Medical Billing

Medical Billing

Course Hours: 
270
Price: 
$1,500.00
Course Type: 
Mentor Supported
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  • Description
  • Objectives
  • Outline
  • Materials
  • Certification
  • System Requirements
  • Watch a Demo

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
Basics of Insurance Billing and Compliance

  • Insurance Billing Specialist
  • Insurance Claims, Coding, & Billing Background
  • Medical Etiquette
  • Medical Ethics
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Fraud and Abuse Laws
  • Compliance Programs
  • Health Care Reform
  • Insurance Policies

Medical Billing Module 2
Basics of Health Insurance

  • History of Health Insurance in the United States
  • Health Care Reform
  • Types of Health Insurance Coverages
  • Private Health Insurance
  • Managed Care Systems
  • Financial Management
  • Medicare
  • Policies and Regulations
  • Medicare Reimbursement
  • Claim Submission

Medical Billing Module 3
State Programs and Veterans’ Health Care

  • Medicaid Programs
  • Medicaid Eligibility
  • Medicaid Benefits
  • Medicaid Managed Care
  • TRICARE
  • History of Tricare
  • Health Plans
  • Veterans Health Administration Program

Medical Billing Module 4
Workers’ Compensation and Disability Programs

  • Workers’ Compensation Laws and Insurance
  • Types of State Compensation Benefits
  • Fraud and Abuse
  • Legal Situations
  • Reporting Requirements
  • Disability Claims
  • Disability Income Insurance
  • Federal Disability Programs
  • State Disability Insurance
  • Voluntary Disability Insurance

Medical Billing Module 5
Documentation and Coding for Professional Services

  • Documentation Process
  • Electronic Health Records
  • Health Record Documentation
  • Review and Audit of Health Records
  • Diagnostic Coding
  • Official Guidelines for ICD-10-CM
  • Procedural Coding
  • Current Procedural Terminology Content and Format
  • Code Modifiers

Medical Billing Module 6
Claims Submission in the Medical Office

  • The Paper Claim CMS-1500
  • Types of Submitted Claims
  • Health Insurance Claim Form (CMS-1500)
  • Claim Completion Guidelines
  • Electronic Claims
  • Clearinghouses
  • Claim Attachment Standards
  • Practice Management System
  • Computer Claims Systems

Medical Billing Module 7
The Claim Follow-Up and Payment Process

  • Revenue Cycle Management
  • Claim Policy Guidelines
  • Explanation of Benefits
  • Claim Management Techniques
  • Rebilling
  • Review and Appeal Process
  • Filing an Appeal
  • Collection Strategies
  • Accounts Receivable

Medical Billing Module 8
Healthcare Facility Billing

  • Ambulatory Surgery Centers
  • Payment Systems
  • Payment Rates
  • Revenue Cycle Management
  • Medical Records for Reimbursement
  • Hospital Outpatient and Inpatient Billing
  • Employment Opportunities
  • 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