Understanding a Health Care Online Degree

April 14th, 2008 • Filed Under

All one has to do is pick up the newspaper and can find an article about the rising cost of health care in the United States. Careers in health care are either in the area of what they call delivery or in the area of administration. To put it in everyday terms, delivery is the caregivers (nurses, doctors) and administration is the back office functions (hospital/clinic management, insurance benefits). It is the area of administration where costs first must be controlled and a health care online degree will teach you the skills needed. Let’s look at some of the areas in health care administration you will learn about in your online degree program:

An online degree in health care administration will bring you up to date on current compliance regulations. The reporting areas of this field are regulated by the Health Insurance Portability and Accountability Act (HIPAA) Title II. Title II of the act calls for the administrative simplification and standardization of health care transactions as well as a national standard provider numbering system. The different transaction reporting formats are also known as 834, 835, 837, and others. And Title II calls for the use of electronic data interchange to transmit the different formats from doctor’s office/hospital to claims payment clearinghouses and insurance companies. It is a very comprehensive set of standards. If you work for a health insurance claims payer, you have to know and comply with these formats and this is where an online degree in this field can benefit you.

If you need to learn medical billing and coding, an online degree in health care might be just right for you. Medical billing and coding has to do with the way forms are filled out in order to specify a patient’s diagnosis and the services provided for treatment of that diagnosis. It is a very comprehensive set of codes that come from what is known as current procedural terminology (CPT) and International Classification of Diseases (ICD). Medical billing specialists are highly skilled in how to properly do what is referred to as coding a claim for submission to the health insurance payer. Health insurance payers have sophisticated computer systems that evaluate the coding of each claim and will reject those that are improperly-coded creating administrative expense and delaying payments to the providers. Your online degree in health care in the area of medical billing and coding can help you to avoid improperly-coded claims.

Utilization review is also critical to controlling health care costs. Your online health care degree can also cover another back office function when it comes to paying for health insurance claims: the utilization review function. This is where certain cases are reviewed to ensure the patient is getting the proper care for the treatment plan. Your online degree in health care will be able to educate you on how this is handled so that the patients subscribing to your health care plan can get the best care possible.

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