UNIT TITLE : PROCESS MEDICAL CLAIMS/BILLING UNIT CODE : ICT325302 UNIT DESCRIPTOR : This unit covers the skills, knowledge and attitude necessary to process medical claims/billing. It covers preparation of requirements for screening and processing of claims/billing. PERFORMANCE CRITERIA ELEMENT Italicized terms are elaborated REQUIRED KNOWLEDGE REQUIRED SKILLS in the Range of Variables Prepare Data are gathered Medical Terminology Analytical skills requirements from patient’s record Systems of the body Reading and for claims as provided by the (e.g., skeletal, comprehension respiratory, processing client. skills cardiovascular) Patient’s medical Researching Human anatomy record are created skills Human physiology or updated based on Basic Fundamental nature of claims processing mathematical a disease process, requirements skills signs, symptoms and Medical provider’s Communication methods of treatment demographics are skills Common medical checked and Computer skills conditions updated based on Medical investigations claims processing and procedures requirements Injuries Common abbreviations for medical and pharmacological terms (e.g., BCG, HRT) Common medications Commonly used medical equipment and instruments Laboratory testing methods Diagnostic and surgical procedures Laboratory values and significance Medico-legal terminology Medical Documentation Medical claim process Healthcare Laws and Ethics Essential of healthcare insurance Medical Coding Systems Diagnosis code set Procedure Code Set Supplies Code Set
UNIT TITLE : PROCESS MEDICAL CLAIMS/BILLING UNIT CODE : ICT325302 UNIT DESCRIPTOR : This unit covers the skills, knowledge and attitude necessary to process medical claims/billing. It covers preparation of requirements for screening and processing of claims/billing. ELEMENT PERFORMANCE CRITERIA Italicized terms are elaborated in the Range of Variables REQUIRED KNOWLEDGE REQUIRED SKILLS Prepare requirements for claims processing Data are gathered from patient’s record as provided by the client. Patient’s medical record are created or updated based on claims processing requirements Medical provider’s demographics are checked and updated based on claims processing requirements Medical Terminology Systems of the body (e.g., skeletal, respiratory, cardiovascular) Human anatomy Human physiology Fundamental nature of a disease process, signs, symptoms and methods of treatment Common medical conditions Medical investigations and procedures Injuries Common abbreviations for medical and pharmacological terms (e.g., BCG, HRT) Common medications Commonly used medical equipment and instruments Laboratory testing methods Diagnostic and surgical procedures Laboratory values and significance Medico-legal terminology Medical Documentation Medical claim process Healthcare Laws and Ethics Essential of healthcare insurance Medical Coding Systems Diagnosis code set Procedure Code Set Supplies Code Set Analytical skills Reading and comprehension skills Researching skills Basic mathematical skills Communication skills Computer skills