Health Information Management

Classes

HCI 124 : Survey of Medical Coding and Billing

This course introduces the student to medical insurance coding using the International Classification of Diseases and Current Procedural Terminology codes for physician services and outpatient procedures. Students develop knowledge and skill in working with the physician to receive maximum reimbursement; demonstrating sensitivity in communicating with providers and patients; and applying managed-care policies, third-party guidelines, and billing and collection practices. Prerequisites: HLT 101 or HLT 106, and BIO 115 or BIO 234. This course runs for seven weeks and includes one lecture hour and three laboratory hours per week. Instructional Support Fee applies.

Credits

1
Cognitive:
  1. Describe how to use the most current procedural coding system
  2. Define upcoding and why is should be avoided.
  3. Describe how to use the most current diagnostic coding classification system.
  4. Describe how to use the most current HCPCS coding.
  5. Explain both billing and payment options.
  6. Identify procedures for preparing patient accounts.
  7. Describe the impact of both the Fair Debt Collection Act and the Federal Truth in lending Act of 1968 as they apply to collections.
  8. Discuss types of adjustments that may be made to a patient account.
  9. Discuss principles of Electronic Medical Record (EMR).
1
  1. Describe the implications of HIPAA for the medical assistant in various medical settings.
Psychomotor:
  1. Perform procedural coding.
  2. Perform diagnostic coding.
  3. Apply both manage care policies and procedures.
  4. Apply third party guidelines.
  5. Complete insurance claims form.
  6. Obtain precertification including documentation.
  7. Obtain preauthorization, including documentation.
  8. Verify eligibility for managed care services.
  9. Utilize computerized office billing systems.
1
  1. Completing a Medicare CMS-1500 (08-05) Claim Form.
1
  1. Computing the Medicare Fee Schedule.
1
  1. Current Procedure Terminology Coding.
1
  1. International Classification of Diseases, 9th Revision, Clinical Modification Coding.
1
  1. Explaining Fees in the First Telephone Interview.
1
  1. Identify Accounts Receivable Using Medical Office Stimulation Software (MOSS).
1
  1. Preparing Itemized Patient Accounts for Billing Using Medical Office Simulation Software (MOSS).
1
  1. Post/Record Adjustments Using Medical Office Simulation Software (MOSS).
Affective:
  1. Work with physician to achieve the maximum reimbursement.
  2. Demonstrate sensitivity and professionalism in handling accounts receivable activities with clients.
  3. Demonstrate assertive communication with managed care and/or insurance providers.
  4. Demonstrate sensitivity with both providers and patients.
5. Communicate in language the patent can understand regarding managed care and insurance plans.

HCI 145 : Coding & Reimbursement Specialist PPE

This course must be taken in the final semester of the Coding and Reimbursement Specialist Certificate. Students will complete a 40-hour externship in a healthcare organization to develop workplace readiness as a Coding and Reimbursement Specialist. Prerequisite: HCI 140, HCI 211, HCI 213. Instructional Support Fee applies.

Credits

1
1. Students will demonstrate the ability to apply coding and/or billing practices in healthcare organization. 2. Students will demonstrate entry level workplace readiness by applying skills/competencies under the supervision of a qualified clinical preceptor in a healthcare organization. 3. Students will demonstrate working knowledge of coding conventions and guidelines in a clinical practice setting.

HCI 249 : Advanced Medical Coding

This course expands upon the knowledge gained in HCI 140, HCI 211, and HCI 213 by applying learned concepts in more complex scenarios. Students will have hands-on experience with accessing reference, encoding, and grouping functions in HIM software. Emphasis will be placed upon accurately identifying the principal diagnosis and secondary diagnoses along with appropriate procedure codes based upon supporting documentation. Compliance and auditing will be presented. Prerequisite(s): HCI 140, HCI 211 and HCI 213. Two lecture hours and three laboratory hours per week. Instructional Support Fee applies.

Credits

3
At the conclusion of this course the student will be able to: 1. Apply diagnosis/procedure codes according to current guidelines. 2. Evaluate the accuracy of diagnostic and procedural coding. 3. Apply diagnostic/procedural groupings. 4. Evaluate the accuracy of diagnostic/procedural groupings. 5. Utilize software applications such as encoders in the completion of Health Information Management processes. 6. Analyze current regulations and established guidelines in clinical classification systems. 7. Determine accuracy of computer assisted coding assignment and recommend corrective action. 8. Identify discrepancies between supporting documentation and coded data. 9. Develop appropriate physician queries to resolve data and coding discrepancies. 10. Comply with ethical standards of practice.