This course focuses on the billing processes and procedures for dealing with managed care organizations such as Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). This course continues to build on skills and content knowledge from all previous MB courses, including medical terminology, billing procedures, billing processing, procedures pertaining to hospitals and clinics, and claim reimbursements and denials.
Students will explore reimbursement methods for managed care plans. The role of the Medical Biller in facilitating the processes and procedures when dealing with a managed care claim, will also be examined.
Students will continue to apply the ICD-10, CPT, and HCPCS codes from the appropriate manuals in advanced case studies.
Credits:
5.0
In Class Clock Hours:
72.00
Lab Hours:
40.00
Prerequisite:
MBCS500