mod7_MBC08_upgrade - Overview Approximately 94 percent of...

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Approximately 94 percent of patients seeking health care have some type of insurance coverage. This means completion of a claim form, an intricate part of the billing process, is necessary. Overview Each insurance program, such as Medicare and Medicaid, has terms pertinent to its particular program. In this section, we will familiarize you with common industry terminology and then introduce you to some of the major carriers and types of insurance plans. Additionally, each plan has its own set of guidelines for completing a claim form. We will discuss these so you will understand the intricacies of this process and be able to complete your own claims. As the healthcare field moves away from sending claims through the mail, we will also discuss Electronic Data Interchange (EDI) as a means for submitting your claims and receiving payment. You will become familiar with the claims submission process and the terminology required for this highly efficient method of communicating with insurance carriers.
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Objectives 1. Understand the terminology used in the insurance industry. 2. Identify and explain various insurance programs, including Blue Cross/Blue Shield, Medicare, Medicaid, TRICARE, and Worker’s Compensation. 3. Abstract information from the patient medical record to complete a CMS-1500 claim form. 4. Complete the CMS-1500 claim form for commercial and government carriers. 5. Recognize common guidelines to complete the CMS-1500 claim form. 6. Understand the advantages of electronic claims submission. 7. Perform the claims processing procedures. 8. Perform payment posting and secondary insurance billing. 9. Demonstrate understanding of tracking and follow-up of outstanding insurance claims.
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Online Course Preparation 1. A Guide to Health Insurance Billing, 2 nd Edition Author: Marie A. Moisio In this unit, we will use: The activities you perform in your student textbook and workbook are self-study. You are not timed, nor does this material need to be sent to your instructor. You will be tested at the end of the Unit on the material covered in the chapter and online. You can do other, unassigned, activities as well in your student workbook, including the computer assignments, if you would like some additional self-study, but it is not required.
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Textbook Reading: A Guide to Health Insurance Billing Since this section of the course covers several chapters in your textbook, you will be given your reading assignments throughout the online lecture. Your reading will come from Chapters 3, 7, 8, and 10-15. Activities: Reinforcement Exercises will be assigned throughout this Unit ASSIGNMENTS:
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Reading Assignment
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This note was uploaded on 02/21/2012 for the course CODEING unknown taught by Professor Unknown during the Spring '12 term at Joliet Junior College.

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mod7_MBC08_upgrade - Overview Approximately 94 percent of...

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