Comprehensive Health Insurance - With Cd - 08 edition

Preface Section I A Career in Healthcare CHAPTER 1: INTRODUCTION TO PROFESSIONAL BILLING AND CODING CAREERS Employment Demand Facilities Physician Practice Hospital Centralized Billing Office Job Descriptions Medical Office Assistant Medical Biller Medical Coder Registered Health Information Technicians (RHIT) Payment Poster Medical Collector Refund Specialist Insurance Verification Representative Admitting Clerk or Front Desk Representative Patient Information Clerk Professional Memberships Certification Medical Office Assistant Certification Medical Billing Certifications Medical Coding Certifications Medical Records Certification Resources Section II: Relationship between the Patient, Provider and Carrier CHAPTER 2: MANAGED CARE TERMINOLOGY The History of Healthcare in America Medical Reform Definition of Managed Health Care Managing and Controlling Cost Discounted Fees Patient Care Delivered Is Medically Necessary Care Rendered By Appropriate Provider Appropriate Medical Care in Least Restrictive Setting Withholding Providers Funds Insurance Plans Commercial Health Insurance Types of Managed Care Organizations Health Maintenance Organizations (HMO) Preferred Provider Organization (PPO) Point Of Service Options (POS) Criticism of MCOs Alternative Health Care Plans Exclusive Provider Organization (EPO) Independent Physician Association (IPA) Physician-Hospital Organization (PHO) Self-insured Employers Types of Insurance Coverage Hospital Hospital Indemnity Insurance Medical Surgical Outpatient Major Medical Special Risk Catastrophic Health Insurance Short-Term Health Insurance Cobra Insurance Full-Service Health Insurance Long-Term Care Supplemental Insurance The Provider s View of Managed Care Restrictions Opportunities Patient Care Facility Operations Collection of Funds Assignment of Benefits