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Medical practices and hospitals depend on the insurance and billing professional for receiving revenues. Vast amounts of information pass through even the most modest of medical offices. The proceedings of every patient (physician observations, prescription history, diagnoses, procedures performed, tracking of diseases, etc.) must be logged and recorded. This information will need to be posted to the insurance companies, coded, billed, and claims filed in order to receive payments from patients and insurance companies. This is one of the most important vital jobs to every medical practice. By learning insurance procedures, this will enable all the insurance information to proceed to the right departments for processing. By learning insurance procedures, this will enable the practice to process insurance information to insurance companies for payment and reimbursements. By learning billing procedures, this will enable the practice to receive revenues. By learning coding, will help provide the codes skills needed to process treatment, medical findings, diseases, and diagnosis, test, and medical procedures performed on each patient. By learning claims processing, a medical practice can be assured, all claims filed with insurance companies, will receive reimbursements, for procedures performed. All of this makes up the process on the accounting and billing cycle. The Medical Insurance, Billing, Coding, and Claims professional is a crucial and increasingly in-demand role in health care, hospitals, medical practices, home business, and all related fields. |
| Leaning all four categories, should put each student above all others who only learn one area of medical. Salary should increase, more job opportunities should be available, and success should be at an advantage. Opening many doors of opportunity in hospitals, nursing homes, physicians’ offices, rehabilitation centers, home health care facilities, ambulatory care facilities, medical surgical supply companies, clinics, laboratories, medical libraries, government medical facilities, insurance companies, health maintenance organizations (HMO’s), mental health facilities, coding and billing organizations, or working from home! You could open your own billing business and work in your spare time or full time. The opportunities could be enormous! You could also save money. By learning all four categories of medical you will not have to pay for each individual course, possibly saving hundreds or even thousands of dollars. Program Features: Objectives of what you will learn throughout the program. Key Terms to help you identify the vocabulary needed. Check List to help gain confidence and understand key concepts, Notes to help bring important points to your attention, Icons, Exercises, Examples, Illustrations, Tables for Reference, Forms, to draw attention to critical areas, Reviews to help enhance critical thinking ability and assign correct codes. Coding exercises provide hands-on coding practice and applications, Claims Instructions simplify the process of completing the claim forms for various types of payers. CD Rom Software for completing claim forms for hands-on computer applications. Studyware CD Rom software to help learn materials in the course and complete coding cases. Exercises on each section to give you plenty of practice to learn how to bill, code, and reimburse. Patient case studies for real world applications. Understanding Medical Insurance Procedures. Disability, Liability, Organizations, and various companies and descriptions. Understanding Managed Care and Legislations. Understanding Insurance Claims and the Insurance Process Understanding Claims Submission and Claims Processing and , Adjudications Managing new and established patients information, forms and documents needed. Collections HIPPA Guidelines and Legal and Regulatory Issues, state and federal statues and the law. Medical Necessity. Medical Coding ICD-9-CM Understanding ICD-9-CM Coding, coding diseases and conditions. Coding Conventions, Coding Hypertension, Neoplasms, V-Codes, Burns, Fractures, E Codes, Coding Procedures, Infecctions/Parasitic Diseases, Endocrine, Diseases of the Blood, Mental Disorders, Nervous System, Circulatory System, Respiratory System, Digestive, Genitourinary, Pregnancy, Diseases of the Skin, Musculoskeletal System, Perinatal, Injury, Poisoning, and more. Hands-on coding practice is provided for proficiency. Medical Coding CPT Understanding CPT coding procedures with cases and case study examples for real coding practice. Learn the CPT coding sections, conventions, symbols, categories, sub-categories, headings, single coding and code ranges, and modifiers. Guidelines and steps to follow for coding procedures and services. Hands-on coding practice is provided for proficiency. Evaluation and Management Coding. Coding anesthesia coding, surgery, radiology, pathology, laboratory, medicine, and assigning the correct CPT modifiers. Coding simulations and case studies are provided for reinforcement. The Reimbursement Process: Understanding co-insurance, co-payments, and how to calculate patient's charges and out patient services with helpful guidelines to follow. Payment Processing: What to charge the patient. Understanding the fee schedules and determining who pays. Laboratory, ambulatory, surgical, durable equipment, home health, hospital, hospital outpatient, hospital inpatient, inpatient rehabilitation, long term care, nursing facility. Claims Processing: Learn special instructions that apply to completion of the CM-1500 Claim Form. Billing and Billing Guidelines: Authorization for Release of Medical Information. The claim form and completing each section is covered. Understanding the type of claims, Primary and Secondary Claims. Steps in Processing Claims with case and claim simulations applications and practice. Commercial Insurance Commercial Claims Step by Step Guidelines with case studies. Blue Cross and Blue Shield Procedures, steps, complete guidelines to follow, all the way to processing to claims. Hands-on case simulations applications and practice. Medicare Procedures, steps, complete guidelines to follow, all the way to processing to claims. Hands-on case simulations with applications and practice. Mediare/Medigap Medicare/Medicaid. Parts A/B, Eligibility, Enrollment, Applying, Qualification. Fees to Claims Processing. Case simulations for hands-on practice. Medicaid: Insurance, Billing and Claims Primary Medicare, Secondary Completion of CMS-1500 Claim Forms for Medicaid. Medicare/Medigap, Medicare/Medicaid. Federal/State Services, Verifying Eligibility, Deadlines, Pre-authorization, Payments for Services. Billing, Deductibles, Co-payments, Claim Procedures with cases simulations for hands-on practice. Tricare Procedures, steps, complete guidelines to follow, all the way to processing to claims. Hands-on case simulations for hands-on applications and practice. Workers' Compensation and Disability Procedures, steps, complete guidelines to follow, all the way to processing to claims. Hands-on case simulations for hands-on applications and practice. UB-04 Hospital Claim Forms, Revenue Codes, and the Chargemaster. Examples and Studies are provided for hands-on applications and real world learning. UB-04 Hospital Billing and Claims Procedures. Guide Dental Claims Billing and Claims Processing. Guide. Medical Software Applications CD Rom is included with the work book, for hands-on computer practice with case studies and medical simulations provided for proficiency. ____________________________________________________________________________________________________ Medical Terminology, Anatomy, & Physiology (Professional) is needed before taking Insurance, Billing, Coding, Claims program. Nurses, RNs, LPNs, may be exempt. Core text is CEU approved. Certified level for CPC, CCS, national certification test and exams. Mock CPC and CRMS exams are included. Start Your Career Now, Fill out the contact form below for more information, to register for class, contact us, or have a representative call you. Take on-line or come in for private like classes. |