AHM 241 - Medical Billing

Course Description

This course is designed to teach coding students the general principles of medical billing. Students will learn to complete and use insurance claims forms and insurance related forms (referrals, pre-authorizations, registration forms). The textbook, class-work and homework activities, lectures and online assignments will provide students with hands-on experiences with a variety of insurance plans and related situations. Reimbursement systems including fee-for-service payments and capitation payments will be covered in detail. Upon successful completion of this course, students should be able to: Describe legal and ethical issues involved in medical billing Describe and explain different types of health insurance carriers and reimbursement systems as well as rules and regulations for each (private insurance, managed care, Medicare, Medicaid, Workers Compensation, Military insurance) List steps involved in the reimbursement cycle and accurately complete insurance related forms in addition to creating financial reports Prepare referral, preauthorization, registration and encounter forms. Initiate claims in paper and electronic format. Document billing information using correct medical terminology and perform an internal and external chart audit Prepare a health insurance claim form and explain claim form requirements. Identify claim errors and learn how to resubmit claims that have been rejected. Generate patient bills when needed through interpretation of explanations of benefits/remittance advice statements Describe the follow up process with insurance companies and patients regarding unpaid bills Record changes, payments, and adjustments at the time of an encounter.

Credit Hours: 3
Lecture Hours: 3


Course Prerequisites: AHM 233 and AHM 130 or AHM 230