India

Medical Billing and Coding

Medical Billing and Coding is a nationally-recognized online program that will prepare you to take your place in the rewarding field of healthcare
Temecula, CA P.O. Box 760,, Temecula, CA 92593
(951) 9723600

Course at a Glance

Mode of learning : Online - Instructor Lead(LVC)

Domain / Subject : Medical/Healthcare/Pharma

Function : General

Duration : 240 Hours

Difficulty : Medium

Medical Billing and Coding

Medical Billing and Coding is a nationally-recognized online program that will prepare you to take your place in the rewarding field of healthcare.  Medicine is more than patient care— it is also a business.  Medical practices rely on medical billers and coders to provide the cash flow that keeps their doors open.  Positions are also available with ambulatory care centers, medical equipment suppliers, insurance companies, public health agencies, consulting firms, and medical billing companies. 

You will learn to function as an important member of the healthcare team by providing key skills such as abstracting from medical records, assigning codes to diagnoses and procedures using the ICD-9-CM, ICD-10-CM, CPT and HCPCS Level II code books, developing insurance claims according to third-party guidelines, and understanding the legal, ethical and regulatory concepts that are vital to this field.  

Upon completion of this program, you will be prepared to take the Certified Billing and Coding Specialist (CBCS) exam, offered by National Healthcareer Association NHA), and will receive the study guide materials, access to practice exams, and exam registration fees. You will also be prepared to sit for the Certified Professional Coder (CPC) exam, offered by the American Academy of Professional Coders (AAPC).

Objectives

After successful completion of the Medical Billing and Coding program, you will be able to perform the following tasks:

  • Adhere to legal concepts, such as advance directive, living will, power of attorney, and guardianship
  • Explain the HIPAA Privacy Rule
  • Safeguard and disclose protected health information (PHI)
  • Recognize the implications of health insurance fraud and abuse
  • Discover the five models of managed care organizations
  • Assign accurate codes from the ICD-9-CM, CPT, and HCPCS Level II coding manuals
  • Assign accurate codes from the ICD-10-CM Official Draft Code Set
  • Develop an insurance claim
  • Use the electronic data interchange (EDI)
  • Recognize health insurances delivered by private companies and government-sponsored programs 

Requirements

This program can be taken from either a Mac or a PC. It is compatible with the Windows XP and later operating systems and IE 7 and later browsers. There are no specific computer requirements other than an Internet connection, e-mail account, Microsoft Word (for assignment submissions), and Windows Media Player (which is available as a free download). We recommend that you use the latest version of Internet Explorer in place of other Web browsers. Adobe Flash Player and Adobe Acrobat Reader are required for this program. 

ed2go will provide the required textbooks for this program:

  • A Guide to Health Insurance Billing, 4th edition
  • 2013 Coding Workbook for the Physician’s Office
  • 2014 CPT Standard Edition
  • 2014 HCPCS Level II
  • ICD-10-CM:  The Complete Official Draft Code Set
  • Official CPC Certification Study Guide, 4th edition
  • ICD-9-CM Expert for Physician’s, Volumes 1 & 2 – 2014
  • Merriam-Webster's Medical Desk Dictionary

Prerequisites

It is recommended that you have knowledge of medical terminology, including anatomy and physiology. In order to sit for national certification exams, candidates must have a high school diploma or equivalent.  Therefore, it is recommended you have this before enrolling for this program.

All of our programs are self-paced and open enrollment, so you can start them when you want and finish them at your own pace.

Course Content

Medical Billing and Coding

  • The Insurance Billing Specialist and Legal Aspects of Insurance Billing
    • Personal Qualifications
    • Career Opportunities
    • Certification
    • HIPAA
    • Insurance Fraud and Abuse
  • Introduction to Health Insurance
    • Health Insurance Terms
    • Managed Care
    • Healthcare Provider Terms
    • Third-party Reimbursement Methods
  • ICD-9-CM
    • Introduction to Coding
    • Format of ICD-9-CM
    • ICD-9-CM Coding Guidelines
    • ICD-9-CM Coding Conventions
    • Steps for Assigning ICD-9-CM Codes
  • ICD-10-CM
    • Overview of ICD-10-CM
    • Format of ICD-10-CM
    • ICD-10-CM Coding Guidelines
    • ICD-10-CM Coding Conventions
    • Steps for Assigning ICD-10-CM Codes
  • CPT and HCPCS Level II
    • Healthcare Common Procedure Coding System
    • Organization of the CPT Code Book
    • CPT Coding Conventions
    • Organization of the HCPCS Level II Code Book
    • Steps for Assigning CPT and HCPCS Level II Codes
  • Abstracting Information from Medical Documents
    • Coding from SOAP Notes
    • Coding from a Consultation Report
    • Coding from Operative Reports
    • Coding from Emergency Room Records
    • Coding from Procedure Reports
  • New Patients, Insurance Claims and EOBs
    • Electronic, Paper and Hybrid Medical Records
    • Practice Management Software
    • Patient Portal
    • Developing an Insurance Claim
    • New Patient Procedures
    • Medical Necessity
    • Explanation of Benefits (EOB)
    • Collection Practices
  • Submitting Electronic Claims and CMS 1500
    • Electronic Data Interchange (EDI)
    • Electronic Claims Submission
    • 1500 Claim Form
    • National Uniform Claim Committee
  • Blue Cross/Blue Shield
    • Participating and Nonparticipating Providers
    • Allowable Fee
    • Usual, Customary and Reasonable (UCR)
    • Blue Shield Claims Submission
  • Medicare
    • Medicare Parts A, B, C, and D
    • Participating and Nonparticipating Providers
    • Advance Beneficiary Notice (ABN)
    • Supplemental Insurance
    • NCCI
    • Medicare Claims Submission
  • Other Healthcare Programs
    • Medicaid
    • TRICARE
    • CHAMPVA
    • Workers’ Compensation
    • Claims Submission

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