ED-MHC-107 Medical Billing Specialist

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Category: 
Medical & Healthcare
Combined Hours: 
450
Course Type: 
Mentor Supported
Bundled Courses:
Medical Terminology
Medical Billing
  • Description
  • Objectives
  • Outline
  • Materials
  • Certification
  • Approvals
  • System Requirements
  • Watch a Demo

Our Medical Billing Specialist program will prepare students for a careen in one of the fastest growing health professions. Medical Billing is listed as one of the fastest growing professions in allied health. The medical industry is experiencing a tremendous demand for individuals with knowledge of medical office operations, terminology and includes diagnostic and procedural insurance forms processing.

Medical Terminology

After completing this course, you should be able to:

  • Identify how to gain and understand the basic word structure in medical terminology
  • Recognize how to relate the medical terms to the structure and function of the human body
  • Identify body systems, body cavities, and planes of the body
  • Define words by dividing them into their component parts
  • Recall the terminology used with medical specialists and case reports

Medical Billing

After completing this course, you should be able to:

  • Identify the core elements of health insurance
  • List features of the different coding systems and their documentation
  • Define the features of processing claim forms both electronic and paper
  • Recall the basics of fee and insurance collection
  • Recognize the features of various health care payer types

Medical Terminology

Medical Terminology Module 1
Basic Word Structure

  • Word Analysis
  • Combining Forms
  • Suffixes & Prefixes
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 2
Organization of the Body

  • Body Systems and Cavities
  • Divisions of the Back
  • Planes of the Body
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 3
Suffixes

  • Introduction to Suffixes
  • Suffixes and Terminology
  • Diagnostic & Procedural Suffixes
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 4
Prefixes

  • Combining Forms & Prefixes
  • Prefixes and Terminology
  • Define Common Prefixes
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 5
Medical Specialists & Case Reports

  • Medical Specialists
  • Combining Forms & Vocabulary
  • Case Reports & Terminology
  • Pronunciation of Terms
  • Exercises & Applications

Medical Terminology Module 6
Body Systems – Part 1

  • Cardiovascular System
  • Digestive System
  • Endocrine System
  • Female Reproductive System
  • Lymphatic System

Medical Terminology Module 7
Body Systems – Part 2

  • Male Reproductive System
  • Musculoskeletal System
  • Nervous System
  • Respiratory System
  • Skin & Sense Organs
  • Urinary System

**Outlines are subject to change, as courses and materials are updated.**

Medical Billing

Medical Billing Module 1
Basics of Insurance Billing and Compliance

  • Insurance Billing Specialist
  • Insurance Claims, Coding, & Billing Background
  • Medical Etiquette
  • Medical Ethics
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Fraud and Abuse Laws
  • Compliance Programs
  • Health Care Reform
  • Insurance Policies

Medical Billing Module 2
Basics of Health Insurance

  • History of Health Insurance in the United States
  • Health Care Reform
  • Types of Health Insurance Coverages
  • Private Health Insurance
  • Managed Care Systems
  • Financial Management
  • Medicare
  • Policies and Regulations
  • Medicare Reimbursement
  • Claim Submission

Medical Billing Module 3
State Programs and Veterans’ Health Care

  • Medicaid Programs
  • Medicaid Eligibility
  • Medicaid Benefits
  • Medicaid Managed Care
  • TRICARE
  • History of Tricare
  • Health Plans
  • Veterans Health Administration Program

Medical Billing Module 4
Workers’ Compensation and Disability Programs

  • Workers’ Compensation Laws and Insurance
  • Types of State Compensation Benefits
  • Fraud and Abuse
  • Legal Situations
  • Reporting Requirements
  • Disability Claims
  • Disability Income Insurance
  • Federal Disability Programs
  • State Disability Insurance
  • Voluntary Disability Insurance

Medical Billing Module 5
Documentation and Coding for Professional Services

  • Documentation Process
  • Electronic Health Records
  • Health Record Documentation
  • Review and Audit of Health Records
  • Diagnostic Coding
  • Official Guidelines for ICD-10-CM
  • Procedural Coding
  • Current Procedural Terminology Content and Format
  • Code Modifiers

Medical Billing Module 6
Claims Submission in the Medical Office

  • The Paper Claim CMS-1500
  • Types of Submitted Claims
  • Health Insurance Claim Form (CMS-1500)
  • Claim Completion Guidelines
  • Electronic Claims
  • Clearinghouses
  • Claim Attachment Standards
  • Practice Management System
  • Computer Claims Systems

Medical Billing Module 7
The Claim Follow-Up and Payment Process

  • Revenue Cycle Management
  • Claim Policy Guidelines
  • Explanation of Benefits
  • Claim Management Techniques
  • Rebilling
  • Review and Appeal Process
  • Filing an Appeal
  • Collection Strategies
  • Accounts Receivable

Medical Billing Module 8
Healthcare Facility Billing

  • Ambulatory Surgery Centers
  • Payment Systems
  • Payment Rates
  • Revenue Cycle Management
  • Medical Records for Reimbursement
  • Hospital Outpatient and Inpatient Billing
  • Employment Opportunities
  • Self-Employment

**Outlines are subject to change, as courses and materials are updated.**

All course materials included.

Medical Billing 

Upon successful completion of our Medical Billing course, students will be prepared for an entry-level position doing medical billing in a medical office setting and will be prepared to sit for the Med-Certification exam to become a Certified Medical Billing Specialist (CBS) or the AAPC certification exam to become a Certified Professional Biller (CPB).

Note: This course is not affiliated with, nor has it been endorsed by AAPC. 

 International Association for Continuing Education and Training (IACET)

Ed4Career has been approved as an Accredited Provider by the International Association for Continuing Education and Training (IACET). In obtaining this accreditation, Ed4Career has demonstrated that it complies with the ANSI/IACET Standard which is recognized internationally as a standard of good practice. As a result of the Accredited Provider status, Ed4Career is authorized to offer IACET CEUs for courses and programs that qualify under the ANSI/IACET Standard.

The Continuing Education Unit (CEU) was created by IACET as a measurement of continuing education. One (1) IACET CEU is equal to ten (10) contact hours of participation in an organized continuing education experience under responsible sponsorship, capable direction, and qualified instruction. Under IACET's care, the IACET CEU has evolved from a quantitative measure to a hallmark of quality training and instruction. For more information on IACET, visit iacet.org.

Internet Connection

  • Broadband or High-Speed - DSL, Cable, and Wireless Connections

*Dial-Up internet connections will result in a diminished online experience. Classroom pages may load slowly and viewing large audio and video files may not be possible.

Hardware Requirements

  • Processor - 2GHz Processor or Higher
  • Memory - 1 GB RAM Minimum Recommended

 

PC Software Requirements

  • Operating Systems - Windows 7 or higher
  • Microsoft Office 2013 or higher. Also, you could use a general Word Processing application to save and open Microsoft Office formats (.doc, .docx, .xls, .xlsx, .ppt, .pptx)
  • Internet Browsers - Google Chrome is highly recommended
    • Cookies MUST be enabled
    • Pop-ups MUST be allowed (Pop-up Blocker disabled)
  • The Kindle Reader App or VitalSource Bookshelf App are needed for many of our courses (No special equipment needed. This can be downloaded for FREE onto your computer.)
  • PowerPoint Viewer (if you do not have PowerPoint)
  • Adobe PDF Reader
  • QuickTime, Windows Media Player &/or Real Player

 

MAC Software Requirements

  • Operating Systems - Mac OS x 10 or higher with Windows
  • Mac office programs or a Word Processing application to save and open Microsoft Office formats (.doc, .docx, .xls, .xlsx, .ppt, .pptx)
  • Internet Browsers- Google Chrome is highly recommended
    • Cookies MUST be enabled
    • Pop-ups MUST be allowed (Pop-up Blocker disabled)
  • The Kindle Reader App or VitalSource Bookshelf App are needed for many of our courses (No special equipment needed. This can be downloaded for FREE onto your computer.)
  • PowerPoint Viewer (if you do not have PowerPoint)
  • Adobe PDF Reader
  • Apple QuickTime Media Player

 


Click on the school name below for purchasing info:

1400 Robinwood Drive
Hagerstown, MD 21742
United States
Phone: 240-500-2553

This course is also available at the following school:

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