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This course has an assignment that is due by 11:55 pm Central Standard Time on Wednesday night of the first week of class.  Failure to complete this assignment will result in your removal from the course for non-participation. 

Textbooks

REQUIRED:

  • Vines, D., Braceland, A., Rollins, E., & Miller, S. (2018). Comprehensive Health Insurance: Billing, Coding, Reimbursement (3rd Ed.). Pearson Publishing. ISBN: 978-0-13-445877-9
  • American Psychological Association. (2009). Publication Manual of the American Psychological Association (6th Ed.). IBSN: 978-1-433-80561-5

OPTIONAL/RECOMMENDED:

  • Vines, D., Braceland, A., Rollins, E., & Miller, S. (2018). Student Workbook for Comprehensive Health Insurance: Billing, Coding, Reimbursement (3rd Ed.). Pearson Publishing. ISBN: 978-0-134-78729-9

Course Description

The course introduces the student to the current foundations of reimbursement for health care services by third party payers. Typical requirements for documentation and reporting for insurance purposes are explored, including the usual insurance requirement for pre-certification or prior authorization for services. Standards for accuracy in coding, and how these interface with the billing function are surveyed. (Prerequisite/Co-requisite: HS304).  3 hours.

Course Objectives

Upon successful completion of the course, each participant should be able to:

  1. Understand the structure, function, and history of various health insurances and types
  2. Differentiate among the terms ‘billing’, ‘coding’, and ‘insurance’ as they pertain to the delivery of healthcare services;
  3. Demonstrate appropriate documentation to support accurate coding and billing of healthcare services;
  4. Analyze service documentation to support accurate coding and billing of healthcare services;
  5. Understand local, state, and federal resources available for the uninsured.