Insurance and Coding (4 Hrs.)
Students begin with an overview of insurance concepts, such as managed care, PPO, and HMO. They also list the types of federal health care plans. Students explore the role of ICD-9-CM and CPT codes in processing claims and define the terminology needed to interpret and submit medical insurance claims. They complete a universal health insurance claim form and discuss electronic claim filing. Students also learn the importance of accuracy in receiving reimbursement in case of an audit.
Unit: Insurance
Description
In this unit, students will learn about health insurance. They will learn key terms associated with insurance and will distinguish between fee-for-services plans and managed care plans. In addition, students will list advantages and disadvantages of managed care and will compare the features of HMO, PPO, and POS plans. Students will also learn the office assistant's role in handling and confirming a patient's insurance benefits.
Lessons
1. Insurance
2. The Assistant's Role
3. Managed Care Plans
4. Quiz
Description
In this unit, students will learn about health insurance. They will learn key terms associated with insurance and will distinguish between fee-for-services plans and managed care plans. In addition, students will list advantages and disadvantages of managed care and will compare the features of HMO, PPO, and POS plans. Students will also learn the office assistant's role in handling and confirming a patient's insurance benefits.
Lessons
1. Insurance
2. The Assistant's Role
3. Managed Care Plans
4. Quiz
Unit: Government Programs
Description
In this unit, students will learn about government-funded health insurance programs. They will distinguish between Medicare and Medicaid and will describe the features of each program. They will also identify the forms of health insurance that are offered to those in the military and their families. In addition, students will describe Workers' Compensation benefits.
Lessons
1. Medicare
2. Medicaid
3. Workers' Compensation
4. Military Carriers
5. Quiz
Description
In this unit, students will learn about government-funded health insurance programs. They will distinguish between Medicare and Medicaid and will describe the features of each program. They will also identify the forms of health insurance that are offered to those in the military and their families. In addition, students will describe Workers' Compensation benefits.
Lessons
1. Medicare
2. Medicaid
3. Workers' Compensation
4. Military Carriers
5. Quiz
Unit: Coding
Description
In this unit, students will learn about coding. They will discuss the history and purpose of coding and will distinguish between diagnostic coding and procedural coding. In addition, students will learn the steps involved in performing both diagnostic and procedural coding.
Lessons
1. Coding
2. Diagnostic Coding
3. Procedural Coding
4. Quiz
Description
In this unit, students will learn about coding. They will discuss the history and purpose of coding and will distinguish between diagnostic coding and procedural coding. In addition, students will learn the steps involved in performing both diagnostic and procedural coding.
Lessons
1. Coding
2. Diagnostic Coding
3. Procedural Coding
4. Quiz
Unit: Claims
Description
In this unit, students will learn about the claims process. They will fill out a claim form and will discuss the steps involved in claim processing. They will also identify methods of reimbursement and learn the procedure for applying insurance payments. Finally, students will discuss legal matters involved in claim processing, including fraud, abuse, and auditing.
Lessons
1. The Claim Form
2. Claims Processing
3. Reimbursement
4. Legal Issues
5. Quiz
Description
In this unit, students will learn about the claims process. They will fill out a claim form and will discuss the steps involved in claim processing. They will also identify methods of reimbursement and learn the procedure for applying insurance payments. Finally, students will discuss legal matters involved in claim processing, including fraud, abuse, and auditing.
Lessons
1. The Claim Form
2. Claims Processing
3. Reimbursement
4. Legal Issues
5. Quiz
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