Understanding Health Insurance: A...
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Book Summary
Understanding Health Insurance: A Guide to Billing and Reimbursement by Michelle Green is a comprehensive textbook that demystifies the complex U.S. health insurance system. It covers plan types, government programs, coding, claims processing, and reimbursement methods, making it an essential resource for students and professionals in medical billing, coding, and healthcare administration who need practical, up-to-date knowledge.
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About Understanding Health Insurance: A...
Understanding Health Insurance: A Guide to Billing and Reimbursement, by Michelle Green, is a widely used textbook that provides a thorough foundation in the U.S. health insurance and reimbursement system. It explains major plan types (HMO, PPO, POS, HDHP), government programs like Medicare and Medicaid, and the revenue cycle from patient registration to claim submission and payment. The text emphasizes practical skills: completing CMS-1500 forms, understanding ICD-10, CPT, and HCPCS coding, managing denials, and complying with HIPAA and other regulations. Updated to reflect current healthcare reform and industry changes, it includes real-world examples, exercises, and review questions. This edition is designed for classroom use and professional reference, helping readers navigate the complexities of insurance billing and reimbursement with confidence.
Who should read Understanding Health Insurance: A...?
This book is ideal for students in medical billing and coding certificate programs, health information management, and healthcare administration degrees. It also suits early-career professionals—billing specialists, coders, patient account representatives, and medical office staff—who need a practical, comprehensive reference. Instructors and trainers will find it a structured teaching tool. Additionally, anyone transitioning into healthcare administration or seeking to understand insurance reimbursement will benefit from its clear explanations and real-world focus.
Pros & Cons
Pros
- ✓ Comprehensive coverage of U.S. health insurance and reimbursement systems
- ✓ Practical, hands-on approach with real-world examples and exercises
- ✓ Up-to-date content reflecting current regulations and healthcare reform
- ✓ Clear explanations of complex coding and billing processes
- ✓ Structured for classroom use with review questions and learning objectives
Cons
- ✗ May become outdated quickly due to frequent changes in healthcare regulations
- ✗ Primarily U.S.-focused, limiting relevance for international readers
- ✗ Some readers find the dense textbook format overwhelming
- ✗ Requires supplemental practice or software for full coding proficiency
- ✗ High cost for a textbook, especially for individual buyers
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Frequently asked questions
Is this book suitable for self-study?
Yes, it includes learning objectives, examples, and review questions, making it useful for self-paced learners, though instructor guidance may help with complex topics.
Does this edition cover ICD-10 and CPT coding?
Yes, it provides an overview of coding systems including ICD-10, CPT, and HCPCS, focusing on how they relate to billing and reimbursement.
Is this book current with healthcare reform?
The edition reflects recent changes such as the Affordable Care Act and updated Medicare/Medicaid policies, but always check for the latest edition for the most current information.
Is this book useful for the CPC or CCS certification exams?
It provides foundational knowledge for billing and reimbursement, but for certification exams, you may need additional coding-specific study materials.
Does it include access to online resources?
Many editions come with access to online learning platforms or additional practice exercises; check the product details for specific inclusions.
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