenue Cycle Management 55(34)
Assignment 4.1 Completing Insurance Verification Forms
55(5)
Assignment 4.2 Payment of Claims: Encounter Form
60(2)
Assignment 4.3 Payment of Claims: Remittance Advice
62(8)
Assignment 4.4 Payment of Claims: Explanation of Benefits
70(6)
Assignment 4.5 Writing Appeal Letters
76(4)
Assignment 4.6 Calculating Patient Coinsurance, Deductible, and Provider Reimbursement Amounts
80(1)
Assignment 4.7 Chargemaster Maintenance
81(2)
Assignment 4.8 Monitoring the Revenue Cycle
83(2)
Assignment 4.9 Multiple Choice Review
85(4)
Chapter 5 Legal Aspects Of Health Insurance And Reimbursement 89(12)
Assignment 5.1 HIPAA: Student Confidentiality Statement
89(1)
Assignment 5.2 HIPAA: Preventing Health Care Fraud and Abuse
89(2)
Assignment 5.3 HIPAA: Privacy and Security Rules
91(1)
Assignment 5.4 HIPAA: Covered Entities
92(1)
Assignment 5.5 HIPAA: Telephone Calls Requesting Release of Patient Information
93(4)
Assignment 5.6 Hospital Inpatient Quality Reporting Program
97(2)
Assignment 5.7 Multiple Choice Review
99(2)
Chapter 6 ICD-10-CM Coding 101(14)
Assignment 6.1 Interpreting General Equivalence Mapping
101(1)
Assignment 6.2 Overview of ICD-10-CM: Comparing ICD-10-CM to ICD-9-CM
102(1)
Assignment 6.3 ICD-10-CM Coding Conventions
103(2)
Assignment 6.4 ICD-10-CM Index to Diseases and Injuries
105(2)
Assignment 6.5 ICD-10-CM Tabular List of Diseases and Injuries
107(2)
Assignment 6.6 Diagnostic Coding and Reporting Guidelines for Outpatient Services
109(3)
Assignment 6.7 Multiple Choice Review
112(3)
Chapter 7 CPT Coding 115(14)
Assignment 7.1 CPT Index
115(1)
Assignment 7.2 Evaluation and Management (E/M) Coding
116(1)
Assignment 7.3 Anesthesia Coding
117(1)
Assignment 7.4 Surgery Coding
118(1)
Assignment 7.5 Radiology Coding
119(1)
Assignment 7.6 Pathology and Laboratory Coding
120(1)
Assignment 7.7 Medicine Coding
120(1)
Assignment 7.8 Assigning CPT Modifiers
121(1)
Assignment 7.9 Coding Patient Cases
122(3)
Assignment 7.10 CPT Code Verification
125(1)
Assignment 7.11 Relative Value Units
125(1)
Assignment 7.12 Multiple Choice Review
126(3)
Chapter 8 HCPCS Level II Coding 129(14)
Assignment 8.1 HCPCS Level II Index
129(1)
Assignment 8.2 HCPCS Level II Coding
130(4)
Assignment 8.3 Coding Drugs Using HCPCS Level II
134(1)
Assignment 8.4 HCPCS Level II National Modifiers
135(1)
Assignment 8.5 Coding Patient Cases
136(2)
Assignment 8.6 Coding Verification
138(1)
Assignment 8.7 Multiple Choice Review
139(4)
Chapter 9 CMS Reimbursement Methodologies 143(16)
Assignment 9.1 Data Analytics for Reimbursement
143(1)
Assignment 9.2 Case-Mix Index, Relative Weights, and MS-DRG Payments
144(1)
Assignment 9.3 Calculating Medicare Physician Fee Schedule Payments
145(2)
Assignment 9.4 Diagnosis-Related Groups
147(3)
Assignment 9.5 Medicare Severity DRGs
150(2)
Assignment 9.6 Ambulatory Payment Classifications
152(4)
Assignment 9.7 Multiple Choice Review
156(3)
Chapter 10 Coding Compliance Programs, Clinical Documentation Improvement, And Coding For Medical Necessity 159(16)
Assignment 10.1 Choosing the First-Listed Diagnosis
159(1)
Assignment 10.2 Linking Diagnoses with Procedures/Services
160(1)
Assignment 10.3 National Coverage Determinations
160(1)
Assignment 10.4 Coding from Case Scenarios
161(1)
Assignment 10.5 Coding from SOAP Notes and Operative Reports
162(4)
Assignment 10.6 DRG Coding Validation Review
166(6)
Assignment 10.7 Multiple Choice Review
172(3)
Chapter 11 CMS-1500> And UB-04 Claims 175(14)
Assignment 11.1 National Provider Identifier (NPI) Standard
175(1)
Assignment 11.2 Medically Unlikely Edits (MUE) Project
176(1)
Assignment 11.3 Identifying CMS-1500 Claims Completion Errors
177(4)
Assignment 11.4 Completing the UB-04 Claim
181(6)
Assignment 11.5 Multiple Choice Review
187(2)
Chapter 12 Commercial Insurance 189(10)
Assignment 12.1 Commercial Primary CMS-1500 Claims Completion
189(3)
Assignment 12.2 Commercial Primary/Secondary Same Payer CMS-1500 Claims Completion
192(1)
Assignment 12.3 Commercial Secondary CMS-1500 Claims Completion
192(1)
Assignment 12.4 Group Health Plan CMS-1500 Claims Completion
192(4)
Assignment 12.5 Multiple Choice Review
196(3)
Chapter 13 Bluecross Blueshield 199(10)
Assignment 13.1 Bluecross Blueshield Primary CMS-1500 Claims Completion
199(3)
Assignment 13.2 Bluecross Blueshield Primary/Secondary Same Payer CMS-1500 Claims Completion
202(1)
Assignment 13.3 Bluecross Blueshield Secondary CMS-1500 Claims Completion
202(4)
Assignment 13.4 Multiple Choice Review
206(3)
Chapter 14 Medicare 209(14)
Assignment 14.1 Medicare Primary CMS-1500 Claims Completion
209(3)
Assignment 14.2 Medicare as Secondary Payer CMS-1500 Claims Completion
212(1)
Assignment 14.3 Medicare/Medigap CMS-1500 Claims Completion
212(1)
Assignment 14.4 Medicare/Medicaid (Medi-Medi) CMS-1500 Claims Completion
212(6)
Assignment 14.5 Medicare Roster Billing Claims Completion
218(3)
Assignment 14.6 Multiple Choice Review
221(2)
Chapter 15 Medicaid 223(10)
Assignment 15.1 Medicaid Primary CMS-1500 Claims Completion
223(3)
Assignment 15.2 Medicaid as Secondary Payer CMS-1500 Claims Completion
226(1)
Assignment 15.3 Medicaid Mother/Baby CMS-1500 Claims Completion
226(1)
Assignment 15.4 CHIP CMS-1500 Claims Completion
226(4)
Assignment 15.5 Multiple Choice Review
230(3)
Chapter 16 Tricare 233(12)
Assignment 16.1 TRICARE Primary CMS-1500 Claims Completion
233(4)
Assignment 16.2 TRICARE Secondary CMS-1500 Claims Completion
237(3)
Assignment 16.3 Standard Time and Military Time
240(1)
Assignment 16.4 Multiple Choice Review
241(4)
Chapter 17 Workers' Compensation 245
Assignment 17.1 Workers' Compensation Primary CMS-1500 Claims Completion
245(3)
Assignment 17.2 Workers' Compensation Intake Form
248(1)
Assignment 17.3 Multiple Choice Review
249
Michelle Green has been a SUNY Distinguished Teaching Professor in the health information technology department at Mohawk Valley Community College in Utica, New York, since 2017. She was the SUNY Distinguished Teaching Professor in the physical and life sciences department at the State University of New York College of Technology for more than 30 years. She has authored three popular textbooks related to coding, revenue management and health information management. An active member of the American Academy of Professional Coders and American Health Information Management Association, Green has been recognized for her excellence in teaching as well as her significant contributions to the health information management profession. Her numerous accolades include the State University of New York Chancellor's Award for Excellence in Teaching, Alfred State College's Alumni Association Teacher of the Year, Who's Who Among America's Teachers and AHIMA's FORE Triumph Educator Award. In addition, she is a Registered Health Information Administrator, a fellow of the American Health Information Management Association and a Certified Professional Coder. She earned an MPS from Alfred University and a Bachelor of Science from Daemen College.