ED-MHC-107 Medical Billing Specialist

Price: 
$2,400.00
Category: 
Medical & Healthcare
Combined Hours: 
450
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
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.**

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