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Master Course Outline
MEDA 149
Medical Insurance Procedures For Medical Assisting


Credits: 5
Clock Hours per Quarter: 50

AA Discipline:

Lecture Hours:50


Description
Provides a basic introduction to accurate billing procedures in the medical office and medical coding procedures used to obtain reimbursement for medical procedures or services. Billing topics include different types of health insurance, and preparation of insurance claim form, applying third party payor guidelines and collection procedures. Coding topics will include the proper application of CPT, ICD-9-CM and HCPCS coding along with an introduction to ICD-10-CM. Admission to the Medical Assisting Program students.

Intended Learning Outcomes
  • Accurately apply ICD-9-CM codes to present a clear picture of the patient's medical diagnosis, symptoms, complaint, or condition.
  • Accurately apply CPT codes to obtain reimbursement for the corresponding procedures and services rendered to treat the identified condition.
  • Follow third party payor guidelines.
  • Complete a paper and/or electronic claim form.
  • Demonstrate knowledge of billing and collection practices in the outpatient setting.
  • Review and learn the differences associated with ICD-10-CM coding.

  • Course Topics
  • Billing and Reimbursement Cycle
  • ICD-9-CM Coding; ICD-10-CM coding differences
  • Coding Linkage and Compliance
  • Provider Charges and Payment Methods
  • Health Care Claim Preparation and Transmission
  • Claim Adjudication, Follow-Up, and Collections
  • Private Payers: Blue Cross and Blue Shield Plans, Commercial Carriers, and Managed Care Organizations
  • Medicare
  • Medicaid
  • TRICARE and CHAMPVA
  • Worker's Compensation and Disability

  • Syllabi Listing See ALL Quarters
    Course
    Year Quarter
    Item
    Instructor  
    MEDA 149
    Spring 2013
    3978
    Sandra Erlewine
    MEDA 149
    Spring 2013
    6409
    Sandra Erlewine
    MEDA 149
    Spring 2012
    3977
    Sandra Erlewine


    Two Year Projected Schedule

    Year One* Year Two**
    Fall
    Winter
    Spring
    Summer
    Mini 
    Fall
    Winter
    Spring
    Summer
    Mini
     
     
    X
     
     
     
     
    X
     
     

    *If fall quarter starts on an odd year (2003, 2005, etc.), it's Year One.
    **
    If fall quarter starts on an even year (2002, 2004, etc.), it's Year Two.