• What is Medical Billing?
• Certification
• Training
• Syllabus
• FAQ's

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 Copayments & Deductibles

Day 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 Copayments & Deductibles
100 Copayment & 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