This course introduces students to the reimbursement methodologies used in healthcare in the United States. The focus of the course will be on the accurate preparation and maintenance of clinical records and medical documentation. Students will analyze insurance plans spanning government and private sectors and learn to properly complete the Centers for Medicare and Medicaid Services claim form (CMS 1500) used in medical outpatient facilities. Topics include working with specific insurance companies, filing error-free claims, resubmitting denied claims, utilizing effective collection strategies, and handling the appeal process.
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