Section
1: Anatomy and Physiology
(4 Weeks)
The Anatomy and Physiology
section of this course will
provide students with a general
overview of the human body,
including its structure, the
functions of its different
parts and systems, and an introduction
to diseases. Students will
learn how to apply this information
while performing insurance
billing and coding functions.
Section
2: Medical Terminology (4
Weeks)
The Medical Terminology section
of this course is designed
to familiarize students with
medical words, phrases, and
medical abbreviations related
to the systems of the human
body and disease processes.
Students will learn definitions
and pronunciation of the different
words and phrases. Students
will gain experience with "real-life" examples
from medical charts.
Section
3: Health Insurance and Reimbursement
(8 Weeks)
This module
is designed to teach students
about major
insurance
programs, federal health care
legislation and programs, and
claims. In addition, you will
learn the process of completing
claims forms efficiently, effectively,
and in compliance with payor
guidelines and regulations.
Using
your working knowledge of medical
terminology and
administrative skills, this
course will review, facilitate,
and reinforce medical terminology
skills while introducing
the
student to health insurance,
managed care, the life cycle
of an insurance claim, legal
and regulatory guidelines,
CMS reimbursement issues,
coding for medical necessity,
CMS
claim forms, commercial claims,
Medicare, Medicaid, Tricare,
and Workers Compensation.
Upon completion
of this module, the student
will be able
to accurately and efficiently
complete claim forms in
conjunction with the required
payor guidelines.
The student
will also have all fundamental
Health
Insurance and Reimbursement
knowledge
necessary for the Medical
Coding (ICD-9-CM, HCPCS, and
CPT)
module that follows.
Section
4: Medical Billing and Coding
(ICD-9-CM, HCPCS, and CPT)
(16
Weeks)
Accurate coding
is crucial to the successful
operation of any health care
facility or providers’s
office because reported codes
determine the amount of reimbursement
received. The annual revision
of coding guidelines and payer
requirements serve to challenge
coders. Those responsible for
assigning and reporting codes
in any health care setting
require thorough instruction
in the use of the ICD-9-CM,
CPT, and HCPCS Level II coding
systems.
This course
will benefit students interested
in pursuing
a career
in the rapidly growing
field of medical insurance,
billing,
and coding and experienced
coders who are already
employed in the health care
field
who would like to enhance
their skills or learn additional
clinical areas.
Upon successful
completion of this course
(and required
prerequisites), the student
will be able to properly
assign the correct ICD-9-CM,
HCPCS, and/or CPT coding
assignment based on the
medical services performed.
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