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Understanding Health Insurance, 12th Edition, is the essential learning tool your students need when preparing for a career in medical insurance billing. This comprehensive and easy-to-understand text is fully-updated with the latest code sets and guidelines, and covers important topics in the field like managed care, legal and regulatory issues, coding systems, reimbursement methods, medical necessity, and common health insurance plans.

The twelfth edition has been updated to include new legislation that affects healthcare, ICDCM coding, implementing the electronic health record, the Medical Integrity Program MIP , medical review process, and more. The practice exercises in each chapter provide plenty of review, and the workbook available separately provides even more application-based assignments and additional case studies for reinforcement.

What is Medical Coding?

Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. Green, Michelle A. Built-in study tools include highlights, study guides, annotations, definitions, flashcards, and collaboration.

Additional Book Details

The publisher of this book allows a portion of the content to be used offline. Many of our policies include embedded documents within the PDFs to help provide you with the best information possible. To open an embedded document please save a copy of the policy PDF to your local desktop then double-click on the embedded document icon to open.

UnitedHealthcare Commercial Reimbursement Policies

You are responsible for submission of accurate claims requests. This reimbursement policy is intended to ensure that you are reimbursed based on the code that correctly describes the procedure performed. References to CPT or other sources are for definitional purposes only and do not imply any right to reimbursement.


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  7. This reimbursement policy applies to all professionals who deliver health care services. Coding methodology, industry-standard reimbursement logic, regulatory requirements, benefits design and other factors are considered in developing reimbursement policy.

    Accordingly, UnitedHealthcare may use reasonable discretion interpreting and applying this policy to services being delivered in a particular case. Finally, this policy may not be implemented in exactly the same way on the different electronic claim processing systems used by UnitedHealthcare due to programming or other constraints; however, UnitedHealthcare strives to minimize these variations. UnitedHealthcare may modify this reimbursement policy from time to time by publishing a new version of the policy on this Website; however, the information presented in this policy is believed to be accurate and current as of the date of publication.

    Understanding Your Health Insurance Costs - Consumer Reports

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