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Elsevier

Health Insurance Today

  • 7th Edition - September 10, 2020
  • Latest edition
  • Authors: Janet I. Beik, Julie Pepper
  • Language: English

Master the complexities of health insurance with this easy-to-understand guide! Health Insurance Today: A Practical Approach, 7th Edition provides a solid foundation in basics su… Read more

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Description

Master the complexities of health insurance with this easy-to-understand guide! Health Insurance Today: A Practical Approach, 7th 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 website. This edition adds coverage of the latest advances and issues in health insurance, including EHRs, Medicare, and other types of carriers. Written by Medical Assisting educators Janet Beik and Julie Pepper, this resource prepares you for a successful career as a health insurance professional.

Key features

  • What Did You Learn? review questions, Imagine This! scenarios, and Stop and Think exercises ensure that you understand the material, can apply it to real-life situations, and develop critical thinking skills
  • Clear, attainable learning objectives highlight the most important information in each chapter
  • CMS-1500 software with case studies on the Evolve companion website provides hands-on practice with filling in a CMS-1500 form electronically
  • UNIQUE! UB-04 software with case studies on Evolve provides hands-on practice with filling in UB-04 forms electronically
  • UNIQUE! SimChart® for the Medical Office (SCMO) cases on Evolve give you real-world practice in an EHR environment
  • HIPAA Tips emphasize the importance of privacy and of following government rules and regulations
  • Direct, conversational writing style makes it easier to learn and remember the material
  • End-of-chapter summaries relate to the chapter-opening learning objectives, provide a thorough review of key content, and allow you to quickly find information for further review
  • Chapter review questions on Evolve help you assess your comprehension of key concepts

Table of contents

Unit 1: Building a Foundation

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

Product details

  • Edition: 7
  • Latest edition
  • Published: October 16, 2020
  • Language: English

About the authors

JB

Janet I. Beik

Janet Beik has degrees in business and higher education. Janet was an instructor in the Medical Assistant Program at Southeastern Community College, in West Burlington, Iowa, for several years. She authored the first edition of her book, Health Insurance Today in 2003, and the 7th edition has just published.
Affiliations and expertise
Southeastern Community College (retired), Administrative Instructor, Medical Assistant Program, West Burlington, Iowa

JP

Julie Pepper

Julie Pepper has spent her entire career in health care as a medical assistant in a variety of offices and clinics, developing expertise in the electronic health record and as an instructor in a medical assistant program. She combines her education in dietetics with her clinical and administrative experience as an instructor in the Medical Assisting program at Chippewa Valley Technical College in Wisconsin, where she taught for 21 years and from where she retired from teaching. Julie was also the program director for the college’s Health Navigator program. She has served as a reviewer and contributor to numerous Medical Assisting educational products over the last decade, including Sim Chart for the Medical Office. She currently serves as the sole author of The Electronic Health Record for the Physician’s Office and The Simulated Administrative Medical Office. She has been leading author of Beik's Health Insurance Today text and workbook since the 8th edition. She also has been a coauthor for Kinn’s Medical Assisting Fundamentals, Kinn’s The Medical Assistant, and Today’s Medical Assistant. Julie strives to bring the needed information to students in a way to keep them interested in learning all that they need to be wonderful employees working in healthcare.
Affiliations and expertise
Professor Emeritus, Medical Assistant Program, Chippewa Valley Technical College, Eau Claire, Wisconsin, USA