BIM 117: Medical Office Accounts Receivable

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Class Program
Business Information Management
Credits 4 Lecture Hours 44
This is a basic class in managing the information required for billing medical insurance in clinic and hospital settings. This class will cover coding, specific form requirements, account aging, posting payments and adjustments to patient accounts, and medical coverage plans, including government plans. Issues related to overall medical business offices will also be part of the class, including correct patient billing and collection procedures. (Formerly: BIM 107 & BIM 111).
Quarters Offered
Spring
Course Outcomes

Upon successful completion of the course, students should be able to demonstrate the following knowledge or skills:

  1. Explain the variety of insurance companies and plans that are offered to patients.
  2. Explain the term electronic health records (EHR) and health information management (HIM).
  3. Communicate with insurance companies to determine patients’ insurance coverage.
  4. Apply diagnosis codes, procedure codes, and fee schedules.
  5. Enumerate the differences between electronic billing and paper billing to insurance companies.
  6. Communicate with insurance companies when billing is denied.
  7. Communicate with patients when there are billing questions.
  8. Read and apply insurance remittance advice or explanation of benefits to patient accounts.
  9. Explain correct patient billing and collection procedures
Institutional Outcomes
IO3 Human Relations/Workplace Skills: Students will be able to demonstrate teamwork, professionalism, and/or workplace specific skills.
Course Content Outline
  • Electronic Health Records (EHR)
  • Types of insurance companies and plans
  • Insurance verification
  • Correct billing procedures
  • Coding (diagnosis and procedure codes)
  • Fee schedules
  • Electronic Billing (EDI)
  • Insurance remittance advice (RA, EOB), electronic remittance advice, electronic funds transfer
  • Communicate with 3rd party payers
  • Collect and apply patient payments
  • Patient statements
  • Collection rules and regulations
Department Guidelines
The syllabus must contain evaluation/grading guidelines, class environment/expectations/rules, course learning outcomes, and a disability services statement. A schedule must be provided to students that contains content covered (text chapters, topics, etc.), tentative test dates (to include final date/time). If an LMS or similar site is used for the course, it must be created following the Quality Matters (QM) principals outlined in the QM workbook questions. These documents should be reviewed with the BIM instructor at least two weeks prior to class start.