MEAS 137 - Outpatient Insurance and Basic Coding

Provides an overview of health insurance plans and the skills needed to complete and submit insurance claims for third party reimbursement. Procedural and diagnostic coding appropriate to the ambulatory healthcare setting is included.

MAJOR COURSE LEARNING OBJECTIVES: Upon successful completion of this course, the student will be expected to:

  1. Identify: (VIII.C.1)
    1. Types of third party plans
    2. Information required to file a third party claim
    3. The steps for filing a third party claim
    1. Verification of eligibility of services
    2. Precertification
    3. Preauthorization
    1. Upcoding
    2. Downcoding (IX.C.4)

    COURSE CONTENT: Topical areas of study include -