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Medical Assisting

MA 155


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Credit Hours

(3-0) 3 Cr. Hrs.

Section Start Dates


Section NoStart Date
215654January 12, 2015
215655January 12, 2015

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Medical Insurance Billing


Course Description

This course introduces the student to the various types of medical insurance including Blue Cross/Blue Shield, Medicare, Medicaid, Workers’ Compensation and other third-party payers. The student will perform the tasks necessary to process claim forms for each type of medical insurance. Manual and computerized billing methodologies are included.

Prerequisites

(A requirement that must be completed before taking this course.)

Course Competencies

Upon successful completion of the course, the student should be able to:

  • Apply diagnostic coding using the ICD-10-CM/PCS, Volumes 1 and 2.
  • Demonstrate procedure coding using the CPT coding manual on the worksheets.
  • Explain the terminology related to medical insurance billing procedures and insurance programs.
  • Compose a Blue Shield claim form.
  • Compose a Medicare claim form.
  • Compose a Medicaid claim form.
  • Compose a claim adjustment form for Blue Shield and Medicaid.
  • Compose a typed Commercial/Private insurance claim form using AMA standard claim forms.
  • Identify methods for paid vouchers, storage and retrieval.
  • Compare the various types of insurance coverage.
  • Apply medicolegal information to complete forms correctly transmitting patient data properly.
  • Illustrate the steps to complete the CMS-1500 claim form.
  • Illustrate the steps involved in submitting electronic claims.
  • Complete the steps to process reimbursement from an insurance carrier.
  • Breakdown Workers’ Compensation Insurance coverage.
  • Determine the purpose of disability compensation.
  • Assess the dental claim form and methods of completion.
  • Compare inpatient and outpatient hospital services related to hospital claim processing.
  • Document the patient billing and collection process.
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