Oct 05, 2022  
2022-2023 College Catalog 
2022-2023 College Catalog
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HIT 112 - Health Insurance and Medical Billing

3 Credits, 3 Contact Hours
3 lecture periods 0 lab periods

Description: Overview and principles of the basics of health insurance and medical billing. Includes principles of health insurance and medical billing, health insurance contracts, claims rocess,
insurance terminology, abbreviations, and symbols. Also includes diagnostic and procedural coding (with emphasis on medical terminology, anatomy and physiology), client eligibility and reimbursement processes.

Recommendation: Completion of HIT 100  and HIT 105  are recommended before enrolling in the course. If any recommended course is taken, see a financial aid or Veteran’s Affairs advisor to determine funding eligibility as appropriate.
  button image Prior Learning and link to PLA webpage

Course Learning Outcomes
  1. Apply policies and procedures for the use of data required in health care reimbursement.
  2. Evaluate the revenue cycle management process.
  3. Describe the differing types of organizations services, and personnel and their interrelationships across the health care delivery system.
  4. Comply with ethical standards of practice.

  1. Principles of Health Insurance and Medical Billing
    1. Introduction to health insurance
    2. Overview of medical billing and HIPAA
  2. Health Insurance Contracts
    1. Characteristics of a valid insurance contract
    2. Federal, State, and private insurance plans
    3. Importance of insurance claims completion, coding, and billing
    4. Insurance problem solving
    5. Common insurance terms
  3. Claims Process
    1. Procedural and diagnostic coding
    2. Importance and usage of modifiers in procedural coding
    3. Insurance claims register or log
    4. Submit claims and know time limits for submitting claims
    5. Claim form preparation
    6. CMS claim form
    7. Importance of documentation
  4. Insurance Terminology, Abbreviations, and Symbols
    1. Common insurance terms
    2. Common diagnostic and legal terms
    3. Abbreviations
    4. Symbols used in codebooks
  5. Diagnostic and Procedural Coding
    1. Define Current Procedural Terminology (CPT) and International Classification of Diseases terminology
    2. Accurate codes using CPT procedural coding and codebooks
    3. Accurate codes using diagnostic coding and codebooks
    4. Understand the relationship of anatomy/physiology and coding principals
  6. Client Eligibility and Reimbursement Processes
    1. Medical billing software
    2. Medical billing procedures
    3. Encounter forms and updates
    4. Submitting claims and EDI
    5. Collection processes and strategies
    6. Charge, bill, and receive
    7. Co-payments

Effective Term:
Full Academic Year 2021/22

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