Health Insurance Today

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. Healthcare Reform: Coverage Types and Sources

Unit 2: Health Insurance Basics 5. Claim Submission Methods 6. New and Traditional Reimbursement Methods 7. The Changing Face of Managed Care 8. Understanding Medicaid 9. Conquering Medicares 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 Glossary