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 the Health Insurance Portability and Accountability Act (HIPAA).

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

Interpret information on an insurance card.
Verify eligibility for services.
Apply the steps to obtain precertification or preauthorization with documentation.
Assist a patient in understanding an Explanation of Benefits (EOB).
Discuss the importance of accurate billing information in an electronic system.
Explain various bookkeeping terms related to medical billing.
Perform accounts receivable procedures to patient accounts.
Compare various types of insurances.
Identify patient financial obligations for services rendered.
Identify processes for claim tracking, denials and appeals.
Discuss fraud and abuse related to third party reimbursement.
Apply critical thinking to all billing processes.

Note: Educational Competencies, mandated for Medical Assistants by the accrediting body MAERB, will be supplied in class.