Buy Best AMOA 204-Medical Office Insurance
This course acquaints students with billing protocol concerning the various insurance filing demands of commercial group insurance, Medicare, Medicaid, Workman’s compensation claims, and other third-party billing entities.
For information regarding the prerequisites for this course, please refer to the Academic Course Catalog.
This course discusses the many aspects of the billing cycle process. The student will learn the functions of a medical office insurance processor and the importance of submitting claims promptly. Without adequately trained insurance processors, companies may not receive the maximum benefits for all services rendered.
Measurable Learning Outcomes
Upon successful completion of this course, the student will be able to:
- Explain the billing cycle process.
- Discuss the rules and regulations, HIPAA, and OIG.
- Differentiate between various types of payers and the processes required to submit a claim.
- Prepare a “clean” claim.
- Explain an EOB (Explanation of Benefits) for processing payments, denials, rejections, appeals, and secondary claims.
- Demonstrate recognition of CPT, ICD-10, and HCPCS codes.
- Discuss hospital claim submission.
After reading the Course Syllabus and Student Expectations, the student will complete the related checklist found in the Course Overview.
Discussions are collaborative learning experiences. Therefore, the student is required to submit a thread in response to the provided prompt for each Discussion. Each thread must be at least 250 words, demonstrate course-related knowledge, and reference the reading material. In addition to the thread, the student must reply to 2 classmates’ threads. Each reply must be at least 150 words.
For each Self-Reflection Journal, the student will reflect on the Learn material and assignments in the assigned Module: Week to determine if he or she is experiencing difficulty with any of the content or has learned something that has made a profound impact on him or her. Each Self-Reflection Journal must be at least 200 words to ensure adequate depth of reflection.
Case studies present realistic, complex, and contextually rich situations that involve problems to solve and/or questions to answer. Therefore, the student will read 3 case studies and answer the questions presented in each. The student must thoroughly respond to each question, citing the textbook, journal articles, and popular healthcare publications for support. The case studies reviewed will be submitted as one document. All non-textbook sources cited must have been published within the last 5 years. The Case Study Activity must follow the current APA format and include in-text citations as well as a reference page.
Within this course, students will be required to read and interact with the textbook within the third-party platform, SmartBook. Students must complete each reading and item in the textbook to earn the points associated with the assigned reading.
Research Paper Assignments (3)
The student will complete a Research Paper to understand the activities and processes of a medical billing specialist. The student will research and write a paper outlining the important functions of a medical billing specialist. This 3-part assignment will consist of the following:
- Research Paper: Preparation Assignment
The student will review the provided list of topics and submit the Research Paper: Preparation Template indicating which 5 topics he/she will research. In addition, the student will provide at least 2 academic sources he/she will use to support the paper. Academic references include textbooks, peer-reviewed journals, .edu websites, and .gov websites (no .com, .net, .org, or blog websites for this assignment).
- Research Paper: Draft Assignment
The student will draft a Research Paper addressing the 5 topics chosen in the Research Paper: Preparation. The paper must be at least 1,500 words (excluding the title page and reference page). The report should address the 5 topics chosen with information/citations from 4–5 academic references published within the last 5 years, and follow the current APA format. Academic references include textbooks, peer-reviewed journals, .edu websites, and .gov websites (no .com, .net, .org, or blog websites for this assignment).
- Research Paper: Final Assignment
After reviewing feedback from the instructor and classmates, the student will make the necessary revisions and adjustments to the first draft of his or her paper. The student must implement any revisions suggested by the instructor. The student will then submit the final version of his /her paper.
Each quiz will cover the reading material for the assigned Module: Week, except Quiz: Diagnostic Coding Basics, which will cover the reading material for Module: 2 Week 2 and Module 3: Week 3. Each quiz will be open-book/open-notes, contain 20 multiple-choice questions, and have a 50-minute time limit.
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