Phase 1: Explore
Activity: Discovering Codes
In this activity, students explore codes used in medical billing and coding. They draw on their experiences with illness and injury and then research codes to see how important it is to be accurate when coding and processing medical claims.
Phase 2: Learn & Practice
Unit 1: Insurance
In this unit, students are introduced to health insurance and industry-related vocabulary. Students also learn about office assistants' responsibilities for insurance and coding and how to apply managed care guidelines in medical offices.
- Introduction to Insurance
- Types of Insurance
- Managed Care Plans
- The Assistant's Role
- Referrals and Preauthorization
Unit 2: Government Programs
In this unit, students learn about government medical programs, including Medicare, Medicaid, and forms of insurance for the military. A lesson on workers' compensation is included in this Unit.
3. Workers' Compensation
4. Military Carriers
Unit 3: Coding
In this unit, students get an introduction to coding and the different codes, including diagnostic and procedural coding. Students identify the steps and guidelines involved in performing diagnostic coding.
2. Introduction to Diagnostic Coding
3. Performing Diagnostic Coding
4. Procedural Coding
Unit 4: Claims
In this unit, students learn about claim forms, how to complete forms, and how claims forms are processed. They also learn about the types of reimbursement and how to obtain reimbursement for claims. Students learn about legal issues, including HIPPA, fraud, abuse, and the Medicare audit process.
- The Claim Form
- Claims Processing
- Legal Issues
Phase 3: Reflect
Reflection Activity: Reflection Questions and Discussion
In this activity, students reflect on the importance of accuracy in insurance and coding, evaluate ethics in the coding industry, and analyze the strengths and areas of growth they bring to a job in insurance and coding.
Phase 4: Reinforce
Activity: Fill Out a Claim Form
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.