Syllabus


  • About Medical Billing

    The Basics Overview:
    Gathering & Entering Data, Paper Claims Processing, Electronic Claims Processing, Posting Payments, Generating Reports, Billing Your Clients

    Types of Insurance Coverage:
    Group Health, Individual Policies, Medicare, Medicaid, Personal Injury (PIP), Workers Compensation, Tricare


  • Insurance Claim Processing, Claim Payment, Report Generation


  • Essential Office Forms(Patient Demographic Form and Completion, Insurance Cards, Insurance Verification Form and Verification Procedures, Superbill, Daysheet), Examining Insurance Cards, Insurance Verification Process, Mock Insurance Verification Conversations, Insurance Verification Exercises


  • Calculating Co-paymentss & Deductibles


  • The Basics of the CMS 1500 Form, Box by Box Breakdown of the CMS 1500 Form, Step-By-Step Instructions for Completing a CMS 1500, Online CMS Form Completion Exercises, Billing Tips Commonly Made Errors

  • Day 14-18   
    Understanding Codes

    Definition, Proper Usage, Resource & Reference Material

    ICD (International Classification of Disease) Coding
    Definition, Proper Usage, Resource & Reference Material


  • The Time-Line of an Insurance Claim
    The Collection of Claim Data
    Patient Demographics, Guarantor Information & Handling, Insurance Coverage Information, Patient Condition Information Patient Treatment Information, Clinic Billing Information

    Claim Information Data Entry
    Claim Submission
    Paper Claims, Electronic Claims, Secondary Claims, Claims Attachments

    Receiving & Posting Payments
    Full Payment, Partial Payment, Deductible


  • Basic Components of Billing Applications Clinic Data: Billing Identification Numbers

    Physician DataTax ID, UPIN, License Numbers, Assignment

    Patient Data Demographics Information, Insurance Information, Procedure Information, Diagnosis Information

    Claim Generation: Charge Entry, Payment Entry, Financial Adjustments, Transaction Notes

    Electronic & Paper Claims, Calculating Co-paymentss & Deductibles, 100 Co-payments & Deductibles Problems & Answers,
    Chapter AC3: Understanding Workers' Compensation

    Introduction to Workers Compensation: Medical Claims, Temporary Disability, Permanent Disability, Vocational Rehabilitation, Survivor Benefits

    Federal Workers Compensation Overview & Claim Filing, State Workers Compensation Overview & Claim Filing, First Report of Injury

    CMS 1500 Completion for Workers Compensation Claims: Box by Box Instruction

    Appeals & Adjudication, Fraud & Abuse, Tips for Successful Workers Compensation Claim Filing & Handling
    FINAL EXAMINATION

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