HIT-150 - Health Claims and Insurance

3 credits

This course provides an in-depth exploration of health insurance and claims processes, emphasizing the importance of medical necessity in healthcare reimbursement. Students will examine reimbursement methodologies, including fee-for-service, prospective payment systems, and value-based payment models. A key component of the course includes mastering insurance math calculations
such as determining co-pays, deductibles, coinsurance amounts, adjustments, contractual allowances, and reimbursement totals. The Essentials of accurate claim completion and submission, ensuring compliance with regulatory and payer requirements are highlighted. Additionally, students will analyze strategies for effective revenue cycle management, focusing on optimizing healthcare reimbursement while Maintaining ethical and legal standards. hands-on practice with claims systems and real-world Scenarios will prepare students to excel in the healthcare reimbursement field.

Prerequisite(s): Completion of MAT 061 or higher placement on the math placement test.