Training Programs Medical Medical Billing Specialist (Voucher Included)
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The Medical Billing Specialist (Voucher Included) includes: Medical Terminology
Medical Billing Specialist

Medical Billing Specialist (Voucher Included)

The medical billing profession has a high projected growth rate, as this role is vital to making sure that all healthcare providers receive payment for the services and supplies they provide. Physicians depend on billers for reimbursements that provide the cash flow used to pay their expenses, keep the medical facilities open, assure compliance with payer guidelines, and deal with government red tape.

medical-billing-specialist
$2,495.00 (USD)
List Price: $3,090.00
Save: $595.00 (19% off)

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Overview

Objective

Outline

  1. Medical Terminology
    1. Introduction to Medical Terminology
    2. The Musculoskeletal System
    3. The Cardiovascular System
    4. The Lymphatic and Immune Systems
    5. The Respiratory System
    6. The Digestive System
    7. The Urinary System
    8. The Nervous System
    9. The Special Senses: The Eyes and Ears
    10. The Integumentary System
    11. The Endocrine System
    12. The Reproductive System
    13. Diagnostic Procedures, Nuclear Medicine, Pharmacology
  2. Medical Billing Specialist
    1. Introduction to Medical Billing
      1. Career Opportunities
      2. Personal and Technical Qualifications
      3. Employment Settings
      4. Telecommunications
      5. Professional Certifications
    2. Introduction to Health Insurance
      1. Health Insurance Terminology
      2. Commercial and Government Payers
      3. Healthcare Documentation
      4. Electronic Health Record
    3. Managed Healthcare
      1. Types of Reimbursement
      2. Managed Care Providers
      3. Managed Care Models
      4. Consumer-Directed Health Plans
    4. Revenue Cycle Management
      1. Phases of Revenue Cycle Management
      2. Encounter Form, Chargemaster
      3. Insurance Claim Cycle
      4. New Patient Registration
      5. Collection Practices
    5. Legal Aspects of Health Insurance and Reimbursement
      1. Laws Affecting Healthcare
      2. Protected Health Information (PHI)
      3. Health Insurance Portability and Accountability Act (HIPAA)
      4. Fraud and Abuse in Medical Billing
      5. Release of Information (ROI)
    6. ICD-10-CM Coding
      1. Overview of ICD-10-CM
      2. Key Features
      3. Organization of the Codebook
      4. Index to Diseases and Injuries
      5. Tabular List of Diseases and Injuries
      6. Coding Conventions
      7. Official Guidelines
    7. CPT Coding
      1. Overview of Healthcare Common Procedure Coding System (HCPCS)
      2. Category I, Category II, and Category III Codes
      3. Organization of the Codebook
      4. Main CPT Sections
      5. Evaluation and Management
      6. Anesthesia
      7. Surgery
      8. Radiology
      9. Pathology and Laboratory
      10. Medicine
      11. Code Modifiers
    8. HCPCS Level II Coding
      1. Overview of HCPCS Level II
      2. Organization of the Codebook
      3. Durable Medical Equipment
    9. Maximizing Reimbursement
      1. Price Transparency
      2. Data Analytics
      3. Billing Audits
    10. Pharmacology for Medical Billers
      1. Pharmacodynamics and Pharmacokinetics
      2. Routes of Administration
      3. Drug Classifications
      4. Prescription Drugs and Over-the-Counter Drugs
      5. Controlled Substances
      6. Medication Lists and the Electronic Health Record
    11. Midterm
    12. Clinical Documentation Improvement (CDI)
      1. Deficiencies in Documentation
      2. Medical Necessity
      3. Coding Audits
      4. Types of Clinical Documentation
    13. Insurance Claims
      1. National Uniform Claim Committee
      2. CMS-1500 Claim Form
      3. Patient and Insured Information
      4. Physician or Supplier Information
      5. UB-04 Claim Form
    14. Commercial Insurance
      1. Individual/Group Health Insurance, Automobile, Disability, Liability, Workers' Compensation
      2. Completing Commercial Health Insurance Claims
    15. Blue Cross Blue Shield
      1. History of BCBS
      2. Types of BCBS Plans
      3. Participating/Nonparticipating Providers
      4. BCBS Billing and Payment Guidelines
    16. Medicare
      1. Medicare Eligibility
      2. Medicare Part A, B, C, and D
      3. National Coverage Determinations/Local Coverage Determinations
      4. Participating/Nonparticipating Providers
      5. Physician Fee Schedule
      6. Medicare Billing and Payment Guidelines/NCCI
    17. Medicaid, CHIP, TRICARE, Workers' Compensation
      1. Medicaid
      2. Children's Health Insurance Program (CHIP)
      3. TRICARE
      4. Workers' Compensation
    18. Certification
      1. Importance of Certification
      2. Study Strategies for the Certification Exam
      3. Prior to the Exam
      4. Morning of the Exam
      5. During the Exam
    19. How to Find a Job in Medical Billing (Optional)
      1. Formulating Your Career Goals
      2. What Employers Want
      3. Showcasing Your Skills
      4. Resume Tips
      5. Cover Letter Tips
      6. Interview Questions
    20. FINAL

Requirements

Prerequisites

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Instructor

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Texas A&M International University
Continuing Education
5201 University Blvd
Laredo, TX 78041 US
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