This module provides an overview of insurance concepts and government funded health insurance programs. Students also explore and practice coding and filing medical insurance claims.
Unit: The Importance of Health Insurance
In this activity, students explore the need for homeowners' insurance and extends the concept to the importance of health insurance. Students solidify their understanding by writing a short paragraph explaining the importance of health insurance.
In this unit, students will learn about: health insurance, fee-for-service plans, managed care plans, HMO, PPO, and POS plans, handling and confirming insurance benefits.
2. Types of Insurance
3. The Assistant's Role
4. Managed Care Plans
5. Referrals and Pre-Authorization
Unit: Government Programs
In this unit, students will learn about: government-funded health insurance programs, Medicare, Medicaid, military insurance and Workers' Compensation benefits.
3. Workers' Compensation
4. Military Carriers
In this unit, students will learn about: coding, the history and purpose of coding, diagnostic coding, and procedural coding.
2. Introduction to Diagnostic Coding
3. Performing Diagnostic Coding
4. Procedural Coding
In this lesson, students will learn about: the claims process, completing claim forms, methods of reimbursement, applying insurance payments, fraud, abuse, and auditing.
1. The Claim Form
2. Completing a Claim Form
3. Claims Processing
5. Applying Insurance Payments
6. Legal Issues
Unit: Reflection Questions and Discussion
In this activity, students will journal about the complexity of insurance and coding, the pros and cons of government assistance programs, and their own strengths and weaknesses regarding insurance and coding procedures. A class discussion on these topics can follow.
Unit: Insurance and Coding Scenario
In this activity, students take on the role of medical office assistant at a family practice. They will code a diagnosis and complete a claim form.
Unit: Current Event
Students will review articles for information related to a topic in the module. Once an article is found, students complete a Current Event form.