New for this edition is a text-specific workbook which provides both review and applications of each textbook chapter. The workbook is learning outcomes-based. In addition to claim completion case studies, applications include math and communication skill development.   Activities require students to research websites, gather information, abstract and summarize content, and write answers.

This edition has been reorganized to follow the medical billing process. Completing the revenue cycle, new chapters on processing payments (RA/EOBs and secondary claims) and patient collections help students understand the complete process.  The organization helps students understand the medical billing work flow and the tasks performed at each step.

Clear, Focused, Authoritative Content: Medical Insurance provides clear, focused, and authoritative instruction on medical insurance and reimbursement. All types of medical insurance are covered, and examples present a realistic mix of managed care (HMO, PPO, and Consumer-Drive Health Plans) and fee-based plans. Both physician office/outpatient billing—using both the HIPAA 837 electronic claim and the new, mandated CMS-1500 (08/05) paper claim-- and hospital billing (CMS-1450--UB-04) are taught. Billing Tips and Compliance Tips throughout the text highlight key points.

Coding Coverage: The program teaches basic medical coding and coding compliance, including a new chapter on HCPCS. This knowledge is essential for ensuring maximum appropriate reimbursement for reported healthcare services. The optional Coding Workbook for Physician Practices provides extensive coding exercises.

HIPAA and Medical Records Coverage: HIPAA and Medical Records are covered in a chapter that introduces documentation, Electronic Medical Records (EMR), HIPAA Privacy, Security, and Electronic Transactions and Code Sets. Throughout the text, HIPAA Tips reinforce this instruction.

Meets Instructor/Student Goals: The text is closely matched with the typical curriculum and goals of both instructors and students. It is tightly focused on important concepts and skills, omitting extraneous material. The coverage of procedural knowledge, communications skills, and health information technology skills prepares students to successfully perform the duties of medical insurance specialists.

Extensive Review Activities: Thinking It Through critical thinking case studies follow every major section and give immediate reinforcement. End-of-chapter activities include review questions, case studies, and optional Internet activities.

This edition of Medical Insurance is correlated to Medisoft™ Version 11.

Updated to include the most current government and industry regulations for medical insurance.