Medical Billing Syllabus
Day 1 and 2
Introduction to Medical Billing
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
Day 3 and 4:
Procedures and Diagnoses
- Insurance Claim Processing
- Claim Payment
- Report Generation
Day 5-7 :
Understanding Office Forms
- 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
Day 8-10 :
The Superbill/Encounter Document
Calculating Co-paymentss & DeductiblesDay 11-13 :
Understanding the CMS 1500 Form
- 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
Day 19-20 :
The Life Cycle of an Insurance Claim
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
Day 20-25 :
Working with Billing/Practice Management Software
Basic Components of Billing Applications Clinic Data
- Billing Identification Numbers
Physician Data
- Tax 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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