south texas college

MDCA 1343 Course Guide

This course emphasizes medical office coding procedures for payment and reimbursement by patient or third party payers for ambulatory care settings. Prerequisite: Admission to the program and Program Chair approval.

Discussion Topic

Ch 8 "Private Payers / ACA Plans"

          This chapter describes the broad groups of private payers, including BlueCross BlueShield, & the types of private plans, along with describing  ACA plans. It also covers participation contracts & managing capitation contracts.


Ch 9 "Medicare"

          This chapter covers Medicare eligibility, enrollment, different plans, reimbursement methodologies, and completion of claims.