Students will acquire and practice the skills necessary to process insurance claim forms and related forms such as referrals, pre-authorizations, registrations, and the CMS-1500 Claim form. This course will familiarize students with billing and coding procedures beginning with the first visit to the physician. Students will learn how to enter patient medical information and services into the medical office computer system by coding those services correctly using procedure (CPT) and diagnosis (ICD-9) codes according the standards set forth by insurance carriers, and by Medicare. Students will also focus on general clinical techniques and concepts and will acquire the knowledge needed to verify a patient’s insurance coverage, and enter patient’s medical information in order to get the claim paid in a timely manner. This course examines health insurance and managed care products in order to finance the delivery of health care services. Students examine the required forms, procedures and general practices of insurance, third party, managed care and other types of reimbursement and payment systems. Additionally, students explore Medicare and Medicaid and pay for performance systems.
Credit Hours: Lecture – 2, Lab – 2, Credits – 3