Expert Certificate Course in Medical Billing

Training Provided by Online Training Directory This course is for students who want to learn all of the skills and knowledge needed to succeed in this medical-support field. When you begin working in the healthcare industry, you will be armed with all of the medical billing skills and confidence you need to do an outstanding job. This course also touches on the business acumen needed to market your new billing skills. This marketing knowledge will prove valuable when dealing with clients. Welcome to our Expert Certificate Medical Billing course All modules in the Medical Billing courses are comprised of teaching materials and exercises, plus online testing, all of which can be easily accessed at the student?s convenience. A typical time frame for completion is listed beside each module based upon a part time study schedule. Time, however, will vary depending on the student?s availability. This Expert course in medical billing offers students the skills they will need to enter the industry. The course is also of value of healthcare professionals who wish to expand on their skills. Medical billing professionals play a vital role in the provision of healthcare insurance to people across the country. They process bills for examinations and treatments, and prepare them for entry in insurance company records. This course will prepare you for a career in this challenging profession. Course work is presented in a modular format and will focus on medical billing techniques and the preparation of claims. Specific information will be provided for all major health insurance providers. Students are provided with exhaustive learning materials including online, workbooks, texts and videos. This course material will offer a superior level of personal support and help you progress in your careers.

Expert Certificate Course in Medical Billing Outcomes
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
3. Comprehensive final exam

Grades & Self Reporting: You will have 6 months to complete this course and take your final exam. If no final is taken, your grade will be posted as a "fail." Shortly after enrollment you will begin receiving regular email notifications regarding your course of study. We will be asking how you are progressing in this class. It is your responsibility to respond to our emails and work to finish this course within the time period stated. Not responding to these update notices could result in significant delays, grade reporting issues and failure in the class. Your goal is to complete the course and pass your final exam.
Expert Course includes

• Unlimited IMMEDIATE online access to course materials (9 online modules - see below)
• Medical Billing Marketing Success: Finding Local Clients
• Ten Medical Terminology videos included:

• Introduction to Terminology #1
• Introduction to Terminology #2
• The Digestive System
• The Urinary System
• The Female Reproductive System
• The Male Resproductive System
• Obstetrics and Neonatology
• The Integumentary System
• The Respiratory System
• The Cardiovascular System

Online Modules MODULE 1: Introduction (4 hr)

• Careers as a Medical Biller
• Education and Certification
• Confidentiality
• Professional Certification

MODULE 2: Insurance Companies (50 hrs.)

• Introduction
• Health Insurance Coverage
• Medicare, Medicaid, Champus
• Workers Compensation
• Types of Insurance Plans
• What is a Contract?
• Order of Benefit Determination
• Who''''s Who in Insurance Terms
• Carrier, Coverage and Plan
• Basic Terms and Definitions

MODULE 3: Making of an Insurance Claim (55 hrs.)

• Health Insurance / What is a Claim
• Forms / Vital Information
• The Universal Claim Form
• Understanding the Providers Charges
• Usual, Customary, Reasonable (UCR) Payment Plan
• Capitation
• Maximum Fee Schedule
• Relative Value Studies (RVS)
• Types of Payments
• Medical and Insurance Terminology
• The HCFA-1500 Standard Data
• Authorization of Benefits
• Developing a clean claim

MODULE 4: Basic Claim Guidelines (55 hrs.)

• Medical Office Forms
• Guidelines for Billing
• Causes for Claim Rejection
• Physician ID Numbers
• A Billing Entity
• Par and Non-par Providers
• General Diagnosis Reporting
• Reporting Diagnosis Codes on The HCFA-1500 Form
• Maintaining Insurance Claim Files
• Types of Claims
• Medical Office Forms
• Common Errors That Delay Processing
• How to Get Paid Better and Faster
• Physician and Payer ID Numbers
• Diagnosis Reference Numbers
• Using The Insurance Carriers Dollars

MODULE 5: Creating a Commercial Claim (45 hrs.)

• Filing a Commercial Claim
• Commercial Claims Step-by-Step Instructions
• HCFA - 1500 Form
• Diagnostic, Treatment and Provider Identification - Blocks 14 through 33
• Claim Detail Lines - Blocks 24A through 24K
• Provider and Billing Entity Identification - Blocks 25 Through 3
• Filing a Commercial Claim I
• Assignment of Benefits Form
• Order of Benefit Determination
• Billing the Prime Insurance with a Secondary Insurance
• Commercial Secondary Claims

MODULE 6: Creating Medicare Claims (55 hrs.)

• Creating a Medicare Claim
• Medicare Eligibility
• Railroad Retirement Medicare
• DME Claims
• Coalminers? Claims
• Employed Elderly Healthcare Coverage
• What is a Medicare Intermediary?
• Medicare Guidelines
• A Brief History of Medicare Assignments
• Medicare Supplemental Insurance
• Filing a Medical Claim Medicare as a Primary Payer
• Special Handling
• Step-by-Step Claim Form Instructions
• Provider and Billing Entity Identification - Blocks 25 through 33
• Medicare and Medigap Crossover Claims
• Medigap for Par Providers Instructions
• Medicare Secondary Payer (MSP)
• Medicare and Medicaid Crossover Claims
• Medicare as a Primary Payer

MODULE 7: The ''''Blues'''' (50 hrs.)

• The ?Blues?
• BC/BS Distinctive Plan Features
• Types of BC/BS Accounts
• Indemnity Benefit
• Standard ''''Blues'''' Plan Claims Procedures
• The ?Blues? as a Secondary Insurance Policy Instructions
• Additional Blues Secondary Coverage
• Blue Cross and Blue Shield Addresses
• Blue Cross and Blue Shield Federal Employees Programs
• Explanation of Benefits (EOB)

MODULE 8: Creating Champus Claims (55 hrs.)

• Champus, Champva, and Tricare
• Champus Eligibility
• Who Can Treat a Champus Patient?
• Champus & Champus Identification Cards
• Champus Benefits
• Nonavailability Statement
• Champus Billing Information
• Champus Claims Procedures
• Champus EOB and Payment Voucher
• Champus Non Availability Statement (NAS)
• Statement of Personal Injury Possible Third Party Liability
• Champus Glossary

MODULE 9: Claim Exercises (60 hrs.) Plus Appendix I: Insurance Contract #1 Appendix II: Insurance Forms and Letters Appendix III: Relative Value Study Appendix IV: Provider and Clinic Data Appendix V: HCFA Payer ID Appendix VI: Provider Profile Date Appendix VII: HCFA - NPI Number Appendix VIII: Billing Glossary Appendix IX: Common Medical Diagnosis Contact Hours: 429

About The Training Provider: Online Training Directory