HIM 232 - Medical Revenue - Insurance and Billing Application

4.00 credits

Students will learn accurate processing of health insurance claims. Thorough instructions in all aspects of medical insurance including plan options, payor requirements, state and federal regulations, abstracting of documents, accurate completion of claims, coding diagnoses and procedures. Determine the accuracy of abstracted data elements for data base integrity and claims processing. Includes contemporary prospective payment systems and key health plans, charge master maintenance, and evaluation of fraudulent billing practices. ICD-10-CM, CPT-4 and HCPCS will be reviewed and there will be hands-on application of EHR- Go Coding; Inpatient and outpatient. Recommended: HIM 131 and HIM 231.