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Course Name
Expert Certificate Course in Medical Billing

Contact Hours: 160

Course Description

Consistent cash flow is critical in a healthy outpatient medical practice, and the HCFA-1500 insurance claim form represents from 85% to 95% of the reimbursement flow back to the practice. The form is driven by the medical insurance billing specialist either electronically or manually and gets to the insurance company quickly or slowly respectively.

The medical biller is the key player in the financial operations of the medical office is involved in many aspects from writing office policy to institute the billing standards for the medical practice, submitting claims, interfacing with the customers and insurance companies, to working with the physician or hospital staff to insure proper billing is done. Billers need to know insurance rules and regulations for various insurance plans, Medicare, Medicaid, and third-party payers.

This course is designed to help you learn all of the clerical functions that a medical biller performs in order to process the HCFA-1500 form quickly and accurately. It also covers understanding source documents and the insurance "claim cycle", claim submission, the TRICARE and CHAMPVA programs, workers` comp programs, receiving payments and problem solving, as well as learning how to work with others from staff and patients to insurance company representatives.
This course includes instructor video lectures, instructor presentations, quizzes, tests, and worktext. Included with the worktext is a comprehensive resource CD with quizzes, exams exercises and much more.


Outcome
Upon successful completion of this course, students will be able to:
  1. Show a solid understanding of the medical billing profession
  2. Understand and be able to fill out claim forms
  3. Know the difference between claims filed with different firms
  4. Confidently pursue a career in medical billing

Assessment
Evaluation of student performance will be based on the following:
  1. Online practice exercises.
  2. Individual module tests
Grades & Self Reporting: You will have 6 months to complete this course. The course administrator/mentor may require that you engage in other activities including self-reporting of progress and understanding and comprehension of the course materials.



Outline

Medical Billing & Reimbursement

Level 1
  • Introduction to Medical Billing
  • Fundamentals of Health Insurance Coverage
  • Insurance Claim Cycle
  • Documentation & the Medical Record
  • The Health Insurance Claim Form
  • Fees: Private Insurance & Managed Care
Medical Billing & Reimbursement

Level 2
  • Introduction
  • Medicaid Program
  • Medicare Program
  • TRICARE & CHAMPVA
  • Workers Compensation
  • Patient Billing
  • Tracking Reimbursement