Understanding Health Insurance: A Guide to Professional Billing is a comprehensive guide about health insurance claims processing and reimbursement issues. The book contains chapters on common health insurance plans, reimbursement and legal issues, separate chapters on coding systems, and introductory information on the health insurance field.

The book utilizes a step-by-step approach to successful completion of health insurance claims. The objectives of this edition are to

• introduce information about major third party payers
• provide up-to-date information about federal health care regulations
• clarify coding guidelines and provide application exercises for each coding system
• introduce reimbursement issues
• emphasize the importance of coding for medical necessity, and
• help users develop the skill to complete claims accurately.

Numerous examples help clarify key concepts. Case studies and review exercises provide users with numerous opportunities to apply knowledge and develop skills in completing CMS-1500 claims accurately.