Course Description

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Rationale

Medical office assistants have an important role in healthcare, and one of their responsibilities is medical office billing and bookkeeping. This course provides the necessary technical skills needed to perform this duty. The universal claim form CMS-1500, the carriers that submit the claim form, collections, payments, and accounts receivable will all be covered.

Measurable Learning Outcomes

Upon successful completion of this course, the student will be able to:

1. 1. Explain the job functions of a medical biller.
   2. Discuss the different health insurances and how to read an ID card.
   3. Discuss the elements of medical coding (CPT, HCPCS Level II, ICD-10, and modifiers).
   4. Explain the different forms, including patient registration, patient encounter, hospital sheet, and the CMS-1500 claim form.
   5. Demonstrate how to bill for office visits, procedures, and inpatient and facility services.
   6. Discuss claim submission and electronic clearinghouses.
   7. Discuss insurance explanations of benefits, payments, denials, and appeals.
   8. Explain accounts receivable, collections, and how collections and the state insurance commission work.
   9. Discuss ethical medical billing through the integration of a Christian worldview.

Course Assignment

Textbook readings and lecture presentations

Course Requirements Checklist

After reading the Course Syllabus and Student Expectations, the student will complete the related checklist found in the Course Overview.

Essay Assignments (6)

You will complete 6 essays, each focusing upon a specific concept from the Module: Week. The essays must be 350-450 words and be in APA formatting.

CMS-1500 Paper Assignment

The student will write a research-based paper that provides a contrast between the CMS-1500 (08/05) and the CMS-1500 (02/12). The paper must be 4–6 pages, include at least 4 references in addition to the course textbooks and the Bible, and be in current APA format.

Quizzes (3)

Quiz: Medicare and Medicaid will cover the Learn material from Module 1: Week 1 – Module 3: Week 3, and Quiz: Managed Healthcare and Revenue Cycle will cover the Learn material from Module 4: Week 4 –  Module 6: Week 6. These quizzes will be open-book/open-notes, contain 25 multiple-choice questions, and have a time limit of 1 hour. Quiz: Cumulative Assessment will cover the Learn material from Module 1: Week 1 – Module 8: Week 8, be open-book/open-notes, contain 50 multiple-choice questions, and have a time limit of 2 hours.