BTECM 250 Medical Claims and Insurance Management (5 credits)
Formerly BTECH 250
Course Description
Emphasis on the production of the medical insurance forms required for insurance billing, including an introduction to CMS-1500 and UB-92. Includes completion of medical claim forms for (includng, but not limited to): Medicare, Medicaid, private/commercial insurance, Blue Cross, VA, and Worker’s Compensation.
Course Content
A. Roles, responsibilities, and legal considerations of a medical billing specialist
B. Medical insurance form completion
C. Basic knowledge of diagnostic and procedural coding guidelines
D. Claims processing guidelines for types of major medical insurance
E. Medical record documentation guidelines
Student Outcomes
1. Describe basic information regarding major insurance programs and federal health care legislation.
2. Display basic knowledge of ICD-10-CM, CPT, and HCPCS coding and define the differences between these systems.
3. Extract information from case studies to accurately complete the appropriate insurance claim form or forms.
4. Evaluate the advantages and disadvantages of electronic claims submissions and the safeguards that need to be in place to ensure confidentiality.
5. Explain the impact of coding compliance and clinical documentation on health care settings.
Degree Outcomes
Program Outcome: Manage time and multiple tasks appropriate to the office. Apply technical skills to meet industry standards in the office. Demonstrate knowledge of the United States’ Health Insurance Privacy and Accountability Act (HIPAA).
Information Competency: Graduates will be able to seek, find, evaluate and use information and employ information technology to engage in lifelong learning.
Lecture Contact Hours 50
Lab Contact Hours 0
Clinical Contact Hours 0
Total Contact Hours 50
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