Maricopa Community Colleges  HCE227   19976-19985 
Official Course Description: MCCCD Approval: 03/25/97
HCE227 19976-19985 L+L 3 Credit(s) 3 Period(s)
Front Office: Insurance and Coding
Application of office management skills in a simulated medical environment. Includes maintaining patient records and office information processing, with emphasis on medical insurance, insurance billing, and coding procedures. Prerequisites: HCE103.
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MCCCD Official Course Competencies:
 
HCE227   19976-19985 Front Office: Insurance and Coding
1. Utilize transcription equipment and tapes to produce mailable copy. (I)
2. Apply typing rules as related to medical documents. (I)
3. Use standard abbreviations for selected medical terms. (I)
4. Identify different types of medical insurance. (II)
5. Prepare different types of medical insurance billings. (III)
6. Apply the correct CPT-4 (Current Procedural Terminology) and ICD-9 (International Classification of Diseases) code for medical insurance claims. (III)
7. Create and accurately maintain financial and insurance documents for the medical office. (III)
8. Interpret medical insurance payments (IV)
9. Adhere to legal and ethical standards regarding the release of patient information. (V)
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MCCCD Official Course Outline:
 
HCE227   19976-19985 Front Office: Insurance and Coding
    I. Office Information Processing
        A. Transcription of medical practitioner's dictation
        B. Transcription of medical reports
        C. Transcription of correspondence
        D. Creation and maintenance of files
      II. Medical Insurance Providers
          A. HMO (Health Maintenance Organization)
          B. PPO (Preferred Provider Organization)
          C. Medicare
          D. Third party reimbursement
          E. Other
        III. Management of Billing Medical Insurance
            A. Completion of forms
              1. General
              2. Industrial
              3. Medicare and Medicaid
              4. Champus
              5. Managed care
              6. Electronic transfer
            B. Coding procedures
              1. ICD-9
              2. CPT-4
            C. Collection
          IV. Interpretation of Insurance Reports and Payments
              A. Adjustable
              B. Withholds
              C. Deductibles and co-payments
            V. Legal and Ethical Standards
                A. Confidentiality
                B. Release of patient information
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