uCertify

Medical Billing and Coding Training

Learn medical coding to succeed in the healthcare industry. Step-by-step claim submission, coding, and reimbursement.

(MED-BILL.AE1) / ISBN : 978-1-64459-474-2
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About This Course

The Medical Billing and Coding training course is designed for those wanting to pursue a rewarding career in the healthcare industry. It equips you with the essential skills to perform critical tasks in healthcare revenue cycle management. The comprehensive course guides you through real world scenarios ensuring you are prepared to accurately code diagnoses and procedures, submit clean claims, and maximize reimbursements. Additionally, this online Medical Coding and Billing course is equipped with many interactive features like ‘Prep Engine’ which provides a different set of questions to prepare for the exam in the test environment.

Skills You’ll Get

  • Expertise in accurately representing medical procedures and diagnosis using CPT, ICD-10, and HCPCS codes
  • Knowledge of the billing process: claim submission, coding, and reimbursement
  • Knowledge of HIPAA, Medicare, and Medicaid regulations and their impact on billing practices
  • Skilled in handling medical billing software and EHR (Electronic Health Records) systems
  • Perform detailed review and analysis of medical records for coding purposes
  • Identifying and resolving billing issues and disputes
  • Communicating precisely with patients, healthcare providers, and insurance companies
  • Dealing with commercial insurance claims
  • Providing Data to the World Health Organization

 

Download Course Outline

1

Introduction

  • About This Course
  • Icons Used in This Course
  • Where to Go from Here
2

Dipping Your Toes into Medical Billing and Coding

  • Coding versus Billing: They Really Are Two Jobs
  • Following a Day in the Life of a Claim
  • Keeping Abreast of What Every Biller/Coder Needs to Know
  • Deciding Which Job Is Right for You
  • Prepping for Your Career: Training Programs and Certifications
  • Planning for the Future
3

Exploring the Billing and Coding Professions

  • Looking at the Medical Coding Job
  • Breaking Down the Medical Biller’s Job
  • In Tandem: Working Together or Doing Both Jobs Yourself?
4

Weighing Your Employment Options

  • Choosing Your Environment: Doctor’s Office, Hospital, and Others
  • Remote Access: Setting up Off-Site
  • Reviewing Other Work Options: Freelancing, Temping, and More
  • Heeding a Word of Advice for New Coders
5

Compliance: Understanding the Rules

  • You Rule! Meeting the Rule Makers
  • Complying with HIPAA
  • Unbundling the Compliance Bundle
  • Getting the Most out of the Dreaded Audit
6

Not-So-Strange Bedfellows: Medical Terminology and Medical Necessity

  • Brushing Up on Basic Anatomy
  • Say What? Deciphering Medical Terminology
  • Understanding Medical Necessity
  • Scrubbing In: Proving Medical Necessity for Surgical Procedures
  • Connecting with the World of Evaluation and Management Codes
7

Getting to Know the Payers

  • Wading through Commercial Insurance Payers
  • Medicare: Meeting the Chief Government Payer
  • Working with Other Government Payers
8

Your Basic Certification Options, Courtesy of the AAPC and AHIMA

  • Introducing the Two Main Credentialing Organizations: AAPC and AHIMA
  • Looking at the Basic Certifications
  • Choosing the Certification That’s Right for You
  • Examining the Exams: A Quick Review of the Main Tests
9

The Path to Certification: Finding a Study Program

  • The Big Picture: Thinking about Your Degree and Career Objectives
  • Considering the Time Commitment
  • First Things First: Squaring Away Your Prerequisites
  • Picking a Program of Study
  • Caveat Emptor: Watching Out for Diploma Mills
10

Signing Up and Preparing for the Certification Exam

  • Establishing a Study Routine and Strategy
  • Focusing on the Right Topics
  • Preparing Yourself for Test Day
  • Signing Up for and Taking the Big Test
11

Adding Street Cred: Specialty Certifications and Continuing Ed

  • Introducing Specialty Certification Options
  • Building on Your Cred with Continuing Education
12

Processing a Run-of-the-Mill Claim: An Overview

  • Dreaming of the Perfect Billing Scenario
  • Delving into the Details: Contract Specifics
  • Covering Your Bases: Referrals and Preauthorization
  • Tracking Your Claim from Submission to Payment
  • Fighting for Proper Payment: Filing an Appeal with the Payer
13

Homing In on How to Prepare an Error-Free Claim

  • Assigning CPT Codes
  • Applying Modifiers Correctly
  • Looking for Money Left on the Table
  • Checking and Double-Checking Your Documentation
14

From Clearinghouse to Accounts Receivable to Money in the Pocket

  • Spending Time in the Clearinghouse
  • Facing Factors Affecting Reimbursement Amounts
  • Payment or Denial: Being in the Hands of the Payer
  • Breaking Down the Remittance Advice
15

Handling Disputes and Appeals

  • Dealing with Disputes Involving Contract and Non-Contracted Payers
  • Knowing When to File an Appeal: General Guidelines
  • The Art of the Appeal: Understanding the Basics before You Begin
  • Going through an Appeal, Step by Step
  • Appealing Medicare Processing
  • Appealing a Workers’ Comp Claim
16

Keeping Up with the Rest of the World

  • WHO’s on First: Providing Data to the World Health Organization
  • Charting Your Course with ICD
  • Moving beyond ICD-10
17

Dealing with Commercial Insurance Claims

  • Meeting Commercial Insurance
  • Cashing In with Commercial Payers
  • Knowing What’s What: Verifying the Patient’s Plan and Coverage
18

Caring about Medicare and Medicaid

  • Brushing Up on Medicare Basics
  • Working with Medicare Claims
  • Deciding What Gets Paid
  • Working with Medicare Contractors
  • Doing Business with Medicare Part C Plans
  • Verifying Coverage and Plan Requirements
19

Coding Ethics: Being an Advocate for Your Employer

  • Playing the Part of the Professional Medical Biller/Coder
  • Protecting Yourself and Your Integrity
  • Getting the Most Bang for Your Client’s Buck — Honestly
20

Ten Common Billing and Coding Mistakes and How to Avoid Them

  • Being Dishonest
  • Shifting the Blame
  • Billing More than Is Documented
  • Unbundling Incorrectly
  • Ignoring an Error
  • Mishandling an Overpayment
  • Failing to Protect Patients from Out-of-Network Penalties
  • Failing to Verify Prior Authorization
  • Breaking Patient Confidentiality
  • Following the Lead of an Unscrupulous Manager
21

Ten Acronyms to Burn into Your Brain

  • ACA: Patient Protection and Affordable Care Act
  • ACO: Accountable Care Organization
  • CDI: Clinical Documentation Improvement
  • CMS: Centers for Medicare & Medicaid Services
  • EHR: Electronic Health Record
  • EOB: Explanation of Benefits
  • HIPAA: Health Insurance Portability and Accountability Act
  • INN: In-Network
  • NCCI: National Correct Coding Initiative
  • OON: Out-of-Network
22

Ten (Plus One) Tips from Billing and Coding Pros

  • Insist on Proper Documentation
  • Verify Patient Benefits
  • Get Vital Patient Info at Check-In
  • Review the Documentation ASAP
  • Set Up a System to Ensure Accuracy
  • Play Nice with Others
  • Follow Up on Accounts Receivable Daily
  • Be a Bulldog on the Phone
  • Know Your Payer Contracts by Heart
  • Create a File System That Lets You Find What You Need
  • Make Payers Show You the Money!

Dipping Your Toes into Medical Billing and Coding

  • Gaining Knowledge about Federal and State Regulations
  • Knowing about Billing and Coding Job

Exploring the Billing and Coding Professions

  • Learning about Super-Bill
  • Looking at the Medical Coding Job
  • Verifying Documetation
  • Choosing Medical Coding as a Profession
  • Understanding the CMS-1500 Form
  • Understanding Payers and Organizations
  • Knowing about the HCFA/CMS-1500 Form

Compliance: Understanding the Rules

  • Understanding HHS agency
  • Working with OIG
  • Understanding HIPAA Titles
  • Working with Key Provisions of HIPAA
  • Understanding Compliance Bundle
  • Learning about Laparoscopic Procedure

Not-So-Strange Bedfellows: Medical Terminology and Medical Necessity

  • Knowing about Medical Terminologies
  • Learning about Arthroscopic Surgery
  • Learning about Hospital Visit Code
  • Examining Patient Status

Getting to Know the Payers

  • Understanding Commercial Plans
  • Learning about TPAs
  • Identifying the Carriers
  • Working with Medicare Type
  • Understanding Payouts
  • Knowing about Tricare Program

Your Basic Certification Options, Courtesy of the AAPC and AHIMA

  • Getting to Know about the AAPC Certifications
  • Understanding AHIMA Certifications

The Path to Certification: Finding a Study Program

  • Learning about Online Programs
  • Learning about Community College

Signing Up and Preparing for the Certification Exam

  • Learning about Respiratory System
  • Learning about Endocrine System
  • Learning about Muscular System
  • Understanding Digestive System

Adding Street Cred: Specialty Certifications and Continuing Ed

  • Understanding AAPC Certifications

Processing a Run-of-the-Mill Claim: An Overview

  • Learning about Contracts
  • Knowing about Carve-Outs
  • Knowing about Prior Authorization

Homing In on How to Prepare an Error-Free Claim

  • Assigning CPT Codes
  • Applying Modifiers Correctly
  • Understanding Tricare

From Clearinghouse to Accounts Receivable to Money in the Pocket

  • Understanding Insurance Claim

Handling Disputes and Appeals

  • Appealing Medicare Processing

Keeping Up with the Rest of the World

  • Working with the 5010 Platform

Dealing with Commercial Insurance Claims

  • Cashing In with Commercial Payers

Caring about Medicare and Medicaid

  • Knowing about Advance Beneficiary Notice

Coding Ethics: Being an Advocate for Your Employer

  • Avoiding Accusations of Fraudulent Billing

Ten Acronyms to Burn into Your Brain

  • Learning about Medical Offices
  • Understanding HIPPA
  • Understanding NCCI

Any questions?
Check out the FAQs

Find out more about this online course for ‘Medical Billing and Coding’ here.

Contact Us Now

Those aspiring to work in the financial operations of the healthcare sector should take up this course. It combines medical knowledge with administrative skills creating high-demand job opportunities.

No, you don’t need any prior experience. This is a beginner-friendly course suitable for both, beginners as well as those with prior experience in healthcare.

In this course, you’ll be exploring a wide range of topics including, Fundamentals of Medical Billing and Coding, Medical Terminology and Anatomy, Coding Systems for Medical Procedure and Diagnosis, Step-By-Step Billing Procedure, Payer Regulations, HIPAA Compliance, Claim Processing, and EHR Systems.

Yes, you’ll be awarded a certificate of completion after completing the course and the final assessment.

Completing this course will provide you with the essential skills and knowledge to apply for various career opportunities including Healthcare Administrator, Medical Biller, Medical Coder, Billing and Coding Specialist, Revenue Cycle Manager, Insurance Claims Examiner, and Fraud Investigator.

The average annual salary of a certified professional lies between USD 43,000 to USD 62,000 annually.

There are the two basic certification options for this course:

  • AAPC (American Academy of Professional Coders) 
  • AHIMA (American Health Information Management Association)

Choosing the right certification for Medical Coding depends on what you want to pursue for specialization, physician office billing or hospital billing. Depending on your interests, you can choose from: 

  • AAPC coding is usually for outpatient settings (doctors' offices and clinics) 
  • AHIMA coding is for inpatient settings (hospitals)

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