SE School for Career Development©

HOSPITAL BILLING & CODING            SPECIALIST  (Certified Certificate Program) Hospitals are the number one employer hiring thousands of personnel. Hospitals can have many different departments, divisions, subsidiaries, branches, and separate entities. An all-in-one program. Cardiology Centers, Diabetes Divisions, Neonatal Facilities, Burn Centers, Cancer Centers, Rehabilitation or Therapy Centers, Emergency Departments, Psychiatric Centers, Drub Rehabilitation Centers, Pain Clinics, Radiology, and many more divisions, within the hospitals, employing millions of personnel depending on size. Within each division there are many different subdivisions. Admissions, registration, customer service, in-patient, out-patients, account receivables, account payables, insurance, billing coding, reimbursements, claims, collections, and many more units. Working in a hospital can offer security, prestige, confidence, and knowledge in knowing there will always be needs for medical professionals. The Hospital Billing Coding Specialist program can help provide individuals with all the necessary skills to achieve a fulfilling rewarding career as a Professional Hospital Billing and Coding Specialist. Opening many many doors of job opportunities in many different departments in hospitals, all in one course, and save in the process.   Your key toward success.

For every patient that receives treatment and care at a hospital, a record is established. A record or documentation of the procedures is logged. This is maintained by the clinical staff members or employees. Observations, medical or surgical interventions, and treatment is performed. This information or statistics, gathered over a period of time will produce a record for the insurance and billing departments. The staff in the accounting, insurance, billing, and claims departments will process the patient’s procedures performed, and bill the correct agencies, insurance organization, and/or the patient.  Statistics such as the patient personal information, insurance information, treatment, procedures, correct codes, and charges are entered into the hospital computers for electronic processing. The claims and other departments will track all claims, payments, reimbursements, rejections, and make the necessary adjustments. The opportunities and growth level could be tremendous creating many jobs opportunities in: Hospital Admissions Hospital Insurance Hospital Billing Account Receivables Hospital Coding Hospital Reimbursements Hospital Claims In Patient and Out Services Account Receivables Payment Processing Hospital Collections and more. You could learn many different skills needed in different departments in hospitals that could open many doors of opportunity from surgery centers, ambulatory care centers, and speciality departments. Because of the diversified opportunities within the hospital settings, SE School for Career Development is offering a very good program for professional Hospital Billing and Coding. Hospital Billing and Coding program covers important aspects of hospital insurance, billing, and coding, from patient admissions to accounts receivable management, HIPAA and more. You'll discover actual hospital cases from authentic documents, comparisons of the UB-04 and UB-92 claim forms, an interactive CD ROM that simulates the hospital billing and coding environment, and complete coverage of: The hospital regulatory setting                                    Claims Form Structure and function of hospital departments             Reimbursements Patient accounts and data flow                                  Accounts Receivable Management The billing process                                                    Coding and much more. What you can learn: Hospital Introduction, History, Diagnostic, Technology, and Therapeutic Advanced in Medicine. Managed Care, Hospital Systems, Hospital Services, Classification, Facilities, and Terms. Hospital Regulatory Environment Federal Legislation, State Regulations, Health Education and Welfare, Federal Regulatory Agencies, State Regulations, State Hospital Licensing Requirements.  Accreditation. Hospital Organization Structure and Function A break down of each department and description of functions withing the hospital.  Administrative, Financial, Operational, Clinical, Outpatient, Ambulatory Surgery, Emergency, and Inpatient. Hospital Billing and Coding Process Patient Accounts and Data Flow in the Hospital, Outpatient,  Inpatient. Patient Admissions, Patient Care Process, Admissions Process, Preadmission Testing,  Patient Care Process, Admission Process. Patient Interview, Registration, Insurance Verification, Patient Medical Records, Room Bed Assignment.  Medical Record Documentation.  Patient Care Services. Charges, Charge Procedures, Hospital Charges.  Patient Discharge. Hospital Billing Process and Patient Transactions.  Account Receivable Management.  Aging Reports. The Hospital Billing Process Purpose of the Billing Process.  Paper Guidelines.  Participating Provider Agreements, Claim Forms, Clean Claims, Reimbursement Methods, Reimbursements by Service and Payer Category. Services and Items Billed by the Hospital.  Categories. Coding Systems.  Procedure, Diagnosis Systems. Coding for Outpatient and Inpatient. Claim Forms.  CMS-1500 and CMS-1450 (UB-92).  Detailed Itemized Statement. Manual versus Electronic Claim Submissions.   Hospital Billing Process. Patient Admission/Registration, Patient Care Order Entry, Charges, Chart Review and Coding, Charge Submission, Reimbursement, Accounts Receivables. Account Receivable Management Life Cycle of a Hospital Claim.  Hospital Billing.   Insurance Billing and Patient Statements.   Third Party Payer, Remittance Advice.  Patient Account Transactions.  Patient Payments, Adjustments, Balance Billing, Secondary Billing.  Accounts Receivable Management.  Reports, Procedures. Lost, Rejected, Denied, and Pending Claims.  Collections, Outstanding Patient Accounts, Outstanding Third Party Claims, Claim Inquiries, Insurance Claim Tracker,  Appeals. Hospital Diagnosic Coding Coding Medical Conditions. History and Purpose of Diagnosis Coding.  Utilizing Data for Coding, Documentation, Medical Necessary, Claim Forms, Reimbursements.  ICD-9-CM Coding, Contents, Volume 1, II, and III Contents.  Procedures on Coding.  Official Guidelines. Coding Procedures, Services, and Items Documentation, Medical Necessary, Claim Forms, Reimbursements, Procedure Coding Systems, Outpatient Services Coding, Inpatient Services, Non-Patient Services.  HCPCS Levels, CPT Content, Conventions and Format.  ICD-9-CM Volume III Procedures, Official Conventions.   Steps to Coding with HCPCS and ICD-9-CM Volume.   Coding Guidelines and Applications Relationships between billing and coding.  Documentation, Claim Form Submissions and Coding. Coding and Payer Processing.  Coding Outpatient and Non-Patient Services, Inpatient.   ICD-9-CM Official Diagnosis Coding Guidelines.  Inpatient, Outpatient.  ICD-9-CM Volume III General Procedure Coding Guidelines.  Health Care Common Procedure Coding System (HCPCS) Coding Guidelines.  Reading the Medical Record and Identify the Main Terms.   Application Coding Guidelines. Claim Forms Purpose of the claim form.  Manual and electronic claims.  CMS-1500 Instructions. Manual and Electronic Claims Submissions. CMS-1450 (UB-92) completion and instructions.  UB-04.Understanding the sections and completing each section, step-by-step procedures and guidelines. Case scenarios are provided for real world applications. Insurance Third Party Payers, Insurance Carriers, Plans, Covered Services, Coverage Limitations.   Primary, Secondary, Tertiary Pay Responsibilities, Patient and Financial Responsibilities. Provision of Service, Reimbursement.  Reimbursement Methods.  Billing Requirements, Documentation, Coding, Claim Forms, Timely Filing.  Appeals Process. Government Payers Government Sponsored Programs.  Medicare, Medicaid, Tricare.  Administration, Eligibility, Coverages, COB.  Participating Provider Agreement.  Medical Necessity, Reimbursements Methods. Billing. Prospective Payment Systems Understanding Prospective Payment Systems. Inpatient and Outpatient Prospective Payment Systems Diagnostic Related Groups.  Diagnosis Related Groups, Coding for Diagnosis Related Groups. Hospital Outpatient Services, Ambulatory Surgery Center.  Payment Classifications. HIPAA and Compliance HIPAA Overview.  Health Care Reform. Preventing Health Care Fraud and Abuse and Administrative Simplification.  Privacy Rule, Protected Health Information, HIPAA Private Practices, Patient Privacy Rights, Use and Disclosure of Protected Health Information.  Administrative Safeguards, Technical and Physical Safeguards, Enforcement and Penalties.  HIPAA Compliance. A comprehensive presentation of billing and coding in the hospital environment. Cases on CD Rom provide different scenarios of hospital simulated situations, that allow student to work from different source documents to produce a completed UB-92 claim form. This software serves to simulate the patient registration and charge entry functions to show how patient billing information from multiple sources is entered correctly on the UB-92 claim form on the computer.   The hands-one applications and practice should help prepare for hospital proficiency. Once completing the program, and receiving your certification certificate, you can start your career search, for many job opportunities.   ______________________________________________________________________________ On Site Tuition Fee $999.99 plus book(s), materials, SH Fees.  Comparable to a $4,000.00 course. On Line Tuition Fee $899.99 plus book(s), materials, shipping and handling fees may apply..