HIM 130 - Billing and Reimbursement

Class: 3 Credits: 3
This course provides an introduction to medical insurance billing and reimbursement practices with emphasis on the primary payers such as Medicare and Medicaid.

Prerequisite(s): Take AOT 141 or MGT 101 with a minimum grade of “C”.

Course Topics:

Career availability in Health Insurance
Health Insurance
Managed Care, Medicare, Medicaid, Blue Cross, Tricare
HCFA 1500 Form
Insurance processing terms
Insurance appeal letters
Processing insurance claims
Insurance claim denials
Reimbursement methodologies

Textbooks:
Textbook information can be found on the Book Inn Web site

Required Materials:

Medical dictionary

Grading System:
An overall grade of C or higher is required for transferability.

A 90 - 100
B 80 - 89
C 70 - 79
D 60 - 69
F 0 - 59

Student Learning Outcomes:

Complete a HCFA 1500 Form.
Differentiate between Managed Care, Medicare, Medicaid, Blue Cross and Tricare.
Write an appeal letter to an insurance company.
Differentiate between the different reimbursement methodologies.

For SCC Online Courses:
If the course you are taking is online, please review the SCC Online Policies that include:

Required materials for all online courses
Mandatory Attendance Requirement
Proctored Exams

Face Covering Requirements:
All faculty, staff and students must wear a face mask/covering at all times (absent a medical condition) on all SCC campuses when safe social distancing measures are not possible or difficult to follow. For further details, refer to the Student Guidelines for Face Coverings and Social Distancing on the SCC Coronavirus COVID-19 Information page.

Standard SCC Course Policies:
Please review the Standard SCC Course Polices on the following topics:

Academic Integrity
Academic Misconduct
Add/Drop period
Appeals Process
Class Attendance
Classroom Behavior (traditional and online)
Classroom Conduct/Expectations
Lab Procedures (general SCC policy regarding this)
Online Confidentiality
Services For Students with Disabilities
Withdrawal Policy

Official Course Syllabus
2020-2021