Medical Insurance Coding and Billing

Course Number: 
Course Credits: 
Course Description: 
This course introduces medical insurance, billing, and coding. Overview of insurance plans, insurance claims, and health insurance terminology will be covered. 3 theory hours, 4 guided practice hours. Vocational program course. May be used as a general elective in the AA degree.
Course Prerequisites: 
Prerequisites: Completion of MEDAS 151 with a grade of "B-" or better.
Course Outcomes: 
  • Inform a patient of financial obligations for services rendered
  • Demonstrate professionalism when discussing patient's billing record
  • Display sensitivity when requesting payment for services rendered
  • Interpret information on an insurance card
  • Verify eligibility for services including documentation
  • Obtain precertification or preauthorization including documentation
  • Complete an insurance claim form
  • Interact professionally with third party representatives
  • Display tactful behavior when communicating with medical providers regarding third party requirements
  • Show sensitivity when communicating with patients regarding third party requirements
  • Describe how to use the most current procedural coding system
  • Describe how to use the most current diagnostic coding classification system
  • Describe how to use the most current HCPCS level II coding system
  • Discuss the effects of:
    • upcoding
    • downcoding
  • Define medical necessity as it applies to procedural and diagnostic coding