CRS 110 - Medical Insurance & Reimbursement Systems

CRS 110 - Medical Insurance & Reimbursement Systems This course prepares students to understand the evolution and function of health insurance, to include Medicare, Medicaid, commercial and managed care. The students will learn to understand, prepare and process claims. Course Outcomes: Identify types of insurance plans and models of managed care currently deployed in the health related insurance field. Apply third-party insurance guidelines to complete and process insurance claim forms after performing basic mathematical calculations, obtaining exact answers to claims processing functions, and determining whether those answers are reasonable. Communicate results of claims processing using mathematical processes and concepts that demonstrate the following: copay, coinsurance, write-off/discount, primary insurance payment, secondary insurance payment, patient responsibility. Demonstrate competency in applying and utilizing RVU's (relative value units), RBRVS (resource based relative value system) and DRG's (Diagnostic Related Groups).
file Credit Unit 1 (160 KB)
file Credit Unit 2 (733 KB)
file Credit Unit 3 (3 MB)
file Credit Unit 4 (3 MB)
Microsoft Word QM Rubric (18 KB)
file CANVAS COURSE EXPORT PACKAGE (47 MB)
Adobe PDF Additional SME Review (30 KB)

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Date:
2015
Primary Material Type:
Online Course
Other Material Types:
Collection
Institution:
Linn-Benton Virtual College
Project Name:
LB iLearn Online
Funding Source:
TAACCCT Round 3
Subjects:
Medical Office, Medical Insurance, Medical Coding

Industry / Occupation

Industry Partner:
Corvallis Internal Medicine, PC - Acted as SME and provided content.
Industry Sector:
Health Care and Social Assistance (62)
Occupation:
Healthcare Practitioners and Technical Occupations (29-0000)

Education / Instructional Information

Instructional Program:
Health Professions and Related Clinical Sciences (51)
Credit Type:
  • Credit
Credential Type:
  • Certificate
Educational Level of Materials:
  • 1st year Community College or equivalent
  • 2nd Year Community College or equivalent
Time Required:
1 credit - 30 hours of student time
Language:
English (United States)
Interactivity Type:
Mix of Active and Presentation.
Quality Rubric:
QM
Quality Note:
This course was subjected to a six step review process: 1. A SME creates the outline and all content. The course is submitted to a course developer for implementation into the CANVAS LMS system. Areas of confusion or items that need additional clarity are identified and remediated. 3. An instructional design checklist is applied to ensure ADA, UDL, and Creative Commons compliance. 3. Course is reviewed using a modified Quality Matters Rubric. 4. The initial offering is by the original SME to identify other necessary revisions. 5. Course goes through a secondary Quality Improvement process evaluation by an Instructional Designer and is subject to a Quality Improvement checklist. 6. Course is reviewed by third-party evaluator acting in the role of a SME.
Quality of Subject Matter was assured by:
  • Consultations during development of instructional materials
  • Participation as an ongoing member of team developing the instructional materials
  • Conducting an evaluation of the instructional materials and providing a report
  • Using an approved rubric to conduct the evaluation of the instructional materials and providing a report
  • Other
Quality of Online/Hybrid Course Design assured by:
  • Custom Quality Rubric
  • Expertise of Project's Instructional Designers
Course Note:
Allied Health

Accessibility

Accessibility Features:
  • Text Access - Text to Speech
  • Text Adjust - Compatible
  • Text Adjustment - Adjust Font and Colors
  • Reading Layout - Reflow the Text
  • Reading Layout - Page numbers match printed material
  • Reading Layout - Reflow the Text
  • Hyperlinks Rendered As Active
  • Colors Compatible With Assistive Technology
  • Contrast Ratio of at Least 4.5:1.
  • Non-Decorative Images Have Alt Text
  • Decorative Images Marked With Null Alt Text
  • Transcript Provided With Audio Content

Copyright / Licensing

Copyright Owner:
LB iLearn Online
Primary License:
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
 

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