Medical Billing

Category:

Medical & Healthcare

Course Hours:

270

Course Type:

Mentor Supported

You may also like:

Medical Coding

Medical Terminology

Medical Billing is listed as one of the fastest growing professions in allied health. The medical industry is experiencing a tremendous demand for individuals with knowledge of medical office operations, which includes diagnostic and procedural insurance forms processing. This Medical Billing course covers all the plans that are most commonly encountered in clinics and physicians' offices. An emphasis on the role of the medical insurance specialist prepares you for success in the workplace, including areas such as diagnostic coding, procedural coding, Medicare, HIPAA and bill collection strategies. Our Medical Billing course will give you the skills you need to be competitive in the healthcare marketplace.

Prerequisite(s): None

After completing this course, you should be able to:

Identify the core elements of health insurance
List features of the different coding systems and their documentation
Define the features of processing claim forms both electronic and paper
Recall the basics of fee and insurance collection
Recognize the features of various health care payer types

Medical Billing Module 1

Career Role and Responsibilities

• Background of Insurance Claims, Coding, and Billing

• Role of The Insurance Billing Specialist

• Professionalism

• Health Insurance Portability and Accountability Act

• Transactions and Code Sets

• National Identifiers

• Compliance Defined

• Fraud and Abuse Laws

• Compliance Audits and Oversight

Medical Billing Module 2

Basics of Health Insurance, Medicare, and Medicaid

• History of Health Insurance in the United States

• Health Care Reform

• Private Health Insurance

• Managed Care

• Medicare Policies and Regulations

• Additional Insurance Programs

• Medicaid Programs

• Medicaid Eligibility

Medical Billing Module 3

Tricare, Workers’ Compensation, and Disability Income Insurance

• History of Tricare

• Tricare Authorized Providers

• Tricare Health Plans

• Workers’ Compensation Defined

• Workers’ Compensation Insurance Programs

• Workers’ Compensation Eligibility

• Disability Income Insurance Defined

• History of Disability Income Insurance

• Disability Income Insurance Policies

Medical Billing Module 4

Medical Documentation and Coding Part I

• The Documentation Process

• Release and Retention of Records

• Abstracting from Health Records

• Review and Audit of Health Records

• Diagnosis Coding Overview

• International Classification of Diseases

• Assigning a Diagnosis Code

• Organization and Format of ICD-10-CM

Medical Billing Module 5

Coding Part II

• Understanding the Importance of Procedural Coding Skills

• Current Procedural Terminology Content and Format

• Surgery Guidelines

• Code Modifiers

• Healthcare Common Procedure Coding System

• HCPCS Level II Code Categories

• Modifiers

• Reimbursement for HCPCS Codes

Medical Billing Module 6

Claims Submission

• The Paper Claim CMS 1500

• Types of Submitted Claims

• Abstracting from Medical Records

• Basic Guidelines for Submitting a Health Insurance Claim Form (CMS 1500)

• The Electronic Claim

• Standard Unique Identifiers

• Building the Electronic Claim

• Follow-Up of Electronic Claims Processing

Medical Billing Module 7

Revenue Cycle Management

• Claim Policy Guidelines

• Explanation of Benefits

• Claim Management Techniques

• Claim Inquiries

• Collection Strategies

• Patient Education

• Collecting Fees

• Self-Pay Billing

Medical Billing Module 8

Health Care Facility Billing and Employment

• History of Health Care Facilities

• Types of Health Care Facilities

• Regulation of Health Care Facilities

• Introduction to Facility Billing

• Outpatient and Inpatient Diagnosis Coding Guidelines

• Introduction to Inpatient Facility Procedure Coding

• Employment Opportunities

• Professional Organizations

• Self-Employment

**Outlines are subject to change, as courses and materials are updated.**

Ed4Career is committed to being both environmentally conscious and making it easier for you to study! We’re making your education mobile! All of our textbooks are now provided as eTextbooks. You can access them on your laptop, tablet, or mobile device and can study anytime, anywhere.

The move away from physical books to eTextbooks means you get the latest, most up-to-date version available. This also makes your training more accessible, so you can study anywhere you have your phone or tablet. The best part is that all materials are included in your training cost so there are NO extra fees for books!

Upon successful completion of our Medical Billing course, students will be prepared for an entry-level position doing medical billing in a medical office setting and will be prepared to sit for the Med-Certification exam to become a Certified Medical Billing Specialist (CBS) or the AAPC certification exam to become a Certified Professional Biller (CPB).

**Certification exams are not included in the cost of the course.**

Internet Connection

Broadband or High-Speed - DSL, Cable, and Wireless Connections

*Dial-Up internet connections will result in a diminished online experience. Classroom pages may load slowly and viewing large audio and video files may not be possible.

Hardware Requirements

Processor - 2GHz Processor or Higher
Memory - 1 GB RAM Minimum Recommended

PC Software Requirements

Operating Systems - Windows 7 or higher
Microsoft Office 2013 or higher. Also, you could use a general Word Processing application to save and open Microsoft Office formats (.doc, .docx, .xls, .xlsx, .ppt, .pptx)
Internet Browsers - Google Chrome is highly recommended
- Cookies MUST be enabled
- Pop-ups MUST be allowed (Pop-up Blocker disabled)
The Kindle Reader App or VitalSource Bookshelf App are needed for many of our courses (No special equipment needed. This can be downloaded for FREE onto your computer.)
PowerPoint Viewer (if you do not have PowerPoint)

Adobe PDF Reader

QuickTime, Windows Media Player &/or Real Player

MAC Software Requirements

Operating Systems - Mac OS x 10 or higher with Windows
Mac office programs or a Word Processing application to save and open Microsoft Office formats (.doc, .docx, .xls, .xlsx, .ppt, .pptx)
Internet Browsers- Google Chrome is highly recommended
- Cookies MUST be enabled
- Pop-ups MUST be allowed (Pop-up Blocker disabled)
The Kindle Reader App or VitalSource Bookshelf App are needed for many of our courses (No special equipment needed. This can be downloaded for FREE onto your computer.)
PowerPoint Viewer (if you do not have PowerPoint)
Adobe PDF Reader
Apple QuickTime Media Player

Status message