Medical Billing

Medical Billing

Course Hours: 
270
Price: 
$1,500.00
Course Type: 
Mentor Supported
  • Description
  • Objectives
  • Outline
  • Materials
  • Certification
  • Approvals
  • 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 market place.

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
  • Types of Coverage

Medical Billing Module 2
Medical Documentation and Coding

  • The Documentation Process
  • Documentation Guidelines
  • Electronic Health Records
  • Documentation Terminology
  • Diagnostic Coding
  • ICD-10 Diagnosis and Procedure Codes
  • Procedural Coding
  • Methods of Payment
  • Official Guidelines for ICD-10-CM
  • CPT Coding

Medical Billing Module 3
Paper and Electronic Claims

  • Paper Claim CMS-1500
  • Types of Submitted Claims
  • Health Insurance Claim Forms
  • Claim Completion Guidelines
  • Electronic Data Interchange
  • Transaction and Code Sets Regulations
  • Claim Management Techniques
  • Claim Inquiries
  • Filing an Appeal

Medical Billing Module 4
Fee & Insurance Collection

  • Claim Policy Guidelines
  • Explanation of Benefits
  • Medical Review
  • Management of Plans
  • Plan Administration
  • Financial Management
  • Cash Flow Cycle
  • Accounts Receivable
  • Credit and Collection Laws
  • The Collection Process

Medical Billing Module 5
Health Care Payers, Part 1

  • Private Insurance
  • Managed Care Systems
  • Medicare Reimbursement
  • Claim Submission
  • Medicaid Programs and Eligibility
  • Medicaid Benefits
  • Medicare Policies and Regulations
  • Medicare Managed Care Programs
  • Payment Fundamentals

Medical Billing Module 6
Health Care Payers, Part 2

  • TRICARE Programs
  • TRICARE Standards
  • CHAMPVA Programs
  • TRICARE & CHAMPVA Claims Procedures
  • Workers’ Compensation Laws
  • Workers’ Compensation Eligibility & Coverage
  • Workers’ Compensation Fraud & Abuse
  • Occupational Safety & Health Administration Act (OSHA)
  • Disability Income Insurance
  • Disability Benefit Programs
  • Disability Claims
  • Federal & State Disability Programs

Medical Billing Module 7
Inpatient & Outpatient Billing

  • Hospital Billing
  • Patient Accounts Representative
  • Admissions Procedures
  • Utilization Review
  • Coding Hospital Diagnoses & Procedures
  • Coding Inpatient Procedures
  • Coding Outpatient Procedures
  • Reimbursement Process
  • Billing Problems
  • Hospital Billing Claim Form
  • Employment Opportunities
  • Searching for a Job
  • Self-Employment
     

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

Ed4Online 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.**

 International Association for Continuing Education and Training (IACET)

Ed4Online has been approved as an Accredited Provider by the International Association for Continuing Education and Training (IACET). In obtaining this accreditation, Ed4Online has demonstrated that it complies with the ANSI/IACET Standard which is recognized internationally as a standard of good practice. As a result of the Accredited Provider status, Ed4Online is authorized to offer IACET CEUs for courses and programs that qualify under the ANSI/IACET Standard.

The Continuing Education Unit (CEU) was created by IACET as a measurement of continuing education. One (1) IACET CEU is equal to ten (10) contact hours of participation in an organized continuing education experience under responsible sponsorship, capable direction, and qualified instruction. Under IACET's care, the IACET CEU has evolved from a quantitative measure to a hallmark of quality training and instruction. For more information on IACET, visit iacet.org.

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

While our courses are accessible through multiple mobile learning platforms, some courses may include a CD or DVD with the Textbook, so you may need access to a computer with CD-ROM or DVD Drive.

 

PC Software Requirements

  • Operating Systems - Windows 7 or higher
  • Microsoft Office 2007 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)
  • Kindle Reader App is 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)
  • Kindle Reader App is 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
  • Courses that include a CD-ROM or DVD may require an external drive and Parallels software to view.
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