Understanding Health Insurance: A Guide to Billing and Reimbursement, 2023 Edition

ISBN: 0357764064

Author: Michelle Green

Strengthen your skills and develop a solid foundation for professional success with Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2023 Edition. This reader-friendly, comprehensive resource provides a practical, up-to-date guide to current medical code sets and coding guidelines, preparing you to assign ICD-10-CM, CPT and HCPCS Level II 2023 codes; complete health insurance claims; and master key revenue management concepts. You'll focus on important topics such as managed care, legal and regulatory issues, coding systems and compliance, reimbursement methods, clinical documentation improvement, coding for medical necessity and common health insurance plans. The current edition introduces the MIPS Value Pathways; explains major changes for selecting codes in the CPT 2023 evaluation and management section; and clarifies key health insurance concepts such as risk adjustments, hierarchical condition category coding, patient portals, balance billing, coordination of benefits, third-party administrators, Medicare appeals process and whistleblowers. In addition, a helpful workbook provides hands-on assignments and case studies, while MindTap online resources offer interactive practice in completing CMS-1500 claims and assigning codes.