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AHE 110 - Introduction to Medical Coding and Insurance
Credits: 5
Variable Credit Course: No
Lecture Hours: 44
Lab Hours: 22
Worksite/Clinical Hours: 0
Other Hours (LIA/Internships): 0
Course Description: Use of the Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) manuals to properly code and process government and private insurance forms. Other procedure/diagnosis coding systems include: Diagnosis Related Groups (DRGs), Healthcare Common Procedure Coding System (HCPCS), Resource Based Relative Value Scale (RBRVS); and managed care referrals and pre-certifications.
Prerequisite: AHE 102 and OBT 162 with a C or higher.
Strongly Recommended:
Special Requirements:
Meets FQE Requirement: No
Integrative Experience Requirement: No
Student Learning Outcomes
- Apply managed care insurance policies and procedures.
- Apply third party insurance guidelines.
- Obtain managed care insurance referrals and pre-certifications.
- Perform procedural coding in the outpatient setting.
- Perform diagnostic coding in the outpatient setting.
- Complete insurance claim forms.
- Compare and contrast the top five government and commercial insurance health plans in the U.S.
- Discuss selected financial forms and records related to medical insurance.
Course Contents
- Introduction to types of insurance.
- Discussion of various reporting procedures.
- Creation of insurance claims for manual and electronic claims.
- Primary and secondary carriers.
- Insurance payment and rejection procedures.
- Methods of reprocessing claims.
- Universal insurance forms.
- Methods to keep office/clinic staff current in medical coding.
- Financial forms and records related to medical insurance.
Instructional Units: 5.5
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