Statistics published by the U. S. Department of Commerce (1980) indicate that in 1977 we spent 8. 1% of our gross national product (GNP) on life, health, property-casualty, and other forms of insurance. An additional 5. 7% was used to pay the Social Security tax, which is another form of insurance premium, for a total of 14. 8% of the GNP. Although insurance had its historical origin in marine insurance, it has now developed into one of the major industries of the American economy and extends into many areas of economic activity. One area where growth has been particularly strong is the medical sector. Health insurance is a major institution in all industrialized countries. It became a government responsibility in 1883 when Bismarck intro- duced a compulsory program of health insurance for industrial workers in Germany. Programs for workers in various industrial and income categories soon followed in other European countries-Austria (1888), Hungary (1891), Norway (1909), Servia (1910), Great Britain (1911), and Russia and Romania (1912) (Rubinow, 1913:250). Programs in these countries were extended in subsequent years, and other countries in Europe followed with their own programs. Consequently, today most industrial countries have universal or near-universal health insurance coverage. In the United States the issue of national health insurance has been seriously debated since just prior to World War I, and polling data since the 1930s show that a substantial majority of the public has been supportive of such a program (Erskine, 1975).
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.
Discover the essential tool to prepare for a career in medical insurance billing -- UNDERSTANDING HEALTH INSURANCE, 13E. This comprehensive, easy-to-understand, updated book presents the latest code sets and guidelines. You cover today's most important topics, such as managed care, legal and regulatory issues, coding systems, reimbursement methods, medical necessity, and common health insurance plans. Updates introduce new legislation that impacts health care, including the Affordable Care Act (Obamacare); ICD-10-CM coding; electronic health records; Medicaid Integrity Contractors; case mix management; hospital-acquired conditions; present on admission; and value-based purchasing. Practice exercises and the workbook (available separately) provides application-based assignments and case studies to reinforce your understanding, as well as CMRS, CPC-P, and CPB Mock Exams. New editions include online access to SimClaim CMS-1500 claims completion software and Optum's EncoderPro.com Expert.
<p>Praise for Design Details for Health</p> <p>"Cynthia Leibrock and Debra Harris have developed a vitally important reference. They draw upon and compile a rich source of evidence that supports the application of specific research-based details for particular health-related settings."—From the Foreword by Dr. Wayne Ruga, AIA, FIIDA, Hon. FASID <p>The revised edition on implementing design details to improve today's health care facilities—an inspiring, comprehensive guide <p>In this significantly revised second edition, Cynthia Leibrock and Debra Harris offer up-to-date information on design details that can improve patient outcomes and user experience by returning authority to the patient, along with fascinating case studies and research demonstrating the positive role design can play in reducing health care costs. Design Details for Health, Second Edition offers contemporary examples showing how design can improve patient comfort and independence, and demonstrates how to design highly functional health care facilities that operate at peak performance. The book addresses a range of health care facility types including hospitals, ambulatory care, wellness centers, subacute care and rehabilitation, adult day care and respite, assisted living, hospice, dementia care, and aging in place. This Second Edition includes: <ul> <li><p>The latest research, which was only anecdotal in nature as recently as a decade ago, illustrating how design through evidence produces measurable outcomes</li> <li><p>Real-world case studies of a range of excellent health care facilities that have been designed and built in the twenty-first century</li> <li><p>Updated contributions with leading practitioners, researchers, and providers conveying how design has a positive impact on health care delivery</li> </ul> <p>When design empowers rather than disables, everybody wins. Sensitive to the needs of both patients and providers, Design Details for Health, Second Edition is essential reading for today's architects, interior designers, facility managers, and health care professionals.
In clear, easy-to-grasp language, the author covers many of the topics that you will need to know in order to win your dream job and be the first in line for a promotion.