hcr220 | undergraduate
Claims Preparation I: Clean Bills Of Health
This undergraduate-level course is 9 This course is available as part of a degree or certificate program. To enroll, speak with an Enrollment Representative.
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Visit Charges and Compliance Billing
- Evaluate billing compliance strategies
- Relate physician and payer fees to medical compliance
- Discuss the impact of the Medicare National Correct Coding Initiative on medical billing and coding processes
Health Care Claim Preparation and Transmission
- Compare the role of HIPAA 837 with CMS-1500 in the claim process
- Explain the importance of preparing and submitting "clean claims"
- Complete a CMS-1500 claim form.
HIPAA and Medical Records
- Summarize the purposes and provisions of HIPAA.
- Relate ethics and etiquette standards for medical record keeping to HIPAA
- Debate how medical compliance plans limit liability.
- Discuss the relationship between medical records documentation and billing
- Explain the purposes of the Alphabetic Index and Tabular List
- Discuss V and E Codes
- Determine appropriate diagnosis code categories
Procedural Coding: Introduction to CPT
- Assign appropriate Evaluation and Management (E/M) codes
- Describe CPT coding categories.
- Identify CPT modifiers
Summarizing the Medical Billing Process
- Illustrate the billing process using the CMS 1500 form
- Discuss social, legal and ethical ramifications of HIPAA violations
- Relate HIPAA, ICD, CPT and HCPCS to the medical billing process
Introduction to the Medical Billing Process
- Compare and contrast features of various health plans.
- Explain capitation and fee-for-service payment methods.
- Explain the basic steps in the medical billing process.
Procedural Coding: Introduction to HCPCS
- Explain HCPCS coding steps in the billing process
- Compare permanent codes and temporary codes
- Apply Level II HCPCS modifiers
Patient Encounters and Billing Information
- Describe factors that determine patient eligibility
- Describe patient charges, billing procedures, and transactions
- Discuss strategies to improve the patient intake process
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