Medical Billing and Coding

In-Classroom Hours: 100/ Online Hours: 60
Retail Price: $3,299.00

General Information:

Call for details - Classes start soon!  Flexible schedules.

Course Overview:

Medical Billing and Coding Career Prep Complete is a growing career field with numerous job opportunities.  This course combines the basics of medical coding, medical billing, and medical terminology to provide a comprehensive program that will prepare you to work as a Medical Coding and Billing Specialist in a professional medical office.  In this course, you will learn about the necessary medical terminology, insurance guidelines and compliance requirements, medical billing functions, and legal and ethical issues.  Upon completion of this course, you will be fully prepared to begin working in a professional medical office.  Students will be prepared to take either the AMCA Medical Coder & Biller Certification (MCBC) national certification exam or the NHA Billing and Coding Specialist Certification (CBCS) national certification exam.

Recommended Prerequisites: High School Graduate or GED holder

Course Exam:

Students will have the choice to take either the AMCA Medical Coder & Biller Certification (MCBC) national certification exam or the NHA Billing and Coding Specialist Certification (CBCS) national certification exam.

Topics Covered:

  1. Describe the role of the Certified Medical Billing Specialist
  2. Describe the origin of medical language.
  3. Analyze the component parts of a medical term.
  4. List and define basic prefixes, suffixes, and combining forms.
  5. Use basic prefixes, suffixes, and combining forms to build medical terms.
  6. Explain common rules for proper medical term formation, pronunciation, and spelling.
  7. Assess the responsibilities assigned to insurance billing and coding specialists and electronic claims processors.
  8. Describe the health care delivery system.
  9. Explain the responsibilities of the billing and coding specialist to protect patient rights under HIPAA.
  10. Demonstrate a basic understanding of the anatomy and physiology of body systems and related medical terminology in order to properly process clean claims.
  11. Utilize the ICD‐9-CM manual, including V codes, E codes, and the Neoplasm and Hypertension tables.
  12. Demonstrate a basic understanding of the ICD-10-CM and ICD-10-PCS
  13. Utilize the CPT manual and the various guidelines.
  14. Demonstrate diagnostic and procedural coding.
  15. Describe basic guidelines for submitting insurance claims.
  16. Explain the difference between clean, pending, rejected, incomplete, and invalid claims.
  17. Identify solutions for denied and rejected paper and electronic claims.
  18. Identify when a paper claim can and cannot be used.
  19. Explain the relationship of transactions and security with electronic data.
  20. Communicate (verbally and non‐verbally) effectively and appropriately in the workplace

 

Modules:

Unit 1: Overview of Medical Coding and Billing

  • The Insurance Billing Specialist
  • Career Opportunities
  • Certifications
  • Medical Coding
  • Medical Billing

Unit 2: Insurance, Compliance and Regulations

  • Basics of Health Insurance
  • HIPAA             
  • Compliance, Privacy, Fraud and Abuse in Insurance Billing
  • Military Insurance, Worker’s Compensation and COBRA
  • Medicaid, Medicare, and CHIP
  • Ethics and Legal Issues

Unit 3: Medical Terminology

  • Overview of the Human Body
  • Body Systems
  • Anatomy and Pathology
  • Word Parts
  • Dividing and Combining Terms
  • Abbreviations, Symbols and Special Terms

Unit 4: Medical Billing

  • Obtaining and Managing Patient Information
  • Developing an Insurance Claim
  • Submitting a Claim
  • Medical Documentation and the Electronic Health Record
  • Medical Records
  • Hospital Billing

Unit 5: Medical Coding

  • Overview of Medical Coding
  • ICD-9 Coding
  • ICD-10-CM Coding
  • ICD-10-PCS Coding
  • CPT and HCPS Level II

Instructional Strategies:

  • Lecture
  • Skills Demonstration
  • Group Activities
  • Individual Activities

Methods of Evaluation:

  • Quizzes/Exams
  • Written Assignments
  • Skills Demonstration

Instructor Biography:

Coming soon!

Grading System:

Student must pass all unit tests and module exams at 70% or better to be eligible for a certificate of completion and to be prepared to take the final examination if applicable in their particular program.

Attendance Policy:

Students are expected to arrive on time and participate in course discussions. Successful completion of the course of study recommends 100% attendance. If during the course period the student’s attendance level drops below 80%, they will be encouraged and given the opportunity to attend the next class for the course they enrolled in. Should materials change, student is responsible for all additional cost.

Refund Policy:

  • 3-DAY MONEY BACK POLICY: Students may withdraw from the program for any reason within 3 days of executing the enrollment agreement prior to the start of program. In this case, the student’s enrollment agreement shall be rescinded provided the student returns all course materials.
  • No Refund after 3 days: If, for any reason, a student wishes to withdraw after the initial 3-day period prior to the start of the class, they are not released from their obligation to pay the program fees in full and are not entitled to any refund.

Re-Admission Policy:

Any student who has dropped out of the program, or has been suspended from the program for nonattendance may be readmitted within one year by completing a personal interview with the director of education and paying any applicable fees at the time of readmission. Students who were terminated due to conduct issues are not eligible to be readmitted.

Policy on Student Conduct:

Appropriate Conduct: All students are expected to conduct themselves in an orderly and professional manner. Any student not conducting themselves in an orderly and professional manner, which includes use of drugs and alcohol during school hours, dishonesty, disrupting classes, use of profanity, excessive tardiness, insubordination, violation of safety rules, improper usage of lab or classroom computers, or not abiding by the school rules will lead to either probation or dismissal from classes.