Oct 06, 2022  
2020-2021 Lane Community College Catalog 
2020-2021 Lane Community College Catalog [ARCHIVED CATALOG]

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HIM 160 - Healthcare Insurance and Billing

4 Credit(s)

This is a hands-on course interactive course where students will learn how medical insurance plays an important role in the financial well-being of every health care business. This course is designed to emphasize the revenue cycle-ten steps that clearly identify all the components needed to successfully manage the medical insurance claims process. The cycle shows how administrative medical professionals follow the money ." This course covers both outpatient physician and inpatient/outpatient hospital situations. 

Learning Outcomes
Upon successful completion of this course, student s will be able to:

  1. Identify a new versus established patient, obtain patient demographic information, insurance verification, and authorizations and collect ti me-of-service payments
  2. Understand and explain the importance of accurate documentation when working with electronic health records
  3. Describe the different types of medical insurance,their characteristics and eligibility requirements
  4. Determine Coordination of Benefits for patients with more than one insurance plan
  5. Code diagnoses using the basic steps and principles of the ICD-10-CM coding system
  6. Code procedures/services using the basic steps and principles of the CPT/HCPCS coding system
  7. Complete HIPAA-compliant health care claims for Medicare, Medicaid, and TRICARE/CHAMPVA; Workers' Compensation; and private payers, including BlueCross and BlueShield Plans, commercial carriers, and managed careorganizations
  8. Understand and complete the hospital billing cycle following the guidelines previously learned
  9. Discuss HIPAA/HITECH, legal, and ethical considerations with emphasis on confidentiality, protected health information and fraud related to insurance
  10. Discuss the processing of payers' remittance advices (RAs) and patient billing/collections

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