ED-MHC-107 Medical Billing Specialist

Price: 
$2,400.00
Category: 
Medical & Healthcare
Combined Hours: 
450
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Course Type: 
Mentor Supported
Bundled Courses:
Medical Terminology
Medical Billing
  • Description
  • Objectives
  • Outline
  • Materials
  • Certification
  • System Requirements
  • Watch a Demo

Our Medical Billing Specialist program will prepare students for a careen in one of the fastest growing health professions. 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, terminology and includes diagnostic and procedural insurance forms processing.

Medical Terminology

After completing this course, you should be able to:

  • Identify how to gain and understand the basic word structure in medical terminology
  • Recognize how to relate the medical terms to the structure and function of the human body
  • Identify body systems, body cavities, and planes of the body
  • Define words by dividing them into their component parts
  • Recall the terminology used with medical specialists and case reports

Medical Billing

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 Terminology

Medical Terminology Module 1
Basic Word Structure

  • Word Analysis
  • Combining Forms
  • Suffixes & Prefixes
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 2
Organization of the Body

  • Body Systems and Cavities
  • Divisions of the Back
  • Planes of the Body
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 3
Suffixes

  • Introduction to Suffixes
  • Suffixes and Terminology
  • Diagnostic & Procedural Suffixes
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 4
Prefixes

  • Combining Forms & Prefixes
  • Prefixes and Terminology
  • Define Common Prefixes
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 5
Medical Specialists & Case Reports

  • Medical Specialists
  • Combining Forms & Vocabulary
  • Case Reports & Terminology
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 6
Body Systems – Part 1

  • Cardiovascular System
  • Digestive System
  • Endocrine System
  • Female Reproductive System
  • Lymphatic System

Medical Terminology Module 7
Body Systems – Part 2

  • Male Reproductive System
  • Musculoskeletal System
  • Nervous System
  • Respiratory System
  • Skin & Sense Organs
  • Urinary System

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

Medical Billing

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.**

All course materials included.

Medical Billing 

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).

Note: This course is not affiliated with, nor has it been endorsed by AAPC. 

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