Jul 03, 2024
OHIO University Undergraduate Catalog 2023-2024
OHIO University Undergraduate Catalog 2023-2024
[Archived Catalog]
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MAT 2300 - Administrative Medical Assisting Techniques II
Theory and application of skills necessary to process managed care/insurance in the ambulatory health care setting. Covers topics such as, managed care health insurance plans, procedural and diagnostic coding, insurance claim processing, managed care billing with computers, community resources for health care, and protective practices in the administrative setting. Suggested prerequisites: MAT 1010, 1400, & 1700 (grades of C or better); required immunizations; first aid & provider-level certifications; OTEC 1210, permission.
Requisites: Permission required
Credit Hours: 4
Repeat/Retake Information: May be retaken two times excluding withdrawals, but only last course taken counts.
Lecture/Lab Hours: 3.0 lecture, 2.0 laboratory
Grades: Eligible Grades: A-F,WP,WF,WN,FN,AU,I
Course Transferability: CTAG course: CTMAT006 Process Insurance Claims
College Credit Plus: Level 1
Learning Outcomes:
- Describe and define RBRVS and DRGs.
- Describe guidelines and processes used in processing an insurance claim.
- Describe how to use the most current diagnostic coding classification system.
- Describe how to use the most current procedural coding system.
- Describe procedures for implementing both managed care and insurance plans.
- Describe third-party claims.
- Discuss precertification, preauthorization, eligibility verification, and managed care language.
- Discuss referal processes for patients in a managed care program.
- Discuss utilization review principles.
- Identify types of insurance plans and models of managed care.
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