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Note: some or all of the courses in the subjects
marked as "Transfer" can be used towards a transfer degree: Associate of Science
and Arts or Associate of Engineering Science at DACC. Transferability for
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Areas of Study
| PHMB200 syllabus
|COURSE NUMBER: ||PHMB200|
|COURSE TITLE:||Billing Public Health Services and Procedures|
|SEMESTER CREDIT HOURS:||3|
|STUDENT ENGAGEMENT HOURS:||136.5|
This course develops the vital skills needed to set-up and maintain a medical billing department for small independent medical practices and public health departments. Will cover how to process provider credentialing, understand contracting between health care providers and health plans, and select a clearinghouse that fits the needs of the practice. Course will develop a general understanding of the billing process and important guidelines for public health departments to adhere to in order to properly bill for public health services.
Disclaimer: Funding for the materials in this course were made possible by funds received by Illinois Public Health Association (IPHA). The materials used in this course were developed by the Illinois Public Health Association (IPHA) as part of the Immunization Billing Project and HIV Category B Third Party Billing Project. Both of these projects were funded by grants from the Centers for Disease Control and Prevention (CDC) through the Illinois Department of Public Health (IDPH).
There are no prerequisites for this course. This course is available for web registration. The expanded version of objectives is available from the Health Information Technology director.
STUDENT LEARNING OUTCOMES:
Upon completion of this course, students will be able to:
- Explain credentialing of public health department providers.
- Analyze contract negotiations with third party insurance providers.
- Identify the purpose of and choose a suitable clearinghouse.
- Verify medical documentation meets billing criteria.
- Assign medical codes for public health services.
- Understand billing procedures for public health services.
- Investigate and minimize billing denials through proper coding.
- Understand Medicaid and Medicare billing policies in relation to public health services.
Credentialing and Contracts
- Credentialing process for public health providers
- Negotiating contracts with insurance providers
Ethical Coding and Billing
- The correct designation of ICD-CM codes
- The correct designation of CPT procedure codes
- The correct designation of HCPCS codes
- Medical documentation standards
Coding and Billing Guidelines for:
TEXTBOOK / SPECIAL MATERIALS:
- Laboratory Services
- Preventive Services
- Family Planning Services
- Prenatal Services
- Well-Baby Services
- Developmental Screenings
- STB, HIV, TB and Communicable Diseases
- Mental Health Services
- Home Health Services
- Dental Services
See bookstore website for current book(s) at https://www.dacc.edu/bookstore
A point system will be used to determine student's grades:
90-100% = A
80-89% = B
70-79% = C
60-69% = D
59% & below = F
NOTE: Must receive C or better to pass
|STUDENT CONDUCT CODE:||Membership in the DACC community brings both rights and responsibility. As a student at DACC, you are expected to exhibit conduct compatible with the educational mission of the College. Academic dishonesty, including but not limited to, cheating and plagiarism, is not tolerated. A DACC student is also required to abide by the acceptable use policies of copyright and peer-to-peer file sharing. It is the student’s responsibility to become familiar with and adhere to the Student Code of Conduct as contained in the DACC Student Handbook. The Student Handbook is available in the Information Office in Vermilion Hall and online at: https://www.dacc.edu/student-handbook|
|DISABILITY SERVICES:||Any student who feels s/he may need an accommodation based on the impact of a disability should contact the Testing & Academic Services Center at 217-443-8708 (TTY 217-443-8701) or stop by Cannon Hall Room 103. Please speak with your instructor privately to discuss your specific accommodation needs in this course.|