MA 155 - Medical Insurance Billing

Credits: 3
Lecture Contact Hours: 3
Description: This course introduces the student to the various types of medical insurance including Blue Cross/Blue Shield, Medicare, Medicaid, Workers’ Compensation and other third-party payers. The student will perform the tasks necessary to process claim forms for each type of medical insurance. Applying the guidelines of CPT, ICD-10 CM and Health Insurance Portability and Accountability Act (HIPAA) must be demonstrated by the student.

Prerequisites: MA 134. HIT 104.
Corequisites: None.
Recommended: None.

Course Category: Occupational
This Course is Typically Offered: Winter, Spring, Fall
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Course Competencies

Apply coding using the CPT and ICD-10-CM coding nomenclature.
Utilize medical terminology related to medical insurance billing procedures and insurance programs.
Compose a claim adjustment form for third party reimbursement.
Compose a third party claim form.
Compare the various types of insurance coverage.
Apply tactful communication skills with medical providers and patients.
Identify guidelines for Workers’ Compensation and auto insurance coverage.
Compare clinic versus inpatient and outpatient hospital services related to hospital claim processing.
Interpret information on an insurance card.
Apply HIPAA guidelines in the billing process.
Apply both sensitivity and ethical consideration in all communications.
Execute understanding of obtaining precertification or preauthorization including documentation.