MEDR 5214 - Insurance & Reimbursement Proc

A lecture and lab-based course that includes study of the principles and practice of insurance and reimbursement processing, to 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; and 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 Notices).