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New!

Understanding Health Insurance: A Guide to Billing and Reimbursement, 2025 Edition, 20th Edition

Michelle A. Green

  • Copyright 2026
  • {{checkPublicationMessage('Published', '2025-01-01T00:00:00+0000')}}
Starting At £51.50 See pricing and ISBN options
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Understanding Health Insurance: A Guide to Billing and Reimbursement, 2025 Edition 20th Edition by Michelle A. Green
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Overview

Prepare students for successful careers in revenue management, medical billing or health insurance processing with Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2025 Edition. Updated annually, this reader-friendly resource highlights the latest developments in health insurance and revenue management as well as recent changes to ICD-10-CM, HCPCS Level II and CPT® codes and guidelines. Students will acquire valuable knowledge about health insurance, managed care, revenue management, legal and regulatory issues, coding systems, reimbursement and common health insurance plans. This text offers a range of print and digital options to best suit your classroom needs. The comprehensive MindTap online courseware includes specialized software for SimClaim CMS-1500 claim simulation, allowing for easy integration with your school's LMS and gradebook functionality.

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Meet the Authors

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Michelle A. Green

Michelle Green has served in the capacity of full-time or adjunct faculty member as needed since 2017, and during Spring 2023 was named interim program director in the health information technology department at Mohawk Valley Community College in Utica, New York. She was the SUNY Distinguished Teaching Professor in the physical and life sciences department at the State University of New York College of Technology at Alfred for more than 30 years. She has authored three popular textbooks related to coding, revenue management and health information management. An active member of the AAPC and American Health Information Management Association, Green has been recognized for her excellence in teaching as well as her significant contributions to the health information management profession. Her numerous accolades include the State University of New York Chancellor's Award for Excellence in Teaching, Alfred State College's Alumni Association Teacher of the Year, Who's Who Among America's Teachers, AHIMA's FORE Triumph Educator Award and NYHIMA’s Educator Award. In addition, she is a Registered Health Information Administrator, a fellow of the American Health Information Management Association and a Certified Professional Coder. She earned an MPS from Alfred University and a Bachelor of Science from Daemen College.

What's New

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  • The 2025 Edition includes updated health insurance and medical billing and reimbursement concepts, focusing on essential skills for healthcare professionals. New content covers artificial intelligence, managed care contracts, risk adjustment methodologies and payment models, and national standard formats for claims submission. Additional new content covers the Medicare drug price negotiation program, Office of the national Coordination for Health Information Technology and it's eHealth Exchange, and Health Information Technology for Economic Clinical Health Act, Medicare [inpatient] code edition, new technology add-on payments, and appeals and denials in individual health insurance chapters.
  • Updated MindTap online learning platform! Revisions throughout this edition's digital resources reflect functionality enhancements, customization improvements, and assessment updates
  • Carefully updated instructions for completing insurance claims within chapters 11-16.
  • Chapters 6–16 include new and revised ICD-10-CM, HCPCS Level II and CPT® codes. All content, related exercises in Chapters 6–8 and chapter reviews reflect the latest coding changes and guidelines and their impact on assigning codes.

Features

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  • Clear learning objectives at the beginning of each chapter allow students to self-assess comprehension of chapter content. In addition, boldfaced key terms appear throughout each chapter to help students master the technical vocabulary associated with billing, coding, reimbursement and health insurance claims processing. The text's proven learning design methodology clearly maps chapter content, both to major topics to be covered and to well-defined learning objectives.
  • Clear learning objectives at the beginning of each chapter allow students to self-assess comprehension of chapter content. In addition, boldfaced key terms appear throughout each chapter to help students master the technical vocabulary associated with billing, coding, reimbursement and health insurance claims processing. The text's proven learning design methodology clearly maps chapter content, both to major topics to be covered and to well-defined learning objectives.
  • Clear instructions for completing CMS-1500 insurance claims reflect current requirements, including any recent changes. Updates to instructions appear throughout the textbook, and SimClaim software is available on the accompanying MindTap Courseware. SimClaim offers multiple case studies that include billing data and patient histories. Auto-graded features provide students with instant feedback.
  • Review questions include multiple choice questions to help accurately assess student comprehension of chapter content. Additional questions focus on gauging understanding of key concepts and applications such as practice in calculating insurance or Medicare payments, co-payments and coinsurance. To gain valuable hands-on practice, students can complete coding exercises throughout Chapters 6–8. Answers to exercises are available in the solutions and answer guide.

Table of Contents

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1. Health Insurance Specialist Career.
2. Introduction to Health Insurance and Managed Care.
3. Introduction to Revenue Management.
4. Revenue Management: Insurance Claims, Denied Claims and Appeals, and Credit and Collections.
5. Legal Aspects of Health Insurance and Reimbursement.
6. ICD-10-CM Coding.
7. CPT Coding.
8. HCPCS Level II Coding.
9. CMS Reimbursement Methodologies.
10. CMS-1500 and UB-04 Claims.
11. Commercial Insurance.
12. BlueCross BlueShield.
13. Medicare.
14. Medicaid.
15. TRICARE.
16. Workers’ Compensation.
Appendices.
Bibliography.
Glossary.
Index.

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MindTap Options

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MindTap
Each MindTap product offers the full, mobile-ready textbook combined with superior and proven learning tools at one affordable price. Students who purchase digital access can add a print option at any time when a print option is available for their course.

This Cengage solution can be seamlessly integrated into most Learning Management Systems (Blackboard, Brightspace by D2L, Canvas, Moodle, and more) but does require a different ISBN for access codes. Please work with your Cengage Learning Consultant to ensure the proper course set up and ordering information. For additional information, please visit the LMS Integration site.

Standalone Digital Access — Ultimate Value

Recommended and most popular

  • ISBN-10: 8214483441
  • ISBN-13: 9798214483443
  • RETAIL £90.99
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Textbook Only Options

Traditional eBook and Print Options

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  • ISBN-10: 8214113059
  • ISBN-13: 9798214113050
  • RETAIL £51.50

  • ISBN-10: 8214112974
  • ISBN-13: 9798214112978
  • RETAIL £143.00
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Supplements

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Cengage provides a range of supplements that are updated in coordination with the main title selection. For more information about these supplements, contact your Learning Consultant.

FOR STUDENTS

International MindTap Instant Access for Green's Understanding Health Insurance: A Guide to Billing and Reimbursement - 2025 Edition

ISBN: 9798214483443
International MindTap Instant Access for Green's UNDERSTANDING HEALTH INSURANCE: A GUIDE TO BILLING AND REIMBURSEMENT, 2025 Edition, is the comprehensive digital learning solution that powers students from memorization to mastery. It gives you complete control of your course and provides engaging content to build students' confidence. Cengage's award-winning MindTap platform gives you complete ownership of your content and learning experience. The Learning Path mirrors the chapter organization of the core text and provides readings, activities and auto-graded quizzing. Customize the interactive syllabi and emphasize the most important topics. The platform includes a complete eBook with read-speaker and highlighting capabilities. Digital flashcards are also included to help students learn key terminology. All online text media materials accessible through this access code are available in EMEA, Latin America, Asia, and India only.