Comprehensive Health Insurance: Billing, Coding, and Reimbursement

Comprehensive Health Insurance: Billing, Coding, and Reimbursement is your how-to guide to key health insurance concepts. You’ll learn key medical administrative tasks, from submitting claims and verifying benefits to posting payments and appealing claim denials. Using a step-by-step approach, the authors cover the foundations and interconnection of insurance policy, billing, coding and reimbursement. Case studies and patient files contextualize and simplify the many complexities of health care.

The 3rd Edition includes 2017 ICD-10, CPT and HCPCS codes. It assesses the impact of the Affordable Care Act, while examining health care trends such as care delivery models and innovation driven by competition. Concierge medicine and telemedicine are explored as new methods of healthcare treatment and cost savings.

About our authors

Deborah Vines has worked extensively for over 30 years in the healthcare industry as a practice administrator and manager in physical therapy, dermatopathology and pediatrics. She has also held management positions in the hospital setting. As director of operations for a national healthcare staffing corporation, she has traveled across the United States, working directly with physicians and medical human resources personnel to secure jobs for individuals in the medical billing, coding and collection fields. One of Ms. Vines’s mentionable achievements is that in one fiscal year, through mentoring and training, she assisted 300 recruits to find employment in the medical billing industry. This achievement led her to open the Allied Career Center in Dallas, Texas, a successful vocational school specializing in medical office specialist training.

Ann Braceland, NCICS, has been working in the medical field since graduating from Gwynedd Mercy College with an associate’s degree in nursing science. As a practice manager, her extensive work in managed care and medical billing and coding has allowed her to research and find means of informing others through her teaching of the changes and challenges that arise in the medical field. Mrs. Braceland has established and managed satellite offices in physical and occupational medicine. She is a Medicare representative with a vast spectrum of knowledge that she uses to train staff and physicians in compliance coding and billing. As director of training for the instructors of Allied Career Center in Dallas, Texas, her presentation of the material for students led to the publication of this book. Mrs. Braceland is a National Certified Insurance and Coding Specialist.

Susan Miller has worked in the health care industry for 25 years, managing and supervising medical billing processes. She has lectured in a classroom setting, providing students with knowledge and skills on medical billing and coding. Ms. Miller continues her health care career in medical billing, providing support to staff members on billing and coding guidelines.