HIT-155 - Health Claims and Insurance

2 credits

This course is designed to develop knowledge of various health insurance policies and plans. The student will become proficient in health insurance terminology and concepts. Managed care models, as well as government, state, and commercial insurance will be compared and contrasted. The course will also cover worker’s compensation, disability, and Tricare. Insurance forms and documentation for health claims reimbursement and billing will be utilized. Reimbursement calculations for DRG capitation, fee for service, risk accounts, Medicare, and Medicaid, and private insurance will be examined. The course will examine the billing process, claim adjudication, managing insurance and patient account receivable and collection activity.

Course previously known as: MEDC-219