Health Care Operations coding

Health Care Operations includes quality improvement activities, credentialing, training, underwriting, compliance services, business planning and development, business management and general administration.

Protected Health Information (“PHI”)

• Identifies a person (reasonable basis to believe that it can be used to identify a person) (e.g.: Name, MR#, address or face photo…)


    • Relates to person’s past, present, or future:


Physical, Mental Health or Condition; 


Provision of Any Treatment or Health Care; or


Payment for the Provision of Any Health Care.


Prevent PHI from loss, tampering, alteration, destruction, unauthorized access or inadvertent disclosure.

Payment includes bizlling, claims management, medical necessity, utilization review activities, determination of coverage Medical coding training online

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