Letter From the Author

Michelle Green PhotoDear Instructor,

Welcome to a sneak preview of Understanding Health Insurance: A Guide to Billing and Reimbursement, a textbook that covers the processing of health insurance claims for all third-party payers and government health plans in an easy-to-understand and comprehensive manner.

My approach in Understanding Health Insurance is to provide an overview about the health insurance industry in the first five chapters that cover career opportunities, an overview of health insurance concepts, managed care, claims processing, and legal aspects of health insurance. Then, five chapters are devoted to coding and reimbursement concepts, including ICD-9-CM, a new chapter about ICD-10-CM and ICD-10-PCS, CPT, HCPCS level II, reimbursement methodologies, and coding for medical necessity. The last seven chapters of the textbook cover the specifics of third-party payer and government plan insurance claims completion requirements: essentials of insurance claims completion, commercial payers, Blue Cross Blue Shield, Medicare, Medicaid, TRICARE, and workers’ compensation.

Understanding Health Insurance is a perfect solution for a one-semester health insurance processing course. It can also be adopted for a two-semester sequence that incorporates an intermediate-to-advanced approach (when related Delmar, Cengage Learning products are bundled with the textbook). The instructor just selects the chapter concepts to present, depending on the level of course being taught, and the instructor’s manual provides samples of course organization to assist in this process.

The combination of figures, tables, easy-to-read text layout, coding tips, and chapter exercises and reviews demonstrates that this book was written and designed with the student in mind. The textbook online companion includes StudyWARE™ software for students, which includes numerous practice exercises, games, and coding case studies with images and videos. SIMClaim™ software is included online to provide students with an opportunity to practice claims data entry and receive immediate feedback. A free 59-day trial of www.EncoderPro,com Expert software is also accessible online.

The Workbook to Understanding Health Insurance is organized as a companion to the textbook, and each chapter contains many application-based assignments so students can practice the tasks they will eventually complete on-the-job. The workbook also includes a mock CMRS exam and a mock CPC-P exam. The companion website offers additional student (and instructor) resources, including annual coding updates to textbook exercises and workbook assignments.

I am interested in providing you with all of the tools you need to make your class a success, and Understanding Health Insurance instructor resources include a(n):

  • Instructor’s manual organized in an easy-to-use format with teaching tips, course syllabi, chapter lesson plans, answer keys to chapter exercises and reviews, answer keys to workbook assignments, and multiple choice questions (not duplicated in the computerized test bank).
  • An Instructor Resources CD-ROM that contains an electronic version of the instructor’s manual, computerized test bank that includes ExamView Pro test generator software, instructor slides contained in PowerPoint, and the Insurance, Billing and Coding Curriculum Guide (also authored by me).
  • Instructor Companion Site with instructor-only resources (e.g., electronic coding answer keys for patient records).
  • Downloadable WebTUTOR™ course cartridge for Blackboard and WebCT that can be used to supplement on-campus course delivery or as the course management platform for an online course. WebTUTOR™ includes video clips, online quizzes for each chapter, discussion topics and learning links, an online glossary, answer keys to textbook exercises and reviews, instructor slides contained in PowerPoint, testbank, and communication tools, including a course calendar, chat, e-mail, and threaded discussions.

Please enjoy this preview of Understanding Health Insurance. The textbook will publish in February 2012. In the meantime, you can learn more about the book by visiting CengageBrain.com and entering the name of the textbook. To receive a review copy of this text, contact your Delmar Cengage Learning sales representative, or call 800-998-7498.



Michelle A. Green

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