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Instructor Resources: PowerPoint slides, guides to the in-book discussion questions, links to healthcare reform updates, and a transition guide to the new edition. Rather than focus on the day-to-day operations of insurers, Health Insurance looks in from the outside and explains the role that private health insurance plays in the United States. Noted health economist Michael Morrisey presents a rigorous but intuitive examination of the issues raised by insurance and how the market and the government have dealt with these issues. His emphasis is on understanding the underlying problems from an economics perspective and then applying the empirical literature to provide insight into the impact and effectiveness of the solutions. As such, this book serves as a basis for understanding and predicting the effects of the Patient Protection and Affordable Care Act (ACA). This updated edition includes new chapters covering the ACA and the structure, conduct, and performance of the insurance market. Additional resources in each chapter include recent research articles and classic insurance papers that give readers further information on each topic. Topics covered include: The effect of the 2008 recession on insurance coverage Health savings accounts and consumer-directed health plans Adverse selection The predictive power of risk adjustment Moral hazard Selective contracting and market power Employer-sponsored health insurance Medicare and Medicaid "I believe that Health Insurance is an outstanding first textbook in this subject area and represents what must be the best one-volume summary of empirical research on health insurance available anywhere." Curtis Florence, PhD., Adjunct Associate Professor, Rollins School of Public Health, Emory University

May have limited writing in cover pages. Pages are unmarked. ~ ThriftBooks: Read More, Spend Less 1.12

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Book is in very good condition and may include minimal underlining highlighting. The book can also include "From the library of" labels. May not contain miscellaneous items toys, dvds, etc. . We offer 100% money back guarantee and 24 7 customer service.

Health Insurance Politics in Japan: Policy Development, Government, and the Japan Medical Association 1.12

Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry.The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.The Fifth Edition also offers new or expanded coverage of:· “Moral hazard,” and its application in health insurance and managed care· The ever expanding and evolving payment systems and methodologies used in the U.S. Healthcare System· The role of benefits design along with discussion about medical necessity and its impact on benefits coverage· The impact of limitations on sales, governance and administrative (SG&A) costs and profits · Continued changes in payment mechanisms such as value-based payment under the Medicare Improvement for Patients and Providers Act (MIPPA)· Medicare Part D, the drug benefit and the plans that offer it, as well as the complexities of Medicare Advantage payment plans, Medicaid expansion under ACA, and more.

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· What are the characteristics that define a Social Health Insurance system? · How is success measured in SHI systems? · How are SHI systems developing in response to external pressures? Using the seven Social Health Insurance countries in western Europe - Austria, Belgium, France, Germany, Luxembourg, the Netherlands and Switzerland - as well as Israel, this important book reviews core structural and organizational dimensions, as well as recent reforms and innovations. Covering a wide range of policy issues, the book: · Explores the pressures these health systems confront to be more efficient, more effective, and more responsive · Reviews their success in addressing these pressures · Examines the implications of change on the structure of SHI’s as they are currently defined · Draws out policy lessons about past experience and likely future developments in SHI systems in a manner useful to policymakers in Europe and elsewhere Social Health Insurance Systems in Western Europe will be of interest to students of health policy and management as well as health managers and policy-makers. Contributors: Helmut Brand, Jan Bultman, Reinhard Busse, Laurent Chambaud, David Chinitz, Diana M.J. Delnoij, André P. den Exter, Aad A. de Roo, Anna Dixon, Isabelle Durand-Zaleski, Hans F.W. Dubois, Josep Figueras, Bernhard Gibis, Stefan Greß, Bernhard J. Güntert, Jean Hermesse, Maria M. Hofmarcher, Martin McKee, Pedro W. Koch-Wulkan, Claude Le Pen, Kieke G.H. Okma, Martin Pfaff, Richard B. Saltman, Wendy G.M. van der Kraan, Jürgen Wasem, Manfred Wildner, Matthias Wismar.

Buy with confidence! Book is in acceptable condition with wear to the pages, binding, and some marks within 3.1

Prepare for a career in health information management and medical billing and insurance processing with Green's UNDERSTANDING HEALTH INSURANCE, 14E. This comprehensive, inviting book presents the latest code sets and guidelines. Examine today's most important topics, such as managed care, legal and regulatory issues, coding systems and compliance, reimbursement methods, clinical documentation improvement, coding for medical necessity, and common health insurance plans. Updates introduce new legislation that impacts health care, including changes to the Affordable Care Act (Obamacare); ICD-10-CM, CPT, and HCPCS level II coding; revenue cycle management; and individual health plans. Workbook exercises provide application-based assignments and case studies, as well as CMRS, CPC-P, and CPB mock exams.

New! This book is in the same immaculate condition as when it was published 1.74

Student Workbook for Comprehensive Health Insurance: Billing, Coding, and Reimbursement (3rd Edition) [paperback] Vines, Deborah,Braceland, Ann,Rollins, Elizabeth,Miller, Susan [Aug 16, 2017]

NEW EDITION! The advent of federal healthcare reform in the United States has thrust individual health insurance into the limelight as never before. The marketplace for individuals not covered by an employer plan has changed fundamentally in the past few years, with significant new risks and opportunities for the stakeholders involved. Health insurers must quickly develop and implement new strategies to succeed in the post-reform world. At the same time, all other aspects of healthcare also continue to evolve rapidly, not only because of reform efforts, but also because of demographic changes, technological advances, and other forces. This second edition of Individual Health Insurance has been updated for the vast-and still-unfolding-tapestry of changes made by the Affordable Care Act. At the same time, it also features updated and expanded material on many other topics, such as Medicare Advantage and Part D. The authors are internationally known experts on individual health insurance, and their knowledge was supplemented with specialized expertise from several colleagues. This book covers the history of the individual marketplace, the role of government health policy, products currently available, regulation, and all aspects of the development and management of this business. It is a valuable comprehensive resource for those working in the field, whether they are actuaries, managers of payors or providers, or policymakers.

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Understanding Health Insurance: A Guide to Professional Billing, 7th edition, is a comprehensive guide for those learning about health insurance claims processing and reimbursement issues. The text utilizes a step-by-step approach to successful completion of health insurance claims. The objectives of this edition are to 1) introduce information about major third party payers, 2) provide up-to-date information about federal health care regulations, 3) clarify coding guidelines and provide application exercises for each coding system, 4) introduce reimbursement issues, 5) emphasize the importance of coding for medical necessity, and 6) 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. The textbook CD-ROM and accompanying workbook provide additional exercises and practice in completing CMS-1500 claims electronically. Current information is provided on CPT-5 and ICD-10-CM coding systems. The appendices include information about processing UB-92 (CMS-1450) claims and dental claims.

If you are studying for your life and health insurance licensing exam, we have the ultimate study tool for you. Life and Health Insurance License Exam Cram is a great resource to help you learn the concepts, laws, rate calculations and state and federal regulations that will be covered on the exam. You'll also receive a CD that includes a fully-customizable test engine, detailed score report and state-specific law supplement. No matter where you are taking your exam or which area you need to focus on during your studying, Life and Health Insurance License Exam Cram is your smartest way to get certified. Please note: The CD-ROM and test engine is NOT Mac iOS compatible.

COMPREHENSIVE HEALTH INSURANCE: BILLING, CODING & REIMBURSEMENT, 2/e provides students with the knowledge and skills needed to work in a variety of medical billing and coding positions in the medical field. Comprehensive in approach, it covers the foundations of insurance, billing, coding and reimbursement. Students learn not only the submission of claims to the insurance carrier, but also reviewing medical records, verifying patient benefits, submitting a secondary claim, posting payments and appealing the insurance carrier's decision. This edition includes new chapters devoted to HIPAA and ICD-10-CM Medical Coding, as well as outstanding coverage of electronic records. Numerous case studies and patient files are included throughout and demonstrate refunds and appeals, auditing and compliance, Medicare calculations and professionalism.

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This current, accurate and detailed industry guide for financial service professionals examines life and health insurance simultaneously from the viewpoints of the buyer, the advisor, and the insurer—providing a comprehensive and unbiased treatise on individual and group life; a forthright appraisal of life and health insurance industry products with careful consideration of the environment; and a complete examination of life insurance company operations and regulation. Bases financial treatment of life insured operations on modern financial theory, and devotes entire chapters to the economics of life and health insurance; individual life and health insurance policies; life and health insurance evaluation; the uses of life and health insurance in personal and business planning; government and employee benefit plans; and the management, operation, and regulation of life insurance companies. Offers a strong global orientation, supporting fundamental concepts with an extensive integration of economic and financial theory and international comparisons, and examines how today's health insurance products fit into a broad framework from a contractual, cost, and performance viewpoints. New chapters on the tax treatment of life and health insurance address such areas as estate planning, retirement planning, and the business uses of life and health insurance. For financial planners, salesmen, actuaries, investment managers, attorneys, CPAs, and other financial service professionals.

After World War II, the United States and Canada, two countries that were very similar in many ways, struck out on radically divergent paths to public health insurance. Canada developed a universal single-payer system of national health care, while the United States opted for a dual system that combines public health insurance for low-income and senior residents with private, primarily employer-provided health insurance―or no insurance―for everyone else. In National Health Insurance in the United States and Canada, Gerard W. Boychuk probes the historical development of health care in each country, honing in on the most distinctive social and political aspects of each country―the politics of race in the U.S. and territorial politics in Canada, especially the tensions between the national government and the province of Quebec.In addition to the politics of race and territory, Boychuk sifts through the numerous factors shaping health policy, including national values, political culture and institutions, the power of special interests, and the impact of strategic choices made at critical junctures. Drawing on historical archives, oral histories, and public opinion data, he presents a nuanced and thoughtful analysis of the evolution of the two systems, compares them as they exist today, and reflects on how each is poised to meet the challenges of the future.