Understanding Health Insurance: A Guide to Billing and Reimbursement 13th Edition
Michelle A. Green
Understanding Health Insurance: A Guide to Billing and Reimbursement 12th Edition
Michelle A. Green
ISBN-13: 9781285737522 | ISBN-10: 1285737520
© 2015 | Published |  832  Pages
Previous Editions: 9781133283737

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Paperback/Softcover Book/Jrnal
US $187.95
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Understanding Health Insurance, 12th Edition, is the essential learning tool your students need when preparing for a career in medical insurance billing. This comprehensive and easy-to-understand text is fully-updated with the latest code sets and guidelines, and covers important topics in the field like managed care, legal and regulatory issues, coding systems, reimbursement methods, medical necessity, and common health insurance plans. The twelfth edition has been updated to include new legislation that affects healthcare, ICD-10-CM coding, implementing the electronic health record, the Medical Integrity Program (MIP), medical review process, and more. The practice exercises in each chapter provide plenty of review, and the workbook (available separately) provides even more application-based assignments and additional case studies for reinforcement. Includes free online SimClaim™ CMS-1500 claims completion software, and free-trial access to Optum's EncoderPro.com—Expert encoder software.



  • 1. Health Insurance Specialist Career.
    2. Introduction to Health Insurance.
    3. Managed Healthcare.
    4. Processing an Insurance Claim.
    5. Legal and Regulatory Issues.
    6. ICD-10-CM Coding.
    7. CPT Coding.
    8. HCPCS Level II Coding.
    9. CMS Reimbursement Methodologies.
    10. Coding for Medical Necessity.
    11. Essential CMS-1500 Claim Instructions.
    12. Commercial Insurance.
    13. Blue Cross Blue Shield.
    14. Medicare.
    15. Medicaid.
    16. TRICARE.
    17. Workers' Compensation.
    Appendices.
    Bibliography.
    Glossary.
    Index.

    • 59-day free trial of Encoder Pro.com—Expert™ from Optum lets students look up codes and descriptions quickly and with greater accuracy.
    • Alerts such as the HIPAA Alerts, Coding Tips, ICD-10, and Managed Care Alerts draw attention to critical areas of content and provide experience-based recommendations.
    • Notes appear throughout and clarify content, give references, provide background, or emphasize rule exceptions.
    • Study Checklist at the end of each chapter directs students to other learning aids to enhance understanding and build confidence.
    • Practical Claim Handling: In addition to ongoing, in-text references to claim forms and related on-the-job issues, UNDERSTANDING HEALTH INSURANCE, 12th Edition gives readers practice completing actual CMS-1500 claim forms by hand and online using easy-to-follow instructions.
    • Contemporary Coding: Exhaustive CPT and ICD-10 coverage outpaces competing health insurance texts with the latest coding manual information, numerous examples and skill-building exercises, and detailed explanations that prepare students for upcoming changes while building confidence with new requirements.
    • Expanded EMR: Added coverage of Electronic Medical Records includes more workbook problems for better context and clarity.
    • All-New Coding: Completely revised according to 2014's new ICD-10 code sets, UNDERSTANDING HEALTH INSURANCE, 12th Edition also presents the former ICD-9 codes as a legacy classification system.
    • Interactive Learning: The hands-on coding cases, games, and quizzing available in CourseMate and in our online resources help students understand concepts and master skills faster than book learning alone.
    • Revised Claim Forms: New CMS-1500 standardized forms appear throughout the text for practice with manual insurance claims, while the included SimClaim™ practice software trial familiarizes readers with the electronic version of this commonly used claim form.
  • "It is a great text that thoroughly covers all major topics but provides flexibility for adaptation in any course. Honestly, this is the most thorough textbook I have seen for this area of study, and it is a great resource for anyone entering or already working in this field."- Denise Kearney, CPC, Wayne Community College, Goldsboro, NC

For more information about these supplements, or to obtain them, contact your Learning Consultant

  • Workbook for Green’s Understanding Health Insurance: A Guide to Billing and Reimbursement, 12th
    ISBN-10: 1285737547 | ISBN-13:9781285737546
    List Price = 69.95
    The student workbook is design to help the user retain key chapter content. Included within this resource are chapter objective questions, key term definition queries, multiple choice, fill-in-the-blank and true-or-false problems.
    Workbook for Understanding Health Insurance (Book Only)
    ISBN-10: 1285737679 | ISBN-13:9781285737676
    List Price = 71.95
    Workbook for Understanding Health Insurance (Book Only)
    Learning Lab: Medical Billing & Reimbursement, Instant Access
    ISBN-10: 128573761X | ISBN-13:9781285737614
    List Price = 95.00
    Captivate Your Students! Learning Lab: Medical Billing & Reimbursement is an online homework solution that allows your students to practice the most difficult medical billing and reimbursement concepts in a simulated real-world physician's office environment. Developed to help you improve program quality and retention, this Learning Lab prepares your students for their careers by increasing comprehension and critical thinking skills.
    Learning Lab: Medical Billing & Reimbursement, MindLink Instant Access
    ISBN-10: 1285737652 | ISBN-13:9781285737652
    List Price = 95.00
    Learning Lab is an online homework solution that maps to learning objectives in HIM. Interactive case scenarios are used to build students critical thinking skills and help retain the most difficult concepts. This simulated environment engages students with its real-world approach. Learning Labs has a pre-assessment, learning activities and post-assessment.
    CourseMate Instant Access for Green's Understanding Health Insurance: A Guide to Billing and Reimbursement
    ISBN-10: 1285737717 | ISBN-13:9781285737713
    List Price = 187.95
    CourseMate Instant Access
    Premium Web Site, 2 terms (12 months) Printed Access Card for Green's Understanding Health Insurance: A Guide to Billing and Reimbursement, 12th
    ISBN-10: 128587451X | ISBN-13:9781285874517
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    ISBN-10: 1305090381 | ISBN-13:9781305090385
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    MindTap Medical Insurance & Coding Printed Access Card for Green’s Understanding Health Insurance: A Guide to Billing and Reimbursement, 12th is a personalized, fully online digital learning platform of authoritative Cengage Learning content, assignments, and services that engages your students with interactivity while also offering you choice in the configuration of coursework and enhancement of the curriculum via complimentary web-apps known as MindApps.


  • Mount Wachusett Community College, Gardner, Massachusetts
    R Bio: Michelle A. Green, MPS, RHIA, FAHIMA, CPC is an Adjunct Professor in the Health Information Management Department at Mount Wachusett Community College, Gardner, Massachusetts. Ms. Green has also held the position of SUNY Distinguished Teaching Professor in the Physical and Life Sciences Department at the State University of New York, College of Technology, Alfred, from 1984 through 2016. An active member of the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA), Ms. Green has been recognized both for her excellence in teaching and for her significant contributions to the Health Information Management profession. She has earned numerous awards, including the State University of New York Chancellor’s Award for Excellence in Teaching, Alfred State College’s Alumni Association Teacher of the Year, Who’s Who Among America’s Teachers, and the FORE Triumph Educator Award from the AHIMA. Ms. Green is a Registered Health Information Administrator (RHIA), a Fellow of the American Health Information Management Association (FAHIMA), and a Certified Procedural Coder (CPC). She earned a BS from Daemen College and an MPS degree from Alfred University. Ms. Green has authored three successful books related to coding and health information.