Medical Billing and Coding - Live Online

160 Hours / Access Length: Schedule Varies / Delivery: Live Online, Instructor Led

Course Overview:

100 Hours Synchronous Learning / 60 Hours Online Learning3

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 the NHA Billing and Coding Specialist Certification (CBCS) national certification exam.

Recommended Prerequisites: High School Graduate or GED holder

Course Exam:

Students will be prepared to take 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:

1. Role of an Insurance Billing Specialist
2. Privacy, Security, and HIPAA
3. Compliance, Fraud, and Abuse 
4. Basics of Health Insurance & The Blue Plans, Private Insurance, and Managed Care Plans 
5. Medicare 
6. Medicaid and Other State Programs & TRICARE and Veterans Health Care
7. Workers Compensation
8. Disability Income Insurance and Disability Benefit Programs & Medical Documentation and the Electronic Health Record
9. Diagnostic Coding
10. Procedural Coding & The Paper Claim CMS-1500
11. The Electronic Claim
12. Receiving Payments and Insurance Problem Solving & Collection Strategies
13. Ambulatory Surgery Center
14. Hospital Outpatient and Inpatient Billing & Seeking a Job and Attaining Professional Advancement
15. Midterm
16. Reimbursement, HIPAA, and Compliance
17. An Overview of ICD-10-CM 
18. ICD-10-CM Outpatient Coding and Reporting Guidelines & Using ICD-10-CM 
19. Specific Guidelines (ICD-10-CM Chapters 1-10) 
20. Specific Guidelines (ICD-10-CM Chapters 11-14) 
21. Chapter-Specific Guidelines (ICD-10-CM Chapters 15-21)  
22. Introduction to CPT  
23. Introduction to the Level II National Codes (HCPCS) & Modifiers 
24. Evaluation and Management EM Services & Anesthesia 
25. Surgery Guidelines and General Surgery & Integumentary System 
26. Musculoskeletal & Respiratory System 
27. Cardiovascular System & Hemic, Lymphatic, Mediastinum, and Diaphragm 
28. Digestive System & Urinary and Male Genital Systems 
29. Reproductive, Intersex Surgery, Female Genital System, Maternity Care and Delivery &Endocrine and Nervous Systems
30. Eye, Ocular Adnexa, Auditory, and Operating Microscope & Radiology 
31. Pathology Laboratory & Medicine 
32. Inpatient Coding 
33. Final Exam

Testimonial

"From the first phone call, I knew ProTrain was the school for me. Soon I will be sitting at the certification test, and I know I will pass! Our instructor went out of her way to make sure we learned what we needed to be ready for our new career and prepare us for the exam. Now I have the confidence and knowledge to enter this field, thank you for making it possible to follow my dreams and succeed!"

Lonna Wornstaff

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 quizzes, exams, and national exam (if applicable) at a passing rate to be eligible for a Certificate of  Training Completion. If an internship is included in your course you will be required to complete the internship prior to receiving a Certificate of Training Completion.

Attendance:

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 scheduled class for the course they enrolled in. Should materials change, student is responsible for all additional cost.

Payment Plan Policy:

Students may withdraw from the program for any reason up to 1 week prior to the start of program. In this case, the student’s payment plan agreement shall be rescinded. If the payment plan has begun a non-refundable administrative fee of $25.00 will be assessed and remaining funds will be returned to payer in check form by mail. 

Refund Policy: 

There can be no refund for the course, once the first class has been concluded; or if any course material, including the eBook, is accessed. If extenuating circumstances exist, case by case situations will be reviewed by ProTrain. If a refund is issued, the refunded amount (- a $25 processing fee) will be dependent upon books being returned in excellent condition (i.e. no writing, missing pages; ripped or damage to pages and/or binding).

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.

System Requirements:

Internet Connectivity Requirements:

• Cable, Fiber, DSL, or LEO Satellite (i.e. Starlink) internet with speeds of at least 10mb/sec download and 5mb/sec upload are recommended for the best experience.

NOTE: While cellular hotspots may allow access to our courses, users may experience connectivity issues by trying to access our learning management system.  This is due to the potential high download and upload latency of cellular connections.   Therefore, it is not recommended that students use a cellular hotspot as their primary way of accessing their courses.

Hardware Requirements:

• CPU: 1 GHz or higher
• RAM: 4 GB or higher
• Resolution: 1280 x 720 or higher.  1920x1080 resolution is recommended for the best experience.
• Speakers / Headphones
• Microphone for Webinar or Live Online sessions.

Operating System Requirements:

• Windows 7 or higher.
• Mac OSX 10 or higher.
• Latest Chrome OS
• Latest Linux Distributions
  

NOTE: While we understand that our courses can be viewed on Android and iPhone devices, we do not recommend the use of these devices for our courses. The size of these devices do not provide a good learning environment for students taking online or live online based courses.

Web Browser Requirements:

• Latest Google Chrome is recommended for the best experience.
• Latest Mozilla FireFox
• Latest Microsoft Edge
• Latest Apple Safari

Basic Software Requirements (These are recommendations of software to use):

• Office suite software (Microsoft Office, OpenOffice, or LibreOffice)
• PDF reader program (Adobe Reader, FoxIt)
• Courses may require other software that is described in the above course outline.