Understanding Health Insurance: A Guide to Billing and Reimbursement, 2023 Edition

Prepare students for successful careers in revenue management, medical billing or health insurance processing with Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2023 Edition. Updated annually, this reader-friendly resource highlights the latest developments in health care insurance and revenue management, as well as recent changes to ICD-10-CM, HCPCS Level II and CPT® 2023 codes and coding guidelines. This edition introduces the MIPS Value Pathways; explains major changes for selecting codes in the CPT 2023 evaluation and management section; and clarifies key health insurance concepts such as risk adjustments, hierarchical condition category coding, patient portals, balance billing, coordination of benefits, third-party administrators, Medicare appeals process and whistleblowers. The author has also reorganized the chapter on ICD-10-CM Coding to better align with official coding guidelines from The Centers for Medicare & Medicaid Services (CMS). Students will gain valuable knowledge of health insurance, managed care, legal and regulatory issues, coding systems and compliance, reimbursement and revenue management, clinical documentation, coding for medical necessity and common health insurance plans. In addition, an accompanying workbook provides application-based assignments and case studies, while MindTap online resources include specialized software for SimClaim CMS-1500 claims completion.