Department Homepage  Course Listings Degree Options Department Information Home Department Listings eSchedule Catalog Home Home
 
Master Course Outline
OT 232
Medical Insurance Procedures


Credits: 5
Clock Hours per Quarter: 50

AA Discipline:

Lecture Hours:50


Description
Understanding of the medical insurance programs in today's healthcare system. Students will apply knowledge learned to abstract information from medical records and complete universal claim forms that meet billing requirements of private, state and federal insurance programs. Communication with insurance companies, tracking reimbursements, and collection methods are covered. Recommended: OT 234.

Intended Learning Outcomes
  • Given simulated medical records, documents and forms, student will be able to abstract information to accurately complete CMS 1500 claim forms according to various insurance program format requirements with correct procedure and diagnostic codes and accurate dollar amounts.
  • Demonstrate ability to recognize when forms are required and accurately complete forms such as: referrals, waivers, authorizations, disclosures, NPP, etc.
  • Demonstrate understanding of legal and ethical considerations with emphasis on confidentiality and fraud related to insurance and HIPPA regulations.
  • Given a patient's schedule of benefits from various types of insurance contracts. accurately determine amounts owed by each party.

  • Course Topics
  • Fundamentals of Health Insurance Coverage
  • Source Documents and the Insurance Claim Cycle
  • Coding Diagnoses
  • Documentation and the Medical Record
  • Completion and Submission of the CMS 1500 Claim form
  • Fees: Private Insurance and Managed Care
  • Medicare, Medicaid, TriCare, and Workers’ Compensation Programs
  • Credit and Collection Practices
  • Tracking Reimbursement

  • Syllabi Listing See ALL Quarters
    Course
    Year Quarter
    Item
    Instructor  
    OT 232
    Spring 2014
    6062
    Emmalee Brice
    OT 232
    Winter 2014
    6616
    Emmalee Brice
    OT 232
    Spring 2013
    6621
    Emmalee Brice
    OT 232
    Winter 2013
    1789
    Bridget Bergiel
    OT 232
    Spring 2012
    6621
    Bridget Bergiel


    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.