Apr 30, 2024  
2023-2024 Catalog 
    
2023-2024 Catalog Archived

HIM 130 - Billing and Reimbursement


Lecture Hours: 3 Credits: 3

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

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

  • Identity Verification
  • Required materials for all online courses
  • Mandatory Attendance Requirement
  • Orientation and Support
  • Proctored Exams

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

  • Academic Integrity
  • Add/Drop period
  • Attendance
  • Classroom Conduct
  • Equal Access
  • IT Access
  • Online Behavior
  • Online Confidentiality
  • Services For Students with Disabilities
  • Student Concerns
  • Student Help Services
  • Withdrawals


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Official Course Syllabus
2023-2024