hcr230 | undergraduate
Claims Preparation II: Footing The Bills
This undergraduate-level course is 9 weeks This course is available as part of a degree or certificate program. To enroll, speak with an Enrollment Representative.
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TRICARE and CHAMPVA
- Explain TRICARE eligibility and cost sharing requirements.
- Describe CHAMPVA coverage.
- Describe features of TRICARE and its subsidiaries.
- Explain TRICARE provider and non-provider charges.
Worker’s Compensation and Disability
- Describe features of federal and state workers' compensation plans.
- Categorize work-related injuries.
Payments, Appeals, and Secondary Claims
- Evaluate the effectiveness of the RA/EOB in the claim adjudication process.
- Discuss Medicare post payment audits.
- Describe the purpose of the general appeals process.
Patient Billing and Collections
- Illustrate the collection process.
- Explain uncollectible accounts and record retention.
- Determine guidelines for patient accounts.
- Outline effective financial policies and procedures for medical offices.
Policies and Procedures
- Illustrate the claims adjudication process.
- Compose a medical office financial policy.
Hospital Billing and Reimbursement
- Discuss the importance of written consent.
- Compare inpatient and outpatient coding.
- Compare inpatient and outpatient hospital services.
Private Payers, Blue Cross and Blue Shield
- Compare cost control strategies of employer-sponsored and self-funded health plans.
- Summarize group health eligibility, portability and required coverage.
- Describe participation program compensation and billing.
- Explain features of private payer and consumer-driven health plans (CDHP).
- Discuss Medicare eligibility.
- Discuss the impact of Medicare incentive programs.
- Summarize Medigap insurance.
- Describe Medicaid eligibility and coverage.
- Explain how Medicaid covered charges are determined.
- Discuss effects of the Welfare Reform Act on Medicaid eligibility.
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