There is no text to be purchased for this course. Source articles and text chapters are provided within this course in electronic format.

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.

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

1. Differentiate among the terms ‘billing’, ‘coding’, and ‘insurance’ as they pertain to the delivery of healthcare services;
2. Demonstrate appropriate documentation to support accurate coding and billing of healthcare services;
3. Analyze service documentation to support accurate coding and billing of healthcare services;
4. Construct a personal ‘rule guide for documentation’ to use in his or her own practice