MIS 101 - Principles Appl Medical Ins

 
Description
A study of medical insurance programs with emphasis on professional service and diagnostic coding. Topics include processing insurance claims, ICD-9-CM, CPT-4, diagnosis-related grougps, preferred provider programs, and computer -generated insurance claims. The principles of insurance and their applications to specific cases in a medical office and hospital billing department are examined. This course requires a per credit health career fee; check the tuition and fee schedule for the current rate.

1. Outline and describe the roles and responsibilities of the Medical Insurance Specialist.
2. Define medical insurance terms and describe the development of the medical insurance industry.
3. Differentiate between diagnostic and procedural coding and their relationship to insurance claims.
4. Prepare accurate and complete insurance claim forms according to current insurance guidelines.
5. Explain electronic claims submission and its importance in today’s insurance environment.
6. Collect data from patient charts and distinguish between primary and secondary insurance plans.
7. Identify, describe and explain the important federal, state and private medical insurance plans.

1. Medical insurance/billing profession
2. Medical insurance terminology
3. Introduction to coding systems
4. Insurance claim forms
5. Medical insurance plans

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