MAP 141 - Medical Insurance

Credits: 3
Lecture Hours: 3
Lab Hours: 0
Practicum Hours: 0
Work Experience: 0
Course Type: Voc/Tech

This course provides a practical approach in medical insurance billing. Emphasis will be placed on current procedural codes (CPT-4) and international classification of diseases codes (ICD-9-CM) used to facilitate proper coding in submitting claims. Pertinent billing tips will be offered for each type of insurance.
Prerequisite OR Corequisite: HSC 120 with a “C” or better
Competencies

Distinguish between the major classes of health insurance
1. Explain the key components of “individual” insurance
2. Explain the key components of “group” insurance
Define common insurance, medical, and diagnostic terms
1. Demonstrate knowledge of medical terminology
2. Demonstrate knowledge of procedural terminology
3. Use appropriate insurance terminology in class situations
4. Distinguish between major insurers: Blue Cross and Blue Shield, Medicare, Medicaid, Worker’s Compensation, and disability insurance
Define commonly used insurance abbreviations and acronyms
Code with ICD-9-CM coding books.
Code procedures with the CPT-4 coding book (current year).
Process health insurance claim forms
1. Abstract patient chart and ledger information for proper filing
2. Demonstrate knowledge of filing rules and regulations for Iowa claims
3. Code all diagnoses and procedures
4. Post all charges, payments, and adjustments to patient ledgers