HIM-200

Identify a new versus established patient, obtain patient demographic information, insurance verification, and authorizations and collect time-of-service payments

Understand and explain the importance of accurate documentation when working with electronic health records

Describe the different types of medical insurance,their characteristics and eligibility requirements

Determine Coordination of Benefits for patients with more than one insurance plan

Code diagnoses using the basic steps and principles ofthe ICD-10-CM coding system

Code procedures/services using the basic steps and principles of the CPT/HCPCS coding system

CompleteHIPAA-compliant health care claims for Medicare, Medicaid, and TRICARE/CHAMPVA; Workers' Compensation; and private payers, including BlueCross and BlueShield Plans, commercial carriers, and managed care organizations

Understand and complete the hospital billing cycle following the guidelines previously learned

Discuss HIPAA/HITECH, legal, and ethical considerations with emphasis on confidentiality, protected health information and fraud related to insurance

Discuss the processing of payers’ remittance advices (RAs) and patient billing/collections

Utilize electronic health records in the reimbursement cycle

Introduction to the Revenue Cycle

Electronic Health Records, HIPAA & HITECH: Sharing & Protecting Patients

Patient Encounters & Billing Information

Diagnostic Coding: ICD 10-CD-CM

Procedural Coding: CPT & HCPCS

Visit Charges & Complaint Billing

Healthcare Preparation & Transmission

Private Payers/ACA Plans/Medicare/Medicaid/TRUCARE & CHAMPVA

Worker’s Compensation & Disability/Automotive Insurance

Payments (RA’s), Appeals and Secondary Claims/Patient Billing and Collections

Hospital Billing & Reimbursement

Primary and Secondary Case Studies