MOA-168: Facility Billing Concepts

School
Health & Human Services
Department
Medical Assistant/Billing
Academic Level
Undergraduate
Course Subject
Medical Assist/Recept Biller
Course Number
168
Course Title
Facility Billing Concepts
Credit Hours
4.00
Instructor Contact Hours Per Semester
62.00 (for 15-week classes)
Student Contact Hours Per Semester
62.00 (for 15-week classes)
Grading Method
A-E
Pre-requisites
AH-100, MOA-101 and MOA-110 all with a "C" grade or better.
Co-requisites
HIT-150
Catalog Course Description

Focuses on the billing process unique to health care facilities. Examines the hospital billing environment, coding, payment methods, and Universal Billing 1992 (UB-92) claims along with billing simulations.

Goals, Topics, and Objectives

Core Course Topics
  1. The Hospital Environment
  2. Types of Facilities
  3. Hospital Billing Process
  4. Patient Registration
  5. Accounts Receivable Management
  6. Hospital Medical Insurance
  7. UB-92 Forms
  8. Center for Medicare and Medicaid Services (CMS)
  9. Skilled Nursing Facility Consolidated Billing
  10. International Classification of Diseases, Tenth Revision (ICD-10) Diagnostic and Surgical Codes
Core Course Learning Objectives (Separated)
  1. Outline the key elements of hospital billing systems.
  2. Compare and contrast the types of billing systems.
  3. Discuss the hospital insurance billing process.
  4. Explain hospital insurance coding and payment methods.
  5. Describe the use of the Uniform Bill 1992 (UB-92) claim form used by hospitals and ambulatory centers to bill medicare and third party payers.
  6. Explain condition, occurrence, and value coding.
  7. Relate revenue coding to charges.
  8. Explain diagnosis and procedure coding.
  9. Prepare a successful UB-92 claim form.
  10. Explain revenue coding to charges.

Assessment and Requirements

Assessment of Academic Achievement

Assessment of academic achievement will include assignments, quizzes, and tests.

General Course Requirements and Recommendations

Active participation in class assignments will be encouraged and required. Cooperative rather than a competitive atmosphere will be encouraged.

  • Students are expected to attend all sessions of the class.
  • In case of absence, it is the student's responsibility to contact a classmate in advance to obtain missed materials.
  • Failure to officially withdraw from the class may result in a grade of E.

Students graduating from the Medical Insurance Specialist program should be able to demonstrate cognitive knowledge based on academic subject matter required for competence in the field. They will be able to incorporate cognitive knowledge in the performance of psychomotor and affective learning domains.

Texts

Required textbooks to be determined by program faculty.

Approval Dates

Effective Term
Fall 2019
ILT Approval Date
01/11/2019
AALC Approval Date
01/29/2019
Curriculum Committee Approval Date
02/04/2019