Medical Billing, Insurance and Health Record Review

Catalog description

Students will explore the practical applications of medical coding relative to delivery system, health insurance and reimbursement mechanisms. Students will work with both inpatient and outpatient claims forms to gain knowledge of the billing process. However, emphasis will be placed on coding in the outpatient setting. Students will investigate various third-party carriers (governmental and commercial), and will examine different reimbursement methods including DRGs, APCs, RBRVSs, chargemasters, coding compliance as well as the importance of encoding and grouping software. Health records will be analyzed in order to properly fill out insurance claim forms. Pre-requisite(s): HITC 110 Medical Coding or by permission of department chair.