Title: Module 2 Introduction: (CU2 M2) Third Party Claims and Patient Documentation
Course: SkillsCom CRS 110 14.0 > Section: Credit Unit 2 Module 2

You will have an opportunity to review the "keys" for successful third party claims processing as well as the multiple steps of the claim process from start to finish and the documentation that is necessary to process claims. You will have an opportunity to learn a wide scope of topics centered on patient management, including billing policies and practices.

Third-party health insurance is defined as insurance coverage in which a third party, namely the insurance company, pays the actual provider of healthcare services for services rendered to the employee. Third-party insurance is the most versatile and comprehensive option for health insurance.  Third-party health insurance includes public and private health insurance programs as well as managed care and preferred provider networks.

Health insurance works a little differently when it comes to third party insurance. When you get health insurance as the first party, the second party becomes your physician or the hospital when claims are made. The insurance company becomes the third party when it pays the medical expenses to the doctor or medical facility.

Module Outcomes:

- Identify types of third party plans.
- Identify the information required to file a third party claim
- Identify the steps for filing a third party claim
- Interpret information on an insurance card
- Verify eligibility for services including documentation
- Describe the processes for verification of eligibility for services