🌼Module 1: Lesson 1: Understanding Health Insurance Understanding your health insurance is the first step to accessing the care you need. Many people feel overwhelmed by insurance plans, but once you understand the basics, you can make better decisions and avoid costly mistakes. HMO vs PPO vs Medicare Advantage What insurance covers Key terms (deductible, copay, etc.)

🌼 Module 1: Lesson 2: Understanding your health insurance is the first step to accessing the care you need. Many people feel overwhelmed by insurance plans, but once you understand the basics, you can make better decisions and avoid costly mistakes. HMO vs PPO vs Medicare Advantage What insurance covers Key terms (deductible, copay, co-insurance)

Module 1: Lesson 3: Welcome to Our Classroom - Healthcare Navigation 101: Where we Will Navigate HMO vs PPO vs Medicare Advantage - Q&A What insurance actually covers -Q&A Common terms (deductible, copay, out-of-pocket) - Q&A

🌼Lesson 1: How Medical Billing Works -First, you visit a doctor or hospital. After your visit, the provider documents everything—services, tests, and procedures. -Next, this information is translated into billing codes. These codes are sent to your insurance company in what’s called a claim. -Your insurance then reviews the claim and decides what they will pay, based on your plan. -After that, you receive a bill for the remaining balance—this could include, deductibles, or coinsurance.

🌼Lesson 2: Why Medical Bills Are Often Incorrect 1.Incorrect codes 2. Duplicate charges 3. Services not received 4. Insurance denial mistakes 5. Incorrect Identification number 6. Incorrect date of birth (DOB) 7. Incorrect Procedure code 8. Incorrect Diagnosis 9. Incorrect first/last name 10. Out-of-network surprises 11. Other Primary insurance 12. Incorrect Provider Identification Number (ID#) 🌟Key takeaway: Always review your bill—you could save hundreds or even thousands of dollars.

🌼Lesson 3: How to Read a Medical Bill Reading a medical bill may seem overwhelming, but it becomes easier when you know what to look for. Start with the patient information—make sure your name and details are correct.

🌼Lesson 1 A deductible is the amount you must pay out of pocket before your insurance starts to pay. For example, if your deductible is $1,000, you must pay that amount first before your insurance begins covering costs. Some services, like preventive care, may be covered before you meet your deductible. 📝 Lesson Text Deductible = what you pay first Insurance pays AFTER deductible is met Some services may be exempt 💡 Key takeaway: A lower monthly premium often means a higher deductible.

🌼 Lesson 2 : Copays and coinsurance are both ways you share costs with your insurance—but they are different. A copay is a fixed amount you pay for a service, like $25 for a doctor visit. Coinsurance is a percentage of the cost. For example, you might pay 20% while insurance covers 80%. 📝 Lesson Text Copay = fixed amount Coinsurance = percentage Both apply after certain conditions 💡 Key takeaway: Coinsurance can vary depending on the cost of services.”

🌼Lesson 3: Insurance companies have networks of doctors and providers. In-network providers have agreements with your insurance, which means lower costs for you. Out-of-network providers do not have agreements, which often results in higher charges. Always check if your provider is in-network before receiving care. In-network = lower cost Out-of-network = higher cost Always verify before appointments 💡 Key takeaway: Staying in-network can save you a significant amount of money.

🌼 Lesson 1: Understanding Appointment Types Appointment scheduling is more than just picking a date and time—it starts with understanding the correct appointment type Other types may include: Routine check-ups; Sick visits Specialist consultations Scheduling the wrong type of appointment can lead to billing issues 📝 Lesson Text New patient = longer time Follow-up = shorter visit Always confirm visit reason 🌼 Key takeaway: The correct appointment type prevents workflow and billing issues

🌼 Lesson 2: Verifying Insurance Before Scheduling “One of the most important steps in appointment scheduling is verifying insurance before confirming the visit. This helps ensure: The provider is in-network The service is covered The patient understands their financial responsibility Skipping this step can lead to denied claims or unexpected bills. Always collect: Insurance provider name Member ID Group number 🏆 Verifying early helps avoid problems later.”

🌼Lesson 3: Managing Provider Schedules Efficiently-Avoid overbooking “Efficient scheduling also means understanding provider availability. Each provider may have: Specific working hours Blocked times for meetings or procedures Different appointment lengths Overbooking or poor scheduling can create long wait times and stress for both staff and patients. A well-managed schedule improves patient satisfaction and keeps the office running smoothly.”