Health Insurance Today

Corresponding to the chapters in Health Insurance Today, 5th Edition, this workbook gives you practice with the skills you will need to succeed as a health insurance professional. Practical assignments reinforce the information in the text, and engaging learning activities and exercises challenge you to apply your knowledge to real-world situations. Performance objectives include hands-on, application-based learning activities with practice in areas such as completing claim forms, posting payments to a patient's ledger, filling out "Release to Return to Work" forms, and filling out Medicare appeals. Critical thinking activities strengthen your ability to apply health insurance concepts to a variety of challenging situations. Defining Chapter Terms activities help you review and understand key terms in each chapter. Chapter assessments test your knowledge of text content with multiple choice, true/false, short answer, fill-in-the-blank, and matching questions. Problem solving/collaborative (group) activities emphasize the importance of teamwork in the health care field. Case studies ask you to solve a real-world problem related to health insurance, such as completing a CMS-1500 claim form or explaining how HIPAA could affect someone recently out of work. Application exercises ask you to apply your knowledge and skills to real-world situations. In-class projects and discussion topics enhance your understanding of specific content from the text. Internet Exploration exercises in each chapter help you learn how to perform research online. NEW! Key coverage of new topics includes Medicare, Electronic Health Records, and Version 5010. UPDATED! Additional ICD-10 coding content prepares you for the upcoming switch to the new coding system in October 2015. NEW! Content on Patient Protection and Affordable Care Act ensures you stay current on these significant healthcare system changes.

Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

For total preparation, use the text and Student Workbook for Health Insurance Today: A Practical Approach together! This workbook with bound-in CD contains a variety of exercises that test student understanding through simple chapter assessments and offer practice on a variety of actual health insurance billing/coding job functions. Students can test their understanding of material in the text with Defining Chapter Terms exercises and multiple choice, true/false, short answer, and fill-in-the-blank Chapter Assessments. 59 competency-based Performance Objectives activities test students on concepts in a timed, competency-based environment (including a point system and grading sheet for instructor evaluation purposes). 54 case studies, 68 critical thinking exercises, and 44 collaborative learning activities provide ample opportunities for practice, self-assessment and confidence building. 63 Projects/Discussion Topics allow instructors to assign extra projects or hold class discussions that reinforce key points. Internet Exploration assignments ask students to do further research on text content on related websites. At the end of each chapter, students can complete a Self-Evaluation to help them judge their performance. Three different options provide claims form completion practice on the CD-ROM - all tied to exercises in the workbook: Electronic Forms - Common health insurance forms in Word format provide an easy way for students to complete related workbook exercises. Students can save their work at any point -- for completion at a later date or for evaluation by their instructor. Guided Completion - For introductory purposes, select exercises in the workbook direct students to the Guided Completion option where software takes them through each block of the CMS-1500 (08-05) version, offering correction and advice at each stage. Practice Management - Certain exercises within the workbook require students to use a working demo of Altapoint practice management software, giving students valuable practice management experience.

The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.