MEDR 4214 - Insurance & Reimburse Process

An Internet-based course whose content includes a lecture and lab that includes study of the principles and practice of insurance and reimbursement processing. The course will include the assignment and reporting of codes for diagnoses and procedures/services; completion of CMS-1450 and CMS-1500 claims for inpatient, outpatient, emergency department, and physician office encounters. In addition the course will cover the review of inpatient and outpatient cases to identify issues of fraud and abuse. Textbook cases and patient records will be used to code diagnoses/services/procedures and complete claims. Inpatient and outpatient reimbursement will be determined and source documents interpreted (e.g., Medicare Summary Notice).