MOA110
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Processing Health Insurance Claims
Medical Office AssistantHealth & Human Services
Core Course Topics
Introduction to Medical Insurance
Insurance Specialist & Medical Assistant-Roles & Responsibilities
Diagnostic Coding
Procedure Coding
Healthcare Common Procedure Coding System (HCPCS) Coding
The Life Cycle of an Insurance Claim
Managed Health Care
Blue Cross Blue Shield (BCBS)
Medicaid
Medicare
Tricare
Commercial Insurance Carriers
Ethical and legal standards in business practices
Upon successful completion of this course, students will be able to:
Describe the process used to identify and select diagnostic codes using the ICD-10-CM coding system.
Describe the process used to identify and select procedure codes using the CPT manual coding system.
Describe the process used to identify and select procedure codes using the HCPCS coding system.
Complete an insurance claim form for the following carriers: Blue Cross/Blue Shield (BCBS),Health Maintenance Organization (HMO), Medicare, Medicaid, Tricare, and Worker's Compensation.
Utilize the ICD-10-CM and the CPT manuals to complete a paper-based and an electronic insurance claim form.
Explain the advantages of the Affordable Care Act and how it impacts the delivery of health care in ambulatory services.
Demonstrate honesty and integrity in the performance of medical billing and insurance coding practices.
Apply ethical and legal standards in the performance of all medical business practices.