OST 148 Medical Insurance & Billing

Lecture: 3 Lab: 0 Clinic: 0 Credits: 3

This course introduces fundamentals of medical insurance and billing. Emphasis is placed on the medical billing cycle to include third party payers, coding concepts, and form preparation. Upon completion, students should be able to explain the life cycle of and accurately complete a medical insurance claim.

Course is typically offered in Fall.
Course has transfer restrictions - 5 years

Student Learning Outcomes (SLOs)
At the completion of the course, the students should be able to do the following:

Distinguish between the major classes of health insurance options, as they relate to the federal, state and private health insurance plans.
Employ the proper use of terms, phrases, and abbreviations, as they apply to the healthcare industry.
Perform the basic steps in processing an outpatient CMS-1500 insurance claim form, using the industry standard guidelines.
Calculate potential insurance reimbursements of procedures or services, using Resource-Based Relative Value Scale (RBRVS).
Determine how to process Explanation of Benefit Forms, using accepted industry standards.