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HIM 131 Introduction to Insurance and Insurance Billing I
Credit Hours:  3
Effective Term: Fall 2015
SUN#: None
AGEC: None  
Credit Breakdown: 3 Lectures
Times for Credit: 1
Grading Option: A/F Only

Description: Introductory course to insurance systems, billing processes, clinical vocabularies, ethical and legal issues and computer applications used to complete these processes.

Prerequisites: RDG094

Corequisites: None

Recommendations: None

Measurable Student Learning Outcomes
1. (Analysis Level) Identify and research the background and importance of accurate insurance claims submission, coding, and billing, educational requirements for a job as an insurance billing specialist and a coder to include areas of specialization and the associations for credential attainment, principles of documentation, the contents of a medical record, required content of a physician note and basic documentation rules as well as contract management and A/R.
2. (Analysis Level) Analyze issues related to patient confidentiality, privacy, security as well as other legal issues related to coding and billing. Differentiate types of claims submissions, claim rejections, claim appeals and claim processes for reimbursement.
3. (Application Level) Demonstrate the ability to complete the CMS 1500 (08-05) claim form for federal, state, and private payer insurance contracts.
4. (Application Level) Perform oral and written communication collection techniques using common software applications in the execution of work processes.
5. (Analysis Level) Identify, research and explain issues related to manage care health plans, Medicare, Medicaid, TRICARE, Blue Cross, Private Insurance, Private Pay, CHAMPVA, Worker's Compensation, Disability and Medical Funds.
6. (Comprehension Level) Explain and discuss issues and processes related to prospective payment systems.
Internal/External Standards Accreditation