Understanding Health Insurance: A Guide to Billing and Reimbursement, 8th Edition is a comprehensive source for teaching the subject of health insurance and reimbursement. The book contains chapters on introductory information on the health insurance field, managed health care, legal and regulatory issues, coding systems, reimbursement methodologies, coding for medical necessity, and common health insurance plans. Each chapter contains exercises to illustrate content and reinforce learning. Numerous opportunities are provided throughout the book for manual completion of CMS-1500 claims. A CD-ROM at the back of the book allows for electronic data entry of CMS-1500 claim form information. End of chapter review questions in objective format (e.g., multiple choice) test learners on their understanding of book content. Appendices I and II provide case studies that are also included on the Student Practice CD-ROM. Additional appendices provide instruction in dental claims processing and completion of the UB-92 (claim used for inpatient and outpatient hospital claims). The accompanying workbook provides application based assignments for each chapter, additional content review (multiple choice questions), and additional case studies for practice in completing CMS-1500 claims. This edition of the book contains the most up to date information regarding health insurance claims processing and coding and reimbursement issues.
A condensed version of the classic Fundamentals of Risk and Insurance, this accessible text contains the latest forms, statutes and court decisions and examines specific contracts in detail to emphasize insurance principles. Addresses such timely issues as the high cost of medical care and automobile insurance. detail to emphasize insurance principles. The helpful study aids and the critical essentials of risk management and insurance remain intact. A special section on buying insurance prepares the reader for future purchases.
The book examines how the absence of insurance in the past led to some special maritime liability law principles such as 'general average' (i.e., losses or expenses shared by all the parties to a maritime adventure) and the limitation of shipowners' liability. In the absence of insurance, these principles served the function of insurance mostly for shipowners. As commercial marine insurance is now widely available, these principles have lost their justification and may in fact interfere with the most important goal of liability law i.e., deterrence from negligence. The work thus recommends their abolition. It further argues that when insurance is easily available and affordable to the both parties to a liability claim, the main goal of liability law should be deterrence as opposed to compensation. This is exactly the case with the maritime cargo liability claims where both cargo owners and shipowners are invariably insured. As a result, the sole focus of cargo liability law should be and to a great extent, is deterrence. On the other hand in the vessel-source oil pollution liability setting, pollution victims are not usually insured. Therefore oil pollution liability law has to cater both for compensation and deterrence, the two traditional goals of liability law. The final question the work addresses is whether the deterrent effect of liability law is affected by the availability of liability insurance. Contrary to the popular belief the work attempts to prove that the presence of liability insurance is not necessarily a hindrance but can be a complementary force towards the realization of deterrent goal of liability law.
An enchanting, compact and eloquent portrait of the beloved author by her friend and literary executor
An evolving regulatory landscape and changing economic conditions continue to affect business organization and capital requirements in the global insurance industry, leading to new participants, new transactions, and new challenges. PLI s new Insurance and Investment Management M&A Deskbook provides attorneys with an essential reference to keep up with emerging trends in insurance and investment management M&A. The Deskbook covers topics such as acquisitions of public insurance companies, blocks of insurance business and private acquisitions; the regulatory environment of the insurance industry and the financial services industry; investment in the insurance industry by private equity and pension funds; and the expansion of insurance industry participants into emerging markets around the globe. The Deskbook also provides specific guidance for understanding Lloyd s of London and the M&A market for mutual life insurers."