This course is about all types of health insurance such as health maintenance organizations (HMOs), Preferred provider organizations (PPOs), Point-of-service (POS) plans, and High-deductible health plans (HDHPs).  Government programs such as Medicare, Medicaid, Obama Care, CHAMPVA, and Tricare are also included.

• The students learn what are the types of health insurance claims, the use of clearinghouses, Tracking claim forms, and filling out insurance claims.
• Which may be linked to health savings accounts (HSAs) Payment of benefits Government programs such as Medicare, Medicaid, Obama Care, CHP, FHP

Upon completion of this course, the student should be able to do the following:

• Identify and define terminology associated with various insurance types in the medical office
• Identify and understand the application of government, medical, disability, and accident insurance
• Identify and appropriately apply plan policies and regulations for programs including:
• HMO, PPO, EPO, indemnity
• short-term and long-term disability
• Workers’ Compensation
• Medicare and Medicaid
• CHAMPVA and Tricare
• Complete and file insurance claims
• Evaluate claims response (EOB)

Procedure and diagnostic coding including ICD-10-CM and CPT-4 codes

GRADING:

Student performance will be evaluated relative to knowledge, skills, and professional behavior. Exams,
quizzes, and projects will provide evidence of success in meeting the course objectives.

Scale:

Note: A grade of 75% is required for successful completion of the course.