HIM 160 Healthcare Insurance and Billing

This course will introduce the student to health insurance and reimbursement. Topics include plan options, abstracting medical records, federal regulations, and the importance of accurate, compliant coding of diagnoses and procedures.

Credits

4

Course Learning Outcomes

Upon successful completion of this course, the student will be able to:
1. Apply knowledge of major health insurance programs and federal healthcare legislation
2. Explain the major coding systems used in healthcare reimbursement, including ICD-10-CM/PCS, CPT, and HCPCS
3. Analyze the impact of compliant coding, clinical documentation improvement, and coding for medical necessity on healthcare reimbursement
4. Complete CMS 1500 and UB-04 claim forms correctly and explain the purpose of each data field
5. Evaluate the impact of healthcare reimbursement policies and regulations on healthcare providers and payers