Standard letter grades
Contact hours total
Instructor approval required based on completion of first-year HIM curriculum.
Provides an overview of third party payers in a variety of healthcare settings. Includes commercial health insurance, government payers, workman's comp, and liability. This course also addresses coding compliance, coding for medical necessity and completion and submission of claims, including their electronic versions.
1. Examine third party payer types and health insurance models.
2. Compare and contrast managed health care models, commercial insurance, government payers and others.
3. Describe other liability payers, such as home, auto, and general liability insurance.
4. Identify coding compliance standards.
5. Utilize compliance standards for completion and submission of claims, including their electronic versions.
1. History of third party payer types.
2. Current third party payers and health insurance model.
3. Managed health care models.
4. Commercial insurance and Blue Cross Blue Shield.
5. Medicare, Medicaid, Tricare.
6. Workers' Compensation programs.
7. Liability payers, home, auto, general liability.
8. Coding compliance standards.
9. Completion and submission of claims, including their electronic versions.
Computer and reliable internet access.
Portable storage device (ie. usb drive).
Knowledge Is assessed through graded exams, quizzes, assignments and projects; this class requires a passing grade of 75% or better.