Medical Billing and Coding (Voucher Included) – (VIRTUAL) – Course #115116.900

$2,995.00

Total Hours

370
Days

Self Paced Learning
Start Date

Rolling Enrollment
Duration of Program Access

12 Months

Course Description

Medical billers and coders are in high demand. This course offers valuable training in legal, ethical, and regulatory concepts central to this field, including HIPAA compliance, official coding guidelines, and third-party payer requirements. You will also come to understand all phases of the revenue cycle—from patient registration through medical coding, claims submission, reimbursement, and collections. You will also learn common medical terminology to help you converse with others in healthcare easily and with confidence. You will study word parts and the structures and functions of the human body. Also presented are the disorders and medical procedures common to each body system, including musculoskeletal, cardiovascular, respiratory, digestive, nervous, endocrine, integumentary, genitourinary, lymphatic, and immune.

Train for an in-demand healthcare career in medical billing and coding and prepare for industry certification in this course.

Outline

  1. Medical Terminology
    1. Introduction to Medical Terminology
    2. The Musculoskeletal System
    3. The Cardiovascular System
    4. The Lymphatic and Immune Systems
    5. The Respiratory System
    6. The Digestive System
    7. The Urinary System
    8. The Nervous System
    9. The Special Senses The Eyes and Ears
    10. The Integumentary System
    11. The Endocrine System
    12. The Reproductive System
    13. Diagnostic Procedures, Nuclear Medicine, Pharmacology
  2. Medical Billing and Coding
    1. Introduction to Medical Billing and Coding
      1. Career Opportunities
      2. Personal and Technical Qualifications
      3. Employment Settings
      4. Telecommunications
      5. Professional Certifications
    2. Introduction to Health Insurance
      1. Health Insurance Terminology
      2. Commercial and Government Payers
      3. Healthcare Documentation
      4. Electronic Health Record
    3. Managed Healthcare
      1. Types of Reimbursement
      2. Managed Care Providers
      3. Managed Care Models
      4. Consumer-Directed Health Plans
    4. Revenue Cycle Management
      1. Phases of Revenue Cycle Management
      2. Encounter Form, Chargemaster
      3. Insurance Claim Cycle
      4. New Patient Registration
      5. Collection Practices
    5. Legal Aspects of Health Insurance and Reimbursement
      1. Laws Affecting Healthcare
      2. Protected Health Information
      3. Health Insurance Portability and Accountability Act (HIPAA)
      4. Fraud and Abuse in Medical Billing and Coding
      5. Release of Information
    6. VI. ICD-10-CM Coding
      1. Overview of ICD-10-CM
      2. Key Features
      3. Organization of the Codebook
      4. Index to Diseases and Injuries
      5. Tabular List of Diseases and Injuries
      6. Coding Conventions
      7. Official Guidelines
    7. CPT Coding
      1. Overview of Healthcare Common Procedure Coding System (HCPCS)
      2. Category I, Category II, and Category III Codes
      3. Organization of the Codebook
      4. Main CPT Sections
      5. Evaluation and Management
      6. Anesthesia
      7. Surgery
      8. Radiology
      9. Pathology and Laboratory
      10. Medicine
      11. Code Modifiers
    8. HCPCS Level II Coding
      1. Overview of HCPCS Level II
      2. Organization of the Codebook
      3. Durable Medical Equipment
    9. ICD-10-PCS Coding
      1. Overview of ICD-10-PCS
      2. Code Structure
      3. Definitions
      4. Index
      5. Code Tables
      6. Coding Steps
    10. Pharmacology for Coders
      1. Pharmacodynamics and Pharmacokinetics
      2. Routes of Administration
      3. Drug Classifications
      4. Prescription Drugs and Over-the-Counter Drugs
      5. Controlled Substances
      6. Medication Lists and the Electronic Health Record

      MIDTERM

    11. Clinical Documentation Improvement (CDI)
      1. Deficiencies in Documentation
      2. Medical Necessity
      3. Auditing
      4. Coding From Patient Documentation
    12. Insurance Claims
      1. National Uniform Claim Committee
      2. CMS-1500 Claim Form
      3. Patient and Insured Information
      4. Physician or Supplier Information
      5. UB-04 Claim Form
    13. Commercial Insurance
      1. Individual/Group Health Insurance, Automobile, Disability, Liability, Workers' Compensation
      2. Completing Commercial Health Insurance Claims
    14. Blue Cross Blue Shield
      1. History of BCBS
      2. Types of BCBS Plans
      3. Participating/Nonparticipating Providers
      4. BCBS Billing and Payment Guidelines
    15. Medicare
      1. Medicare Eligibility
      2. Medicare Part A, B, C, and D
      3. National Coverage Determinations/Local Coverage Determinations
      4. Participating/Nonparticipating Providers
      5. Physician Fee Schedule
      6. Medicare Billing and Payment Guidelines/NCCI
    16. Medicaid, CHIP, TRICARE, Workers' Compensation
      1. Medicaid
      2. Children's Health Insurance Program (CHIP)
      3. TRICARE
      4. Workers' Compensation
    17. Certification
      1. Selecting the Right Certification
      2. Study Strategies for the Certification Exam
      3. Prior to the Exam
      4. Morning of the Exam
      5. During the Exam
    18. How to Find a Job in Medical Billing and Coding
      1. Formulating Your Career Goals
      2. What Employers Want
      3. Showcasing Your Skills
      4. Resume Tips
      5. Cover Letter Tips
      6. Interview Questions

Hardware Requirements

 

 

 

Course Objectives

  • What you will learn
    • Medical Billing and Coding
    • Medical coding terminology is required for medical coding, including the structures and functions of the human body
    • The disorders and medical procedures common to each body system
    • Legal, ethical, and regulatory concepts central to the field, including HIPAA compliance and third-party guidelines for filing insurance claims
    • The main coding manuals: ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II
    • How to code diagnoses, services, and procedures for all systems of the body
    • Fundamentals of medical billing & coding and medical terminology
    • Word parts and the structures and functions of the human body

    How you will benefit

    • Get hands-on, practical experience in medical billing and coding that will help you on the job
    • Receive a certificate of completion and prepare to sit for the professional certification that best aligns with your interest and career goals
    • Receive a voucher for the professional certification exam of your choice
    • Receive access to study materials that align with the exam option you choose
    • Certified Professional Coder (CPC) exam offered by the American Academy of Professional Coders (AAPC)
    • Certified Coding Associate (CCA) exam offered by the American Health Information Management Association (AHIMA)
    • Certified Billing and Coding Specialist (CBCS) exam offered by the National Healthcareer Association (NHA)

Prerequisites

High school Diploma or Equivalent. 

Certification Requirements:

In order to sit for national certification exams, candidates must have a high school diploma or equivalent. Therefore, it is recommended you have this before enrolling in this course. Certification exams offered by AAPC and NHA are only available online to candidates located in the US. AHIMA only offers in-person exams in both the US and Globally.

Medical Billing and Coding FAQs

What is medical billing and coding?

Medical Billers and Coders are responsible for processing patient data including medical records and related insurance. In this position, you will code a patient's diagnosis and then request payment from the patient's insurance company. You will play an important role in ensuring that healthcare providers are quickly and accurately paid for the treatment they give patients.

Where do you work as a Medical Biller and Coder?

Medical Billers and Coders work in a variety of settings. The most common settings include hospitals, doctors' offices and insurance agencies. Some medical billing and coding professionals work for companies that develop medical software, and some work for education institutions that work to train other medical billers and coders. Government agencies have also been known to employ medial billers and coders including the National Center for Health Statistics and Medicaid offices. You may also have the ability to work for a reputable company from your own home!

What is a day in the life of a Medical Biller and Coder like?

A day in the life of a Medical Biller and Coder is a rewarding one. You are responsible for ensuring that healthcare providers receive appropriate compensation for the care they provide as well as helping patients get the maximum benefit of their insurance. It is a job that requires a high level of attention to detail at all times because codes must be correct to produce appropriate bills for services. Much of your time will be spent in front of a computer organizing statements, reviewing bills, and performing quality control. You also may be required to negotiate with insurance companies via phone on behalf of providers or patients. It's also important to coordinate with other coders to ensure accuracy and adherence to standards. Finally, you'll want to keep up on the latest developments and regulations in the industry through continuing education.

What is the difference between a Medical Biller and a Medical Coder?

Medical billers are mainly responsible for submitting patient records to government agencies and insurance companies for services that have been provided in the care of the patient. Medical coders gather information on patient records and assign the proper codes for patient diagnosis which are then used by medical billers to submit claim forms.

Is medical billing and coding in high demand?

Yes. There is a high demand for qualified medical billing and coding professionals in the healthcare industry today. Demand will increase as the population in the Unites States ages. Jobs for these professionals are on the rise and expected to grow faster than average through 2026 according to the Bureau of Labor Statistics.

What is the salary for a Medical Biller and Coder?

According to the AAPC 2022 Salary Survey results, non-certified medical records specialists average $46,321 per year, while certified medical records specialists can average $56,290 annually — 17.7% more than their noncertified colleagues.

How long do you have to go to school to become a Medical Coder?

Our medical coding courses are self-paced and completed in 12 months or less. You will then have the option to prepare and sit for one of the following national certifications: 1) NHA's Certified Billing and Coding Specialist (CBCS), 2) AAPC's Certified Professional Coder (CPC), or 3) AHIMA's Certified Coding Associate (CCA). Once you are certified, you'll have the qualifications you need to find an entry-level job.

How do I become a Medical Coder without experience?

The path to a career in medical billing and coding typically starts with certification. There are different medical billing and coding certifications offered through certifying bodies, so it's important to choose which one is right for you. This course allows you to choose one of three national certifications to sit for upon completion.

How do I get a medical coding certification online?

To become a Certified Medical Coder, you need to take an online training course that teaches you the CPT®, ICD-10-CM, and HCPCS Level II code sets. Most employers are looking for applicants to have a medical coding certification. After successfully completing this course, you will have the knowledge and skillset to become a medical coder and can sit for one of three national certification exams included in your tuition: 1) NHA's Certified Billing and Coding Specialist (CBCS), 2) AAPC's Certified Professional Coder (CPC), or 3) AHIMA's Certified Coding Associate (CCA).

Do Medical Billers or Medical Coders make more money?

Due to the more technical nature of the job and increased training requirements, medical coders do tend to make more than medical billers on an annual basis. Both medical billers and medical coders are in high demand. According to the AAPC, Medical Billers (also known as Medical Records Specialists) on average can earn a salary of $46,321. According to the AAPC 2022 Salary Survey results, Certified Medical Coders can earn, an average annual salary of $56,981. Keep in mind, years of experience, specialty, geographic location, and multiple certifications can all play a part in this reporting average.

Can you get a job as both a Medical Biller and a Medical Coder?

Other than a handful of exceptions, medical billing and medical coding are two separate professions. You do not need a degree for either profession, but successful coders usually obtain certification. This course will fully prepare you for a career as either a medical biller or a medical coder, including recommended certification. Once you've completed your training, you will decide which area fits your personality and career goals best and move in that direction.

What is a CPC?

CPC, or Certified Professional Coder, is the primary medical coding credential offered by AAPC. AAPC's CPC certification is the gold standard in medical coding and represents world-class expertise that is highly sought and well-compensated by medical organizations across the country.

What does CPC mean for my career in medical coding?

The CPC certification is the gold standard in medical coding and represents world-class expertise that is highly sought and well-compensated by medical organizations across the country.

How do I get my CPC certification?

After successfully completing this online course, you will receive a prepaid voucher to register for the CPC Exam and schedule your test date. Registration should be done three weeks prior to the exam date. After passing the CPC exam, you will have your CPC-A designation without 2 years of prior experience. Completion of the included CPC Practicode will qualify as 1 year of experience towards the full CPC designation. Completing this program also qualifies for 1 year of experience, thus completing both steps and passing the CPC exam will provide you with the full CPC designation and remove the Apprenticeship status.

What is the CPC exam?

The Certified Professional Coder (CPC) exam is administered by the American Academy of Professional Coders (AAPC). It is a common advanced credential for medical coders in physician office settings.

How long is a CPC certificate valid for?

Once the CPC designation is achieved, your AAPC Membership (included) is required to be renewed annually and 36 Continuing Education Units (CEU's) must be submitted every two years for verification and authentication of expertise.

How to become a Certified Professional Coder?

Medical billing and coding is hardly a career you can jump into and learn on the job. A medical biller and coder must understand the Healthcare Common procedure Coding System (HCPCS), as well as CPT Category II codes and ICD-10 codes. Training courses will teach you what these codes are, how to use them, and how to assign them in common medical billing and coding procedures

How much does a Certified Professional Coder make?

According to the AAPC 2022 Salary Survey results, a Certified Professional Coder can average $56,981 annually. Keep in mind, years of experience, specialty, geographic location, and multiple certifications can all play a part in this reporting average.

What does AAPC stand for?

AAPC, or the American Academy of Professional Coders, is an independent organization founded in 1988 to provide education and professional certification to medical coders. They have over 190,000 members and offers 28 certifications related to medical billing, medical coding, healthcare documentation and more.

What is the CCA exam?

The Certified Coding Associate (CCA) exam is an entry-level certification provided through the American Health Information Management Association (AHIMA). It indicates proficiency in medical coding in hospital and office settings.

What does CBCS stand for?

CBCS stands for Certified Billing and Coding Specialist, and it is a designation earned from the nationally recognized National Healthcareer Association (NHA). With this credential, you'll gain billing and coding skills that are essential to various medical facilities including hospitals, surgery centers, physician offices, nursing homes, mental health facilities, home healthcare agencies, and dental offices. Earning your CBCS credential will prove to prospective employers that you have what it takes to work with patient information, prevent fraud and abuse, support coding and billing practices, submit claims, and help healthcare providers gain maximum reimbursement for services.

Does this course prepare you for a certification?

Yes, this course prepares you for three certifications: 1) Certified Billing and Coding Specialist (CBCS) exam, offered by the National Healthcareer Association (NHA), 2) Certified Professional Coder (CPC) exam, offered by American Academy of Professional Coders (AAPC), and Certified Coding Associate (CCA) exam, offered by AHIMA. You will receive a voucher for the certification exam of your choosing after successfully completing the course. Online certification exams through NHA and AAPC are offered in the US only.

When can I start this course?

This course is open enrollment, so you can register and start the course whenever you are ready. Access to your course can take 24-48 business hours.

How long does it take to complete this course?

After you register, you will receive 12 months to complete the course. The time allotted for completion has been calculated based on the number of course hours.

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