Health Insurance I

This course is one of five courses comprising the Patient Access Specialist certification program. Students will be introduced to the world of health insurance. Patient Access Specialists represent the front line of the healthcare service for patients entering a practice, hospital or clinic with a constant eye toward excellent customer services and the overarching goal of achieving a positive experience for the patient. The course will review employment opportunities that involve patient access and billing. Students will gain an understanding of basic health insurance information, including an overview of health care reform. In addition, the course will introduce students to the concepts involved in working with managed care contracts as well as the basics of diagnostic and procedural coding.

In order to optimize these processes and provide the best access for patients, healthcare professionals must have a clear understanding of the intricacies of navigating the health insurance system. In Health Insurance I, learners will be introduced to the ins and outs of various health insurance coverage options for patients and operating processes for medical practices. The course will review employment opportunities that involve patient access and billing. Learners will gain an understanding of basic health insurance information, including an overview of Healthcare reform. In addition, the course will introduce learners to the concepts involved in working with managed care contracts as well as the basics of diagnostic and procedural coding. As one of five courses necessary to gain the Patient Access Specialist certification, the Health Insurance I course will ensure participants have the foundations necessary for success in this position.

Class Objectives

After completing this class, learners will be able to:

• Describe the skills needed to work in the patient access career field
• Explain the history and importance of health insurance in the United States
• Explain key concepts and features associated with managed care contracts
• Use diagnostic coding as part of the billing process
• Use procedural coding as part of the billing cycle