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

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

$3,594.00

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.

Overview

Whether you are just starting work or transitioning from a different field, there has never been a better time to enter a career in medical billing and coding. More than one million practicing physicians in the U.S. rely on medical billers and coders to receive payment for their services. Medical billing and coding positions are in-demand within medical facilities, health insurance companies, specialty pharmacies, medical suppliers, consulting firms, and national medical coding and billing companies. With the right medical billing and coding training, the opportunities are nearly endless!

Our Medical Billing and Coding course will prepare you for success as you learn about legal, ethical, and regulatory concepts central to this field, including HIPAA compliance, official coding guidelines, and third-party payer requirements. You will come to understand all phases of the revenue cycle—from patient registration through medical coding, claims submission, reimbursement, and collections.

This comprehensive medical terminology course introduces key concepts of medical language and human anatomy, emphasizing the interconnectedness of body systems in health and disease. The curriculum covers topics such as the musculoskeletal, cardiovascular, respiratory, nervous, and immune systems, along with mental health and special senses, with exams at the midterm and final stages. Students with prior knowledge can optionally test out by achieving a minimum score of 80%, replacing course content if desired. It is important to understand that this course feature only applies to the online Medical Terminology course, the standalone course, or advanced career training course bundles that include Medical Terminology.

After successfully completing the Medical Billing and Coding course requirements, you should be well prepared to find your place in this rewarding healthcare career. According to the AAPC 2023 Salary Survey results, certified medical records specialists earn 15% more than their non-certified colleagues. You will get to choose a voucher for the professional medical billing and coding certification exam that best aligns with your interests and career goals:

  • 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)

Funding Disclaimer: For Workforce Innovation and Opportunity Act (WIOA) funded students, please consult with your funding source representative before taking advantage of this course's test-out feature. Different funding programs may have specific requirements and/or restrictions. If you attempt the test-out feature(s) in the Medical Terminology course without getting approval, your funding benefits may be jeopardized.

Outline

  1. Medical Terminology
    • Getting Started
    • How to Take This Course
    • Test-Out Exam 1: Lessons 1–Midterm Exam
    • Introduction to Medical Terminology and the Human Body in Health and Disease
    • The Musculoskeletal System
    • The Cardiovascular System
    • The Lymphatic and Immune Systems
    • The Respiratory System
    • The Digestive System
    • The Urinary System
    • Midterm
    • Test-Out Exam 2: Lessons 8–Final Exam
    • The Nervous System
    • Special Senses: The Eyes and Ears
    • The Integumentary System
    • The Endocrine System
    • Mental Health
    • Male and Female Reproductive Systems
    • Diagnostic Procedures, Nuclear Medicine, and Complementary Medicine
    • Final Exam
  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
      7. MIDTERM
    11. Clinical Documentation Improvement (CDI)
      1. Deficiencies in Documentation
      2. Medical Necessity
      3. Auditing
      4. Coding From Patient Documentation
    12. Coding with Your Codify Encoder
    13. 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
    14. Commercial Insurance
      1. Individual/Group Health Insurance, Automobile, Disability, Liability, Workers' Compensation
      2. Completing Commercial Health Insurance Claims
    15. Blue Cross Blue Shield
      1. History of BCBS
      2. Types of BCBS Plans
      3. Participating/Nonparticipating Providers
      4. BCBS Billing and Payment Guidelines
    16. 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
    17. Medicaid, CHIP, TRICARE, Workers' Compensation
      1. Medicaid
      2. Children's Health Insurance Program (CHIP)
      3. TRICARE
      4. Workers' Compensation
    18. 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
    19. 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
    20. Land the Job
    21. Mock Exam
    22. Final Exam
    23. ICD-11 Preview

Hardware Requirements

 

 

 

Prerequisites

High school diploma or equivalent required.

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.

Course Objectives

  • What you will learn
    • Get a better understanding of the value this course provides from our medical billing and coding certification video overview
    • 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 and coding and medical terminology
    • Word parts and the structures and functions of the human body
    • Hands on exposure to an encoder application: Codify (AAPC)

    How you will benefit

    • Gain comprehensive training in medical billing and coding through coursework designed to prepare you for the job
    • Receive a Certificate of Completion and an exam voucher for the professional exam of your choice
    • Receive access to study materials and prepare to sit for the medical billing and coding certification exam that best aligns with your interest and career goals:
      • 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)

Medical Billing and Coding FAQs

What is the salary for a Medical Biller and Coder?

According to the AAPC 2023 Salary Survey results, non-certified medical records specialists average $53,749 per year, while certified medical records specialists can average $62,689 annually — 15% more than their non-certified colleagues.

What is medical billing and coding? What does a medical biller and coder do?

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 medical billers and coders including the National Center for Health Statistics and Medicaid offices. You may also work for a reputable company from your own home as the AAPC reports that remote work is currently up to 63%!

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.

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 2023 Salary Survey results, non-certified medical records specialists average $53,749 per year, while certified medical records specialists can average $62,689 annually — 15% more than their noncertified colleagues. 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 medical billing and coding 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.

Does this course prepare you for a certification?

Yes, this course prepares you for three medical billing and coding 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 3) 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.

Can I test-out of medical terminology content if I have previous knowledge of medical terminology?

Yes. This course includes two, optional, Test-Out Exam features that will allow you to test out of content and graded assessments if your score demonstrates the level of mastery required (80%). It does not count toward your overall score in this course if you do not achieve the minimum score required for mastery. Please note: Third party funded students may not be eligible.

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.

What if I don't have enough time to complete the course within the time frame provided?

If you are unable to complete the course, contact your Student Advisor to help you work out a suitable completion date. Please note that an extension fee will be charged. If you are funded through a third-party organization, approval may also be required.

What kind of support will I receive?

Our courses are designed to accommodate various learning preferences. Depending on the course structure, you may get different forms of support. Self-paced courses are designed to be user-friendly and independent, minimizing the need for external support. In courses with instructors, our direct platform support feature includes opportunities for questions, discussions, and remediation, with email and phone support available for select courses. Our student advising team is available to guide you on program requirements and administrative requests, but they do not provide assistance with course content. Our goal is to provide you with the necessary support for success, whether it's through self-paced exploration, direct communication, or guidance from our advising team.

What happens when I complete the course?

Upon successfully passing the final exam, you will be awarded a certificate of completion from the school or organization that you registered through. In addition, you will receive an exam voucher and applicable study materials for your choice of the following national certification exams: 1) NHA's Certified Billing and Coding Specialist (CBCS), 2) AAPC's Certified Professional Coder (CPC), or 3) AHIMA's Certified Coding Associate (CCA).

Am I guaranteed a job?

ed2go courses will help you gain the skills you need to obtain an entry-level position in most cases. However, you should always research the job market in your area before enrolling.

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