HIMS 1410 - Introduction to Insurance

4.5 Credits

Students gain a broad overview of the health insurance field and the various types of insurance plans, as well as legislation impacting health care. Topics include the types of coding systems and compliance, managed care, Medicare and Medicaid regulations, as well as worker’s compensation. Students learn the importance of submitting clean claim forms, including billing and collection practices, different reimbursement methods, clinical documentation improvement, medical necessity, and revenue cycle management.

Lecture Hours: 4.5
Lab Hours: 0.0
Internship Hours: 0.0
Clinical or Practicum Hours: 0.0

Course Objectives

Compare and contrast health insurance plans.
Identify insurance terms used in health care.
Discuss health insurance topics and insurance carrier issues.
Explain the provisions of HIPAA as it relates to health insurance.
Demonstrate understanding of health care payers (managed care contracts and private payers, Medicare, Medicaid, TRICARE, CHAMPVA, workers’ compensation, disability).
Recognize the differences of ICD-10-CM, CPT, and HCPCS coding procedures.
Utilize appropriate reference materials efficiently to research and/or verify medical data.
Integrate critical thinking and problem solving skills essential in health care insurance and reimbursement.

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