Corresponding to the chapters in Health Insurance Today, 7th 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. This edition expands its focus on case studies and the use of practice management software, adding more opportunities for application in the medical office.
- 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, with Stop and Think exercises allowing you to apply critical thinking skills to solve a problem or answer a question.
- 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 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.
- Defining Chapter Terms activities help you review and understand the key terms in each chapter.
- NEW! Up-to-date information is included on all topics, including key topics like Medicare.
- NEW and expanded case studies and Internet Exploration activities are added.
- NEW! Additional performance objectives are included, using practice management software.
- NEW! Updated charts and forms are included.
1. The Origins of Health Insurance
2. Tools of the Trade: A Career as a Health (Medical) Insurance Professional
3. The Legal and Ethical Side of Medical Insurance
4. Types and Sources of Health Insurance
Unit 2: Health Insurance Basics
5. Claim Submission Methods
6. Traditional Fee-for-Service/Private Plans
7. Unraveling the Mysteries of Managed Care
8. Understanding Medicaid
9. Conquering Medicare’s Challenges
10. Military Carriers
11. Miscellaneous Carriers: Workers’ Compensation and Disability Insurance
Unit 3: Cracking the Codes
12. Diagnostic Coding
13. Procedural, Evaluation and Management, and HCPCS Coding
Unit 4: The Claims Process
14. The Patient
15. Keys to Successful Claims Management
Unit 5: Advanced Application
16. The Role of Computers in Health Insurance
17. Reimbursement Procedures: Getting Paid
18. Hospital Billing and the UB-04
Appendix A: Sample Blank CMS-1500 (02-12)
Appendix B: CMS-1500 Claim Forms and Completion Instructions
Appendix C: UB-04 Claim Form and Completion Instructions