Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. The same process is used for most insurance companies, whether they are private companies or government sponsored programs.

Eligibility: Any Graduate

Course Description:
This course introduces the student to health insurance and reimbursement. In this course the student will become familiar with common medical billing practices, the health insurance industry, legal and regulatory issues and differences in reimbursement methodologies. The student will learn principles of medical billing related to proper claim form preparation, submission, and payment processing, and the follow up process. This course is recommended for anyone who is preparing for a career in a medical billing department at a physician’s office, clinic, or other healthcare entity, and as a claims examiner for insurance carriers.

Course Content:

• Chapter 1 — Health Insurance Specialist Career

• Chapter 2 & 3 — Introduction to Health Insurance/Managed Health Care

• Chapter 4 — Processing an Insurance Claim

• Chapter 5 — Legal and Regulatory Issues

• Chapter 6 — Diagnosis Coding

• Chapter 7 — CPT Coding

• Chapter 8 — HCPCS Level II Coding

• Chapter 9 — CMS Reimbursement Methodologies

• Chapter 10 — Coding for Medical Necessity

• Chapter 11 — Essential CMS-1500 Claim Instructions

• Chapter 12 — Commercial Insurance

• Chapter 13 — Blue Cross Blue Shield

• Chapter 14 — Medicare