| Chapter Objectives (See related pages)
After completing Chapter 15, you will be able to:
15.1 List the basic steps of the health insurance claim process. |
| | | 15.2 Describe your role in insurance claims processing. |
| | | 15.3 Explain how payers set fees. |
| | | 15.4 Define Medicare and Medicaid. |
| | | 15.5 Discuss TRICARE and CHAMPVA health-care benefits programs. |
| | | 15.6 Distinguish between HMOs and PPOs. |
| | | 15.7 Explain how to manage a workers' compensation
case. |
| | | 15.8 Apply rules related to coordination of benefits. |
| | | 15.9 Describe the health-care claim preparation
process. |
| | | 15.10 Complete a Centers for Medicare and Medicaid
Service (CMS-1500) claim form. |
| | | 15.11 Identify three ways to transmit electronic
claims. |
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